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DRAFT TODAY, POST TOMORROW: Some posts may be in draft status until I (aka procrastinator extraordinaire) get around to posting them.



Friday, June 17, 2011

Level 3 madness

After talking to my neurologist about the Provigil prescription costing a lot under my high-deductible plan, I did as he suggested and called my insurance company to find out if they cover Nuvigil.  I found out that both are considered Level 3 medications, so they cost the same, even with mail order.  In addition, Nuvigil requires a pre-certification.  (I think the samples I have taken are keeping me awake at night, too.)  So I am stuck paying a lot for my prescription and there isn't anything I can do about it.  However, once I spend $3,000 out of pocket, I get refunded $1,000 and don't pay anything else for the rest of the year.
Good news, bad news.  Good-ish news first:
  • Paying $284 for a monthly-ish supply of pills will get me to my deductible limit more quickly, so I am extremely likely to get the $1,000 back.
  • Other out-of-pocket expenses will also count, such as my Synthroid prescription, at just over $18 a month.
Bad news:
  • My Provigil went up by about $50!  Yikes!  The insurer is covering about $75, less than a quarter of the cost.
  • My dental and vision are on a separate policy, different provider, so none of those costs count towards my deductible.
Rebuttal good-ish news:
  • I can use my flex plan (I only allocated $960 from my paycheck for the year, thinking my costs weren't so high) to get reimbursed in pre-tax dollars--this can include the vision and dental expenses.
  • The higher cost of my Provigil will get me to my deductible limit even sooner.
So the bottom line bad news is that my prescription deductible increased more than 17%.  I'm all for paying my share, but I'm pretty sure that I'm paying more than my share.  Without insurance, I would "only" pay $75 more, or 22% more than I pay now.  It makes me wonder if the cost of my insurance is even worth it?  I will continue my analysis throughout the year and report my conclusions as I jump to them.

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