By way of explanation, the $4 prescription is a misnomer. Some are $4. But for the most part, what the pharmacy is doing is simply reducing your co-pay to $4. They still charge your insurance for the part above your co-pay, be it Medicare, Medicaid, or private insurance. You’re still paying for the balance of the prescription, just in the form of premium paid in to your insurance that is used to reimburse the pharmacy.
So kudos to Matt who pointed out the following:
“If your copay for generics is $10…what with all the offers at Wal-Mart, etc. it seems it may almost be smarter to just act like you don’t have insurance when you go to get your generics filled and pay the $4. It saves you a few bucks, and I would imagine reduces your insurance’s view of you as a “high-end” user.”
True. And that might work for a period of time, but eventually you will probably hit a snag. And here’s how.
Whenever you take your prescription in, the pharmacy asks Have you ever filled a prescription here before? That way they don’t have to re-enter the records. So the first time you go, you say, No I have no insurance. So far so good.
The next time, your prescription(s) may not be on the list of $4 drugs. And now it REALLY costs something. Oops, well maybe I do have insurance. Here it is.
Next time you go in, they’ll ask you if you’ve ever filled a prescription there before. Nope, you say. Hmmm. We have that name at this address. Is that you? Oh, yes. Is this still your insurance? Um, no. I mean, well, yes. Um, is that on the $4 generics list?
And even if you tell them that the insurance is no longer valid, there’s a decent chance they won’t even ask and may just run it through on whatever insurance they have on record.
“Oh what a tangled web we weave, when at first we practice to deceive.” – William Shakespeare
