Charging more for prescription drug service than the meds cost
Your doc hands you a prescription, you go to the pharmacy to fill it, hand over your insurance card, and slide the credit card for the coinsurance (percentage of the cost) and/or copay (set per-prescription amount). Did you ever ask how much the meds cost in the first place, though?
Obviously it depends on what it is, but you might be paying more than if you'd just kept the insurance card to yourself and gone with the ticket price. And that's on top of the premium you're already forking over every month, for either a separate prescription coverage plan or a general one that has good coverage built in. Unfortunately, your prescription drugs don't have price tags on them, so you have to, you know, actually ask someone. But you should really ask at a few different pharmacies, because you may find that literally the exact same medication costs $43 in one place and $249 in another, which sounds just about as sketchy as buying drugs on the street, but it's what it is!
If you have regular prescriptions, or if you’re planning some travel where you're going to need antimalarials -- something that can get pricey -- you may want to check out the prices before you sign up to pay five times as much in premiums and copays.
Excluding certain conditions or circumstances from coverage
Health insurance companies are kind of infamous for exclusions, which are conditions and treatments that they just won't pay for. Things used to be pretty bad before the Affordable Care Act, where they could say they wouldn't pay for illnesses you had before you bought the plan, otherwise known as pre-existing conditions. Say you're seeing a neurologist and taking prescription meds for migraines, then you get a new job and have to switch insurance plans. The new plan used to have a right to say they straight-up wouldn’t cover that treatment anymore.
Really... ? Because last time I checked, people’s bodies don’t exactly sync up with when they change their insurance coverage.
Now, thankfully, the worst your insurance can do is have a waiting period of some months before they'll help you out with your migraines -- that still sucks, but in the long term, they’re paying. However, they can (and usually will) entirely exclude some treatments from coverage, alternative medicine in particular -- like if you’re getting the migraines treated with acupuncture. Exclusions are spelled out in your policy (in fine print, naturally). Zooming in is worth it.
Denying claims for services
While it's not your insurance company’s fault per se, they’re not going to be investigating things that look weird on the bill your healthcare provider sends them. Did you really get tested for chlamydia twice in one day? Doesn't matter! They'll pay for one test and ignore the other one, which you're going to be getting a bill for if you don't recognize the screw-up and dispute it with your doc's billing department.
Medical billing errors, like duplicates, incorrect codes, and asking you to pay for services you straight-up didn’t receive aren’t uncommon. You need to be checking your doc's bill against your insurance company's explanation of benefits -- two envelopes you'll receive, conveniently, at totally separate times in the mail. When something looks strange, it’s on you to either pay a bunch of extra money or call your doctor's office to (politely) say, "What the fuck?!"
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Marina Komarovsky is a writer who will just have to make millions of dollars and never worry about healthcare again! Follow her: @MariKomarovsky.