A couple of months ago, I started a new job and with a new job came new benefit options. After weighing all of our options, we decided that it would be better financially to move the kids and I to my new employers plan and off of my husbands plan. The monthly cost was about $1 different, but my employers plan had a lower deductible and lower co-insurance percentage – both by half! We knew that our oldest daughter would have some medical testing to do this spring and that it can be quite expensive, so having more coverage seemed like a no brainer.
When the bills for her medical testing came in, I was very pleased to see that they were significantly lower than previous years, as the new insurance was covering more. However, when we needed to have her Adderall refilled, I was very surprised to get hit with a $50 copay, for medication that had previously only had a $10 copay. Further investigation shows me that United Healthcare prefers that we use brand name Adderall ER over the generic Adderall XR. The copay for the generic is $50, meaning, for 30 10mg capsules UHC paid $49.92 of the cost and we paid $50 of the $99.42 the pills cost. If we have her prescription changed to Adderall ER, UHC will pay $226 and our portion will be $10.
To add insult to injury, when I had my first prescription (generic Adderall IR) filled with UHC, I had to go almost 2 weeks without my medication while UHC obtained a prior authorization from my physician. The XR and ER, do not require a PA. However, the IR is the least expensive costing $35.16 for 75 10mg tablets, my cost though was just $10.
My mind is boggled at this absolute atrocity that is Americas healthcare. And to think, this is basic ADHD medication, I can’t even begin to imagine how UHC would screw people over for life saving medications.