How often do health insurers say no to patients? (2023)

Post by Guvante » Tue, Sep 09, 2025, 9:59 PM UTC

ceejayoz wrote: post #93

Guvante wrote: post #83

Earlier quoted context omitted.

Unless you are comparing a generic to a name brand in a situation where the insurance company forces the name brand that shouldn't be the case. For better or worse in your hypothetical the uninsured price legally has to be $1,000 for medicine. They can write off part of that but no one would write off 99.8% as the insurance company would sue their pants off.

> that shouldn't be the case Oh, I agree. But it is. > For better or worse in your hypothetical the uninsured price legally has to be $1,000 for medicine. No, it doesn't. https://www.nbcnews.com/health/health-news/cost-weight-loss-... "In March, Novo Nordisk cut the price of all doses of Wegovy by 23% for people paying in cash, dropping it from $650 to $499 per month for uninsured patients or those without coverage.…

Post by downrightmike » Sat, Sep 13, 2025, 2:07 AM UTC

mustyoshi wrote: post #18

ceejayoz wrote: post #12

Earlier quoted context omitted.

Yes, but you'll often find that in a high-deductible plan the insurance company gets a "discount" of your $1k med down to $200, which they brag about in your EOB… but the medication's cash price for uninsured people would be $20. You're out of pocket $180 more than you should be, and paying the $20 cash price out of pocket means your deductible doesn't budge.

What if the medicine costs 100$ to produce, should uninsured have to pay that rather than a subsidized 20$?