My health insurance company has info on a prescription I bought, but didn't use insurance to buy

[mrmpa]

There is a pharmacy in my town that offers anti-biotics and 5 different diabetes medications at no charge to the customer. So last week I got 2 scripts from my doctor that cost me nothing at this pharmacy, I also received a 3 month supply. Nice deal.

Today, I log on to my health insurance web site to refill 2 other medications. I have a message indicating that I had purchased a certain medication (free one), and perhaps I might want to have my health insurance fill this prescription, because it might be more economical for me. Well, I figure that $0 cost is much more economical than the $5 it would cost through the insurance company.

Now, I'm pretty pissed that my insurance company has information on my prescriptions that they had no part in paying for. So, I was at the pharmacy today to pick up something for my mom and I asked the pharmacist why my insurance company had received this information. The pharmacist asked if I didn't want my insurance company to know what I had been prescribed. I told her "absolutely, that the insurance company had no right to this information as they had no interest in it either financially or in any other way." Pharmacist said that "they do this routinely as many insurance companies like to know what their insured are taking, and perhaps the insurance company can find a way for the consumer to save money." I said, "you're offering something at no cost, how can the insurance company find a more economical way for me to save me money, and don't you think that this is an invasion of my privacy."

Like I said I'm pissed.

[Ilsa]

1. There was no need for the insurance company to know. Seems like

you should mention HIPAA to them to get them to think more logically about releasing your private information.

[mrmpa]

10. I definitely will

[MedicalAdmin]

19. Hippa doesn't apply. You gave your insurance company access.

When you signed on the dotted line you gave the insurance company access to anything medical they can find. I wish they didn't have this right, but by signing the contract...

At our clinic e have special parts of our charts where info we feel the insurance companies shouldn't get access to gets stored so even if they request everything they only get what we know won't come back and bite our patients in the ass. For example genetic tests. Despite the new shiny HCR law which will eventually get rid of preexisting conditions as a reason to deny treatment or coverage, it can still hugely effect premiums. So genetic tests must be paid for with cash and are never released to anyone except the patient. Ever.

Insurance companies are evil.

[postulater]

2. So who pays for the pharmacy to give you free drugs?

How can they afford to provide them for nothing? Maybe they are just billing your insurance without collecting your copay?

No business can last long that gives stuff away like that with any regularity.

[mrmpa]

6. A couple of articles written about this...

this pharmacy is located in a large chain grocery store, they've stated that the drug cost is minimal and they expect people to grocery shop while the prescription is filled. The drugs that are free are drugs that used to be $4 a month or $10 for a 3 month script.

[postulater]

26. Wow, drugs as a loss-leader. That's business for you.

[ArcticFox]

3. Sounds like a possible lawsuit

As a lawyer, I've seen similar things successfully challenged to change corporate practices.

[mrmpa]

12. I think I'll write a strongly worded letter to the CEO, who is a local

born and raised guy.

[highplainsdem]

4. Just did some googling & found out pharmacies sell that info to databases who sell it to insurance

companies:

http://www.businessweek.com/print/magazine/content/08_31/b4094000643943.htm

http://www.washingtonpost.com/wp-dyn/content/article/2008/08/03/AR2008080302077_pf.html

Those are three-year-old articles, so the situation is probably even worse now.

From the Business Week article:

When applying for insurance, individuals routinely sign paperwork allowing providers to review their medical history. To comply with the privacy provisions of the federal Health Insurance Portability & Accountability Act, most insurers have now added a reference to prescription history in the lengthy fine print consumers are instructed to read.

Although those articles are talking about reports the databases provide when people apply for insurance, I wouldn't be at all surprised if insurance companies can also pay to have that prescription information updated.

[glinda]

7. After I bought my dog prescription eye drops BLue Cross raised my rates. You think they might

have confused my records? I am now starting to wonder.

[highplainsdem]

15. It's possible. Though in my experience with Blue Cross they most often raise rates

when you hit a birthday that moves you into another age bracket.

But if insurance companies ARE getting updates on prescription history, it wouldn't surprise me if the information's used to help them decide whether to raise rates or even to try to find some excuse to drop someone.

And these databases might sometimes mistakenly include a pet's prescription...and if they do, I hate to think how many people might be getting turned down for insurance for that reason.

[TorchTheWitch]

17. the prescription would have been written in your dog's name

with your last name attached. Since that name is not listed as either you or one of your covered dependents on your policy they couldn't raise your rates based on that.

I just had to fill a few scripts for my dog yesterday. First time I had to do that with this dog since the vet almost always has whatever he needs in stock (and they make it cheaper than the pharmacy which is apparently unusual). I really had to chuckle when the clerk called out his name with my last name to say it was ready. Made me think of all the ridiculous sounding names that could be... Fluffy Jones, Stinky Peterson, Bubba Smith, Boo-Boo Carpenter, Spot Fletcher, Schlubby Monroe... I think I laughed the whole way home thinking about the endless absurd possibilities.

Yes, I actually have a neighbor that named their dog Schlubby. Have to admit he looks just like a Schlubby though.

[hootinholler]

25. Bubba Smith played football

And while he was mean as a junkyard dog, he was most definitely not canine.

-Hoot

[Phentex]

23. They raised our rates for nothing at all...

For at least a few years, nobody had seen a doctor for more than a sports physical or regular checkup and the rates went up and up and up. They paid for exactly nothing and still raised the rates? Said goodbye to them last year and shaved off $240 a month.

[mrmpa]

13. Googling is good, thank you.

[highplainsdem]

16. You're welcome!

[Ghost in the Machine]

5. Maybe it has something to do with your doctor?

If they turned in anything to your insurance company for payment, maybe it had what you were prescribed in the information, too? :shrug:

[mrmpa]

9. No, it's not from my doc, information was absolutely given to

insurance company by pharmacy. I see it online when I check my claims status, there's one from the pharmacy, showing nothing owed either by insurance or by me. Doc's claim shows up only as an office visit.

[global1]

8. I Would Venture To Day That The Insurance Company Got The Info From Your Doc .......

and not your pharmacy.

You should watch yourself that you don't get yourself in a situation with your insurance company that makes it look like you are withholding info from them. At a later date they can use that against you not to pay a claim or to cancel your insurance. They are just looking for ways to deny coverage.

[mrmpa]

11. Again, they received the info from the pharmacy, that's shown in

my records of transactions. Insurance company already knows about the diabetes as I purchase 2 medications through their pharmacy program. This is a work policy, so they cannot cancel at this point. I'm pissed that they got this information, because what now, I buy over the counter allergy medicine and the pharmacy I buy it from informs them. I'm also pissed because I've gotten 3 emails telling me I can save money if I purchase the meds via the insurance company's program.

[tblue37]

14. They want that info in order to deny coverage if you ever lose your group

coverage. They will point out that you have a condition that justifies denying coverage.

[Marrah_G]

21. Bingo

[bettyellen]

22. yep, my insurance tried to deny coverage for an asthma attack because I had allerigies years before

and had been prescribed allergy medicine long before. Didn;t matter that I had survived for years healthey with the occasional claritin and no doctor visits at all.
I had to fight it hard for a one off treatment for an attack caused by unsafe work conditions. our air vents were spewing dust and making everyone sick. my comanies CFO was proud the company was watching it's own bottom ine. I pointed out I'd get it from workman's comp then. Then they hred someone to clean the vents, LOL, which were digusting.

[Sherman A1]

18. Were they Free or just free to you after the

insurance paid for them? I would double check before sending any letters.

[mrmpa]

27. No charge to insurance company & free to me-no cost to anyone

[Marrah_G]

20. There is a database for scripts and also one for medical issues

I work for a life insurance brokerage. On every application they do an MIB (http://www.mib.com/) report and an RX check (not sure of company name)that goes back ten years. The MIB report uses codes and not actual medical info. These databases are shared throughout the life and health industry. I'm not a fan. I understand why they do it. But I am not a fan.

Unfortunately, our elected officials are bought and paid for, each and every one of them.

[spinbaby]

24. The drug companies, too

I started on one of those "brand name" drugs a couple of months ago and got a letter from the pharmaceutical company extolling the virtues of the drug and reminding my to refill my prescription.