US health insurance doesn’t exactly inspire trust from the general public anymore, and one pharmacy worker from Florida who went viral has added one more reason for the mistrust. The Florida man revealed exactly how health insurance companies are adding some rather egregious markups to otherwise cheap medication, where one drug, which usually only costs $4, became 2400 percent more expensive, going as high as $97.
TikTok account A Dose of Real Life was the whistleblower this time, and it’s run by a couple of parents who also work at a pharmacy in Fort Myers, Florida. In the video, the husband told his wife that an insurance company wants to charge the patient $97 for a medication that costs less than $4 since it’s covered by the insurance program anyway.
“So what are we gonna do?” asked the wife, with the husband replying, “We’re gonna get yelled at by the patient!” and apparently, the patient will also blame the pharmacy for the insurance company’s practice of massively overcharging the patient for medication. The husband ends the conversation with a sarcastic “Love you CVS,” likely referring to CVS Health, which also has a subsidiary called Aetna Health Insurance.
If the patient runs the prescription through their insurance, they could be billed $97, even though the pharmacy’s cost to dispense it is under $4. That charge may count toward their deductible or out-of-pocket limit. The alternative, however, is for the pharmacy to inform the patient that they can opt not to use their insurance and pay the $4 cost out of their pocket instead.
People online are shocked at the legality of this practice
Some viewers pointed out that the patient and the pharmacy could do exactly that, instead of going along with the insurance’s $97 markup. One commenter hoped that, “You need to be a human and write that patient at sticky note and tell them to ask for it to be sold without billing their insurance!” something the pharmacy TikToker replied with, “We always give our patients the option :),” thankfully.
The couple also reiterated that they “Didn’t go along with it. The video was just to show the craziness,” meaning the patient only spent $4 instead of getting bill $97 from their insurance plan. Other commenters were then thankful for the information, as they could now be more clever about purchasing medication supposedly covered by insurance, “That’s why I learned to ask what’s the price without insurance.”
Of course, some people had enough of this practice and started wondering, “How is it legal for the insurance company to price gouge so excessively?!?” An X user also had a more active take on the matter, suggesting “US Health Insurance companies should be prosecuted.”
