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Health Insurance Scams

In Ontario our doctors are paid through our taxes, but not our drugs, dentists, eyeglasses, hearing aids, etc. I don’t have to pay directly to see my psychiatrist, or for my lithium level blood tests, but I do have to pay directly for the lithium itself. I don’t know how drugs work in the rest of the world, but in Canada when a drug has lost its patent we get access to much cheaper generic versions of it.

Before I got back on a health plan I paid $19.31 for 150 capsules of lithium carbonate; I paid $81.80 for 120 tablets of generic Divalproex; and I paid $45.94 for 1mL of generic Modecate. This is basically a month’s supply of meds (3 weeks for the Modecate). That’s $147.05, which is half of what my husband and I spend on food, but I think the cost is affordable for something so important.

My pharmacist does a lot to make me feel welcome. Everyone there calls me by my first name, and many of the staff know what I need before I even ask, without even looking in the computer. The pharmacist even signed my passport application back when there was a requirement to get someone in a position of trust to do that.

I was very disappointed recently when I got my first big prescription filled with my new health insurance. The pharmacist told me there was no generic Divalproex to be had anywhere in the city, so he had to give me the name brand version Depakote/Epival for $165.41. Most of that was covered by my insurance, thankfully. I don’t buy his story of the generic suddenly being out of stock everywhere in the city, however. That was just insulting. Of course the pharmacist is gouging my insurance plan. Thankfully he never gouged me when I had no insurance, but the incident has changed my perception of how much I can trust him. Our relationship is more profit motivated than I thought, I guess. Live and learn.

Here’s a related story. My cousin used to work for a dentist who wasn’t a very nice man. For those patients with health insurance, he would charge less, because the insurance companies knew how much was reasonable to charge for which service. For people without insurance, he would charge substantially more, because the patients would have no idea on their own what was reasonable to pay. His patients, I might add, were not rich by any stretch of the imagination.

I am very thankful my pharmacist is the opposite of that dentist.

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  1. March 26, 2012 at 2:17 am

    It would have been naiive of you to think that this was a friendship unless your pharmacist is a saint. However, it is very possible that he’s telling the truth because he values your trust. Next time you need Valproic acid, go to another pharmacy and ask them if the other brand really did go out of stock recently. Might tell you a lot about that colleague of mine.

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