Fun updates: Buying drugs and insurance
You are not alone. Even the smartest experts get socked.
A few experts have weighed in with personal updates on topics we’ve covered here recently: Buying drugs, finding free COVID tests and picking insurance.
And they find all of this just as hard as the rest of us.
This edition of First Aid Kit is all about finding connections with our fellow humans as we slog through the crap. And sharing an occasional dark laugh, and gaining a couple of new insights.
Let’s set the mood by pretending we’re talking about a more-fun, more-affordable version of “buying drugs.” If you’ve got 90 seconds, please enjoy this:
But sadly we’re talking about prescription drugs. Last time I spelled out my best tips, such as they are, for avoiding the worst ripoffs. We dove deep on the games insurance companies and pharma companies play. Bunch of sharks.
And I immediately heard from Lillian Karabaic about how those sharks are taking big bites out of her wallet with the exact crappy tactics we outlined.
Lillian is my favorite personal-finance expert. She’s super-smart, and supremely good-hearted — specializing in advice for folks who, like her, have followed their hearts into careers in the arts or non-profits.
This was her first response to the news that the sharks were coming after her:
If anyone could’ve kept those sharks at bay, it’s Lillian.
And she’s put up a good fight. After nine hours and 32 minutes of phone calls (she tracked it), she’s got her insurance working on a claims audit.
She expects to lose, but she’s gonna make them work for it.
“I'm kind of delaying the inevitable,” she told me. “At least long enough to apply for a credit card that has a decent point sign-up bonus. So I can get something out of this entire situation.”
And she pointed me to a difficulty I hadn’t known about:
It can be hard to even know if your particular insurance uses the pernicious shark strategy that put her in this position, called a copay accumulator. (I described these in our last installment; they’re bad.)
Lillian worked hard to avoid picking an insurance plan that included this policy…but she couldn’t.
And it turns out she’s not alone in that. Lillian pointed me to a report from The AIDS Institute, where researchers looked into hundreds of insurance plans, trying to figure out which ones included “copay accumulator” provisions.
They scoured the internet, then followed up with scores of long phone calls.
“You spend a lot of time trying to ask the right question in the right way so that you get the right person,” said lead researcher Stephanie Hengst. That is, someone who knows what you’re talking about.
Sounds familiar, right? So will their result: Dozens of times, they came up empty.
However, we got something for their trouble: They made themselves a tip sheet for investigating whether your insurance plan has a copay accumulator, and with their OK, I’ve posted it here.
Also, we got a darkly-funny An Arm and a Leg episode out of talking with Lillian and Stephanie.
If you give a listen, let us know what you think. Now, on to other disasters…
Journalist Libby Watson’s Sick Note newsletter is like First Aid Kit’s super-smart, very-impatient older sibling.
Fuck the band-aids, it says. If you focus on that, you’ll let the assholes off the hook, dummy.
Fair enough. We need a less-horrible system, and we should stay pissed-off enough to fight for it.
And it’s worth covering the same ground from both angles.
So: Where we spent three newsletters putting together everything you need to know to have a shot at picking the least-crappy insurance available, Sick Note recently detailed Libby’s savvy, cranky hunt for new insurance of her own.
Her biggest consideration: Migraine treatments. She’s suffered for years, and recently found something that actually works.
Unfortunately, it’s a super-expensive drug called Vyepti, which isn’t covered by any of the plans she can find. (Libby figures she can fight for a “coverage exception.”)
She’ll also need a specialist willing to prescribe it, and most plans have a very limited number of in-network specialists (like, just one or two). If she ends up with an asshole specialist, that’s a problem too.
Her bottom line, after a lot of research:
Whatever choice I make feels scary. I have no real way of making a ‘good’ choice; I have a lot of ways of making a bad choice. Even if I make the best available decision, I could get screwed if the plan rejects my request to cover Vyepti, or if the doctor turns out to be an asshole.
She also writes: In the end, she knows she’ll get what she needs.
She’s got a flexible job — so she can sink time into research and haggling — and a lot of know-how. And she can spend a little more if she needs to.
But it shouldn’t come to this, for me or anyone. Access to doctors and treatments simply should not be determined by how much money you have, or what kind of job you have, or whether you’re good at making decisions about insurance plans.
Hunnert percent agree. A First Aid Kit won’t solve any of those issues. But I hope it can give you the kind of know-how that people like Libby Watson have.
Wanna go back and watch that High Maintenance trailer now? Seriously, we’ve gotta take care of ourselves.
Getting COVID tests
In January, we looked at how to get COVID tests without paying through the nose.
When we published, one fix was on the horizon: If you bought a rapid test, your insurance — assuming you had insurance — was supposed to reimburse you.
Which sounded inconvenient, at best. And as BuzzFeed reporter Stephanie M. Lee quickly found from her own experience, it could get so much worse.
Now, she’s reported out the full story.
The good news: This was a glitch — the kind of thing that happens when a giant new policy gets rolled out really quickly, as was the case here. If you were to try to get reimbursed for tests now, you’d probably have a better experience.
And the broader, better-for-now news is: The omicron peak has passed – though the pandemic isn’t over – and you can order tests for free directly from the feds. In fact, as Stephanie reports, even if you got tests before, you can order a second round of them; the feds have left-overs.
It’s not everything we want, not by a long shot. But it’s nice to see that even one installment of this newsletter has gone out of date.
Keep the faith, find the fun
When you live in hell, you’ve got to find the fun. And the compassion, including for yourself.
My colleague Daisy Rosario introduced me to Jorts the Cat recently. If you haven’t met Jorts, there’s lots more where this tweet came from.
Whenever you’ve got five minutes, please treat yourself to Jorts’s origin story, its sequel and the epilogue.
You are welcome!
Until next time, take care of yourself,
P.S. It was great to hear from Lillian immediately about our last First Aid Kit. And then we made a podcast about it!
We also heard from the folks at GoodRx, who we mentioned last time. Turns out (a) they read First Aid Kit, and (b) they have user-friendly information (which we had missed) about patient-assistance programs (from shark drug companies) that can sometimes make super-pricey drugs more affordable. Good to know, and we’ve added it to the web version of our last issue.
If there’s ever something you want us to know, you want to get in touch to say hi, whatever the case – we’d truly love to hear from you.
I write this newsletter, and Gabrielle Healy edits and helps produce it. Reach out to us any time with your thoughts, feedback and questions.