I went today to get a prescription filled and even though I have insurance I wanted to pay for it myself, off of insurance. The reason for this is somewhat complicated and tricky, so I won’t even bother to explain. When I went back to get the pills, the girl had put it through the insurance but I told her to take it off, that I will pay myself the full price.
My question is: will this transaction show up with the insurance? I was approved to pay the insurance price but I declined. If I accepted the pills at the full price, that shouldn’t show up with the insurance, even though I was initially approved, right? I’m not trying to hide anything from the insurance company, but it make it a lot easier on my situation If they didn’t know I was taking the meds.
Any ideas-I realize this is a fairly obscure technical question.
When I had insurance I would do a similar thing. I never had a problem with it. What I did was tell the pharmacy NOT to ring thru the insurance. Then I would submit the claim myself. Why? Because I get airline miles. So my monthly drugs came to $300.00 for 4 meds. Thus I got 300 points. If I had let the insurance pay right off, it would have cost me $80.00. So this way I would get a check back for the difference.
I did this with Humana, Blue Cross and Unicare. None of them said anything.
Yes, it will show up in your insurance company’s information on you. The company was queried as to your coverage for this drug and your insurance company will maintain that record.
The standard way of keeping the insurers out of the loop is to go to another physician (live or Internet), use an assumed name, and get your prescription filled under that name. AFAIK, this is not illegal, as it does not involve controlled substances or insurance fraud and, frankly, your need of a medication should be justification enough. (An insurance agent once suggested this procedure to our entire class.)
It may not be illegal, but it is dangerous. The more doctors a person has writing prescriptions, the more likely it is that there will be a medication error. Moreover, some prescription medications require periodic labs to ensure that the drugs aren’t causing damage to the liver or kidneys, for example. Furthermore, we don’t know that the OP isn’t talking about a controlled substance, so if that’s what this is about, taking the action that you describe might be construed as “doctor shopping”, which is illegal in some jurisdictions.
Next time you get this script filled, tell the clerk at the beginning of the transaction that you wish to pay full price and not to put the prescription through your insurance at all.