May, 2019
Archive

By In Around the Web, Prescription Drugs

How PBM’s Work, or, Why Being an Active Health Care Consumer Is Both Hard and Necessary

I was sitting down to write something and then saw this thread on Twitter and decided, to hell with it, this is a brilliant dissection of how pharmacy benefit managers (PBM’s) work and why and how they’re contributing to high prices in health care.

There are several ways to read this thread. Certainly PBM’s are not practicing fairly and with consumers in mind. But their dance partner, insurance companies, are to blame as well for turning the other cheek to the “kickbacks” that the DJ, pharmaceutical companies, are paying the PBMs for promoting certain brand-named drugs over available (and much cheaper) generics.

This scenario is not an uncommon abstraction. In fact, I’m dealing with two similar scenarios right now:

1) a drug I’ve taken for 15 years isn’t covered through my pharmacy of choice, Walgreens, because my PBM is CVS Caremark.

Price to buy through CVS: $12
Price to buy through Walgreens: $421

2) A drug prescribed for my son that is not yet available in generic form costs $309 after the GoodRx discount. I don’t have any option other than to go without or take my chances on a different drug with different/more side effects.

I wrote about a similar type of phenomenon on my LinkedIn profile last week, with a link to the definition of a “Mexican standoff.” For the uninitiated, that’s when two or more people have guns pointed at each other and the only way out is mutually assured destruction…or working together. It’s a favorite movie trope of Quentin Tarantino, and it usually doesn’t end in cooperation.

Until the lords of health care figure out how to work together, it’s on us to look out for our own interests.

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By In Accident & Disability Insurance, Voluntary Benefits

Best Laid Plans Need Best Laid Plans

This stat, from the nonprofit Council for Disability Awareness, is a great reminder that it’s not only a good idea to have an emergency fund but to take a serious look at some kind of disability insurance. Maybe you’ll get your emergency fund to a point where insurance isn’t as critical. Until then, don’t forget to be multi-layered in your hedges against the unexpected.

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By In Financial Independence, General Benefits Knowledge

The Russian Proverb for Employee Benefits: Trust, but Verify

On my personal Twitter profile, I describe myself as a “progressive pragmatist and vice-versa.” What that means is that I tend to look at things optimistically but with a healthy dose of realism. I want things to go well. I want everyone (myself included) to be prosperous and feel important. But I know, from my own upbringing and experiences of family and friends, that positive thinking alone won’t overcome bad odds.

Why am I thinking so philosophically on a Thursday afternoon? Well, I’m sitting in Reagan National Airport — fun fact: “trust, but verify” was a favorite saying of his in relation, ironically, to the Russians, who originated the saying — after attending an event focused on employee benefits. I’ve been to a lot of these types of events and the mood at the more research-focused ones is generally somewhere between unbridled optimism and abject despair.

“The economy is great right now, unemployment is at an all-time low and benefits have never been more important!” 🥳

“Yeah but employees are paying more and have no idea how to use their benefits.” 😩

The thing is, both perspectives are a little bit right. That’s where you come in.

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By In Budgeting, Do the Math, Financial Independence, General Benefits Knowledge, Health Insurance

Congratulations, You’re FIRED! Health (and Health Coverage) Tips for Early Retirees

If you’re in the FIRE vanguard, retiring in your late 20s to mid-30s, you’re (hopefully) living the dream healthy enough to enjoy your retirement to its fullest. If you’ve planned your housing, transportation and other common living expenses well, they will be quite manageable within your budget until it’s time to shuffle off this mortal coil.

But keeping that coil tightly wrapped gets harder with each passing year. Don’t risk your financial health by compromising on your physical health — get insurance. And not just the cheapest insurance. Make sure it’s good enough that it doesn’t leave you with huge bills if something bad happens. Such decisions and expenses should all be part of your FI plan, even if it means a few extra years of saving to be fully prepared for a long, healthy life of early retirement freedom.

Here are some tips for that early retirement health care party…

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