$4 prescriptions

Nurses General Nursing

Published

Specializes in icu, er, transplant, case management, ps.

I have a question. I have Medicare prescription coverage. Two medications I take are four dollars at WalMart. I get charge four dollars, Part D gets charged $31 pluse. I have talked to several others who also are getting charged. When I finally questioned them, they told me it was because Part D is first provider. I had to tell them I wanted to be listed as a cash payee fore they would stop billing Part D. Also WalMart does not state this anywhere in their stores. Have any of you had relatives or patients with the same complaint?

Woody:banghead:

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I lost you...........the total cost is $4 and they're billing Part D anyway? Isn't that fraud? Or am I totally not understanding what you're asking?

Not trying to horn in on the conversation, but most of my home health clients are seniors and I try to learn as much info as I can to pass on to them.

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Specializes in Emergency Dept.

I am certainly NO expert, but I thought those $4 things were for people without ANY insurance. You have a form of insurance therefor, it is picking up the rest of the tab, while you still only have to pay the affordable $4.

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Specializes in ER.

I have had several $4.00 Rx since wal mart started this service. No one ever asked about insurance and I didn't volunteer the info. It never occured to me that there were "strings attached" to the $4.00 RX. Other stores are doing this also, and there may be fine print, but I never looked for it.

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Specializes in Critical Care, Capacity/Bed Management.

I used to work for a pharmacy and a Pharmacist once told me that what they do is lower the price of popular drugs to four dollars and then jack up the price on not so popular drugs which balances out their lower profit from the cheap drugs.

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They do this to recoup their losses. This is why there is a growing trend for people to use multiple pharmacies. They put in their "insurance" meds at one pharmacy and anything that is on a cheap list at another pharmacy, they get from the other pharmacy and lie when asked about having insurance. Anytime you have given a pharmacy all the insurance info, they will always charge your insurance after that.

This is also why there are more problems with docs and pharmacists not knowing ALL the meds a person is on and thus more room for errors or adverse drug interactions. Too many RX's, docs, and pharmacists in the mix make for dangerous care.

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Specializes in Critical Care,Recovery, ED.

IMO its not fraud. All Wal Mart is doing is reducing what it charges for a co pay for those that are insured. For those that are not insured they are absorbing the loss to keep and attract customers for their other products (not just their pharmacy).

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Specializes in Peds, PICU, Home health, Dialysis.

I am insured and I recently went to get a prescription filled and they only charged me $4.

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Specializes in OB,Med/Surg,LTC.

I have insurance and WalMart charges me $4.00 for one of my prescriptions.

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Don't know about where you live, but here in MN if we give someone the $4 price we cannot charge their insurance.

I don't know a whole lot about it, but my pharmacist said that it has to do with that when we are able to bill any third party, we must first sign a contract with that third party that we WILL collect 100% of co-pay owed. (I think that way it makes it so co-pay will be the same at any pharmacy.)

At our pharmacy, we don't have a $4 list, but we "price-match" so if a customer asks for it, and it's on Walmart's list, we do it for $4 cash. The only bad part is the way our system is set up, customer has to ask for it on every refill, because if there is insurance attached to their profile, the computer will always automatically run the claim through, unless we override it.

I agree with whoever said that it causes problems because people have different meds at different pharmacies. The other problem is when some pharmacies have a "reward" for bringing in a new or transferred rx...like a coupon for some free items, or a gift card to the store...some people actually keep track of which pharmacy is doing what that week and go to whoever gives them the better reward. Highly irritating, because some people get all huffy that WE don't give a reward for coming to our pharmacy, and because these same people have their meds scattered over 6+ pharmacies!

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Specializes in Nephrology, Cardiology, ER, ICU.

I'm an advanced practice nurse and I try to use the $4 cash price for many of my pts including changing meds if I have to. At least where I live, my pts tell me they just pay $4 and since the pharmacy (Walgreens, Walmart or Kroger) don't have the insurance info, there is no Medicare Part D billing.

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Specializes in Pediatric ED.

The way it sounded to me when I talked to them was that the move to $4 scripts was primarily for people with no insurance since most of the big insurance companies only make you pay 5-10 for most scripts anyway.

Therefore, if you go to Walmart and they have your insurance on file then they're going to bill it the way they always have. However, you can opt out of them charging your insurance if you want to foot the bill....which is now cheaper in most cases.

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