Meet Katie*
Katie is a 31 year old single woman with a graduate degree. She works at a private school in Texas teaching children with profound special needs. Like many employees of small private schools, she doesn’t get health insurance through her employer. Katie is one of the millions of Americans who is underinsured even though she works full-time.
Katie’s Health History
Katie is a healthy adult who rarely gets sick. But she has anxiety, depression and obsessive compulsive disorder and has been on medications controlling her symptoms for years. She took a daily antidepressant and had Klonopin available for emergencies.
Katie’s Health Insurance Story
Until taking her current job, Katie had health insurance through her previous employer. Their plan was excellent and she only paid about $10 a month for her main prescription. But while the health insurance was great, the salary was low and the work environment was not good.
Katie found a much better position at a new school. The salary was higher, but the new school opted to not cover employees, instead sending them to the individual state health insurance exchanges. They assumed their employees should be able to get a better deal on the exchange. But when Katie applied to the exchange, she was told that she was not eligible for any discounts. Instead, she decided to go through an insurance broker who was able to get her the same plan she’d been on at her previous job at the same price as the plans she could get on the exchange, $260 a month. But after a year the plan was discontinued and she had to start again.
Meanwhile, the prescription she took was moving to generic. What had been a $10 prescription with rebates became a $50-60 medication as the manufacturer stopped honoring rebates. She switched to the generic when it came out and it went back down to $10 a month.
After her plan was discontinued, the insurance broker found her a plan that was the same price per month, but it was a High Deductible Plan. With this plan she had to pay out of pocket for everything up to $6000. High deductible plans can be a good option for people like Katie who are young and healthy, but they don’t cover prescriptions so she would have to pay out of pocket for those as well.
The total for her regular prescription without insurance was now over $370 a month. She couldn’t afford this so she made the difficult decision to go off the medication. Right before switching plans her doctor wrote her a 90 day prescription for weaning off the medication and she filled it. As she came off the medication her anxiety and depression worsened significantly. Because she had to go off her medication anyways, she recently switched plans again to a faith-based insurance that is less expensive and has a lower deductible, but doesn’t cover any mental health.
Life without these necessary medications is difficult and Katie doesn’t think going without her medications will work long-term. She is looking at her budget trying to find ways to cut expenses so she can afford to pay for what she needs, but as a private school teacher, her salary is limited and her budget is tight.
What can Katie do?
RefillWise can help Katie afford the prescriptions she needs. Since she can’t use her prescription insurance to cover the meds that keep her healthy, she can take RefillWise to the pharmacist and use it to receive a discount on her prescriptions.
Katie’s story may sound familiar. Many well-educated, Americans who work full-time are underinsured and unable to afford their monthly prescriptions. RefillWise fills in the gap between what your insurance covers and what your budget can afford.
*Her name has been changed to protect her privacy.
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