Beware Of This Perfectly Legal Healthcare Fraud

I had a sticker shock moment recently when I was told my copay for a small tube of a prescribed antibiotic came to $66. So I asked the cashier, "What would it cost me if I just paid for it without using my insurance?" 

The answer I was given, after she had one of the pharmacists check it out, was a mere $30, less than half of what I would have paid had I used my Medicare and supplemental health insurance. 

This seemed unbelievable, as I always assumed my health plans would help me save on my medical expenses, not add to them.

When I asked how much the store would have charged if they billed insurance, I was told they submit the claim to a third party, which in turn bills insurance for payment. "Then there's some kind of algorithm," he explained, "that determines the actual amount."  

I left the pharmacy better off financially by $36, a little wiser, and more than a little miffed. I find it mystifying--and maddening--that we can't we have a healthcare system that is more transparent, and with competitive and fair pricing that keeps costs reasonable for all.