You're out of pocket $180 more than you should be, and paying the $20 cash price out of pocket means your deductible doesn't budge.
The pattern is even more flagrant when done with post-facto billed services, since the price hasn't even been assented to. The whole medical industry has essentially normalized many different types of fraud against patients, and yet the industry is so entrenched that state/county AGs don't bother going after them.
After all the discount getting inflated by charging non-insured people ludicrous prices is the real issue but not one you can meaningfully complain about as an insured.
And unfortunately if you ask for pricing they will give you the inflated pricing meaning it isn't necessarily deceptive there.
It's even more glaring for post-facto bills from providers, because those prices are being presented on a cost-reimbursement basis (not contractual). The provider is essentially saying "You owe us $500 because that is what it cost to provide your care". But it obviously could not have cost $500 to provide the service, because they're happy to accept $150 in total.
For better or worse in your hypothetical the uninsured price legally has to be $1,000 for medicine. They can write off part of that but no one would write off 99.8% as the insurance company would sue their pants off.
Oh, I agree. But it is.
> For better or worse in your hypothetical the uninsured price legally has to be $1,000 for medicine.
No, it doesn't.
https://www.nbcnews.com/health/health-news/cost-weight-loss-...
"In March, Novo Nordisk cut the price of all doses of Wegovy by 23% for people paying in cash, dropping it from $650 to $499 per month for uninsured patients or those without coverage. (The list price of $1,349 stayed the same.)"
"It follows a similar move from Eli Lilly, which reduced Zepbound’s starter dose to $349 and higher doses to $499 through its self-pay program, Lilly Direct. The discounted doses require patients to manually draw the medication from a vial with a syringe, adding an extra step compared to the prefilled injector pens."
There are entire businesses and apps built around figuring out which is cheaper, paying out of pocket or going through insurance. https://www.healthcaredive.com/news/goodrx-benefits-check-pr...
Universities need to get into the drug production business
