Customers sue UnitedHealth over prescription drug co-pay costs
http://www.reuters.com/article/us-unitedhealth-lawsuit-idUSKCN1252MI
UnitedHealth Group Inc (UNH.N) has been sued by three customers who accused the largest U.S. health insurer of charging co-payments for prescription drugs that were higher than their actual cost and pocketing the difference.
The lawsuit, filed Tuesday in federal court in Minnesota by three UnitedHealth customers, seeks to represent a nationwide class that it says could include “tens of thousands” of people insured by UnitedHealth.
The lawsuit said Minnesota-based UnitedHealth and affiliated companies charged customers co-payments for drugs that were significantly higher than prices it negotiated with pharmacies for those drugs.
For example, the lawsuit claims, one class member paid a $50 co-payment for Sprintec, a contraceptive, while UnitedHealth paid the pharmacy only $11.65. The pharmacy was then required to hand the extra $38.85 over to UnitedHealth under its agreement with the insurer, the lawsuit said.
The lawsuit claims that such a co-payment “is not a ‘co-‘ payment for a prescription drug because the insurer is paying nothing,” but is instead “a hidden additional premium.”
The lawsuit says UnitedHealth has hidden this practice from its customers, forcing them to overpay for a wide variety of common, low-cost drugs.
The lawsuit claims UnitedHealth’s co-payments violate the Racketeer Influenced and Corrupt Organizations Act (RICO), a federal law used to target illegal conspiracies, and in some cases also violate a federal law governing employee benefit plans.
UnitedHealth spokesman Matt Wiggin said in an email that the company had not yet been served with the complaint, and that “pharmacy benefits are administered in line with the coverage described in the plan documents.”
Filed under: General Problems
This has obviously been going on for some time. A couple years ago I was insured with United Health Care and when I went to fill my rx for hormones I was shocked when pharmacy informed me that my co-pay was going to increase from $5.00 to $45.00!!! I asked. What my price would be if I didn’t have insurance and I was told $7.50. I was angry and confused and decided to switch insurance company’s. I have often wondered why the co-pay was higher than cost of the medication. Now I get it. It is fraud in its truest form and I hope UHC is held accountable and fined accordingly. I can only imagine how many unsuspecting customers were taken advantage of. UHC should be shut down completely.
This is the reason I switched to another insurance company a couple years ago. I take estrogen and UHC raised the copay from $5 to $40! When I asked pharmacist how much it would cost without insurance I was told $8.00. I found that unacceptable and changed ins company’s.
Actually, most insurance companies PROHIBIT a Pharmacist – by contract – from telling a pt that the cash price of their Rx is less than their copay… anyone can check the cash price of their Rx on http://www.goodrx.com and it is smart before you get your new Rx filled… if less than your copay.. tell the Pharmacist to fill your Rx for CASH and don’t deal with the insurance company… A pt is not REQUIRED to fill all Rxs and bill the insurance company.. if the pt chooses not to. They are your insurance company… you are not owned by them !
They have did this for a long time. Everyone needs to be contacted. What a mess.
What’s the outcome as I am in the process of moving to UHC under AARP.