There’s More to the Iceberg Than the Tip

I joined Rx Savings Solutions after a career in marketing and product leadership roles with a Fortune 500 company. It didn’t take long for me to realize that Rx Savings Solutions needed to be in the hands of employees and employers, not only because of the savings opportunities it provides to members but for the transparency it provides to the bigger picture of total healthcare costs.

Prior to joining Rx Savings, I had nagging pain in my hip and lower back as a result of a car crash. My orthopedic doctor suggested a topical medication from a specialty pharmacy. He mentioned it might be expensive and I should make sure my insurance covered it. After he called in the prescription, the pharmacy called me with a price of $20. I thought, “That’s not that expensive.” The gel provided a little relief, and when it was time for a refill, I decided it was worth the $20—to help me on tough days or before a lot of activity.

As it so happened, my now former employer had just rolled out Rx Savings Solutions to its employees at about that time. I registered for our service, went to my “medicine cabinet” on the RX Savings portal and looked through my list of claims. A stunning revelation occurred when I saw what my former employer paid for their portion of the topical gel: $1,500!

My $20 out-of-pocket portion was just the tip of the iceberg.

I doubt my former co-workers had any clue how much the company was on the hook for prescriptions like this. I didn’t know until I used Rx Savings Solutions.

This is real money. Money that employers that are “self-insured” (meaning that they pay for their employees’ medical expenses, not the insurance company) set aside to cover doctor visits, surgeries and, yes, medications. Sure, employees are sharing more of that cost with higher copays and deductibles, but like my $20 copay, there can be a whole lot more money beneath the surface.

As consumers, we think we only deal with the ice above the surface, not the massive chunk below. We should know a little more about what is under the surface. That $3,000 my employer forked over could have been avoided and used toward keeping my premiums flat next year instead of causing them to go higher.

My doctor was prescribing me a medication he thought was in my best interest. I could’ve lived without it, but it would’ve been nice to know all the options I had, and the costs associated with them, before making the decision.

That’s exactly what we do at Rx Savings Solutions. We believe members should see the whole iceberg, not just the tip. That way, we’ll all better understand that we’re in this together—employers, employees and our health plans. When members make the best decisions, it benefits all parties.

If you could use a helpful explainer for your employees, check out this quick video.