Hey Feds! Price Shopping for Rx Meds? Don’t ask Aetna!

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Let’s say you are shopping for Health Care Plans during FEHB Open Season, and are considering switching to a High-Deductible Health Plan/Health Savings Account.   You’re curious about the ‘real’ cost of your prescription Meds under a High Deductible Plan and want to find out more.

Aetna has a tool for this, a website advertised for Federal  Employees at Aetnafeds.com.  There is even a ‘test drive’ password, ‘federal3’ that you can use to check the list of doctors and estimate the costs of prescription drugs under their plan.  Performing your due diligence, you login with username and password  ‘federal3’ and take it for a spin:

You Click on “Estimate Drug Costs” and continue with pricing your drug.

Let’s say you are taking Avodart, which is a decent choice for a price comparison, as there is not yet a generic equivalent.  You type in the most common dosage and term, which is 0.5mg and a 90-day supply.  You choose your local Walgreens or CVS pharmacy and click ‘compute’.  Here’s what it shows as “Your Cost’ for a 90-day supply of Avodart:

$85 for a 90-day supply?  Hey, that’s not that bad– I guess my fear of prescription drug costs under a High Deductible/Health Savings Account health plan is unfounded.
NOT SO FAST, SUCKA.  Look in the upper right of the printout (red dashed circle).  What you’re looking at right now is what you will pay AFTER YOU HAVE REACHED THE PLAN DEDUCTIBLE, NOT WHAT YOU WILL PAY WHEN YOU SWITCH TO AETNA HDHP/HSA ON JANUARY 1st.  Now click where it says ‘View Overall Cost’:

$339.77 is what you will really pay for Avodart during the first few months of your Aetna High Deductible Plan.  You pay the retail price for Avodart until you hit your plan’s deductible (which is $3,000 for a Family plan).
So in my judgment, the ‘test drive’ of Aetna High Deductible Health Plan using their provided login ‘federal3’ is misleading.  When you query a drug price, the first page it shows you for ‘Your Cost’ indicates a much lower price ($85 vs $340) for a brand-name drug like Avodart.  You can plug in any brand-name drug name and get the same result.

(On a personal note, when I made the decision to switch my family to a High-Deductible Health Plan, the major factors were

• Continuity of doctors/facilities,
• Covered dental, and
• Cost of prescription meds. 

Based on what I know now, my estimated calculations on prescription meds for my family were WAY OFF.  Whether I was naïve, foolish, or deceived is irrelevant- I’m committed to Aetna’s HDHP/HSA through the calendar year. )

Logging in to Aetna Navigator as myself (a current plan member, having not yet reached my family’s plan deductible), the Prescription Drug Cost tool yields the Retail Price of $367 as “Your Cost” .  This is the price I would pay tomorrow if I had to fill an Avodart prescription:

If you toggle the view to “View Overall Cost”, the pricing does not change in this case- the retail price of Avodart is still shown as $367 either way.   Funny how Aetna no longer equivocates about showing you the price of drugs once you are a captive member of their High Deductible Health Plan:

So, what to conclude? 

At the very least, the “Estimate Drug Costs” tool on the AetnaFeds website is confusing and misleading.  I will leave it up to the reader to make his/her own conclusion if this is a glitch, omission, or deliberate deception by Aetna.

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