Prescription drugs, pharmacies, and insurance

72 posts in this topic

Posted

My doc has prescribed some pain killers for my back, but I find myself in a rather confusing state. I don't know how much these things will cost me and what do I have to do when I go to the pharmacy.

 

So as far as I see it (I'm a public insurance peon), I have to pay €10 for the doc per quarter and then I have to pay a percentage of the prescription value ? My doc said it would cost about €60 for these pills ? But I am wondering do I pay 50% or what ? Do I have to submit the receipt or do they just take my insurance card when I collect the drugs ?

 

I know I could find this out by going to the pharmacy myself, and then asking, but I want to know how much money I should bring and what should I bring. And then I need to lookup the vocab on LEO to make sure I don't get screwed by these people.

 

Also next week I am in Austria and Italy, would it be cheaper to buy the drugs there?

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Posted

On public health insurance you pay 10% of the cost of the prescription per item.

But there is a minimum of €5 and a maximum of €10.

 

So if the retail price of the tablets is € 60 youwill pay € 6.

 

Note: If you are a regular taker of a certain medicine always ask the doctor for the largest size, called N3.

You can get it significantly cheaper as say the retail price might be 20, 30 or 50 Euros for the three sizes, all carrying for you a € 5 fee.

 

Prescriptions are only redeemable in Germany except the postal pharmacies operating out of Holland.

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Posted

Thanks for the tips. Now to spend the afternoon munching pills !

 

I only have one course of drugs availble on my prescription AFAIK :(

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Posted

 

My doc has prescribed some pain killers for my back (...) it would cost about €60 for these pills (...)

 

Also next week I am in Austria and Italy, would it be cheaper to buy the drugs there ?

 

I only have one course of drugs availble on my prescription AFAIK

That sounds like a lot of money for painkillers - are you sure they're not anti-inflammatories? Either way, if you think you might need more than one course of drugs, after getting the prescription filled you can take the packaging and the info leaflet with you to Austria & Italy, the same pills or their generic equivalent might be available over the counter there, you never know.

 

Good luck, hope you feel better soon! :)

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Posted

If at all possible, German doctors already prescribe generics and/or re-imports to get costs down.

 

A retail price of €60 does seem high, I pay mostly the €5 minimum on prescriptions that have a full retail price of way under € 50

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Posted

Hi, does anyone know how it works with private insurance? I have a private insurance and the prescription for my allergy itself came up to €50, not to mention the €300 charge for the allergy test! As I have the option to claim back half of my paid premium if I make no claims throughout the year, I'm just accumulating the charges but it would be good to know if I can claim back prescription from the insurer.

 

And can I ask my doctor in Germany for a prescription and with the prescription get the drugs elsewhere? Because it costs so much here! (And unfortunately the drug I have to take is prescription only, even in the USA)

 

AND I had a custom-made insole. Can that be claimed too?

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Posted

ZImmer: there is no conrete reply anyone can give you because the coverage of private insurances does so widely differ. With some insurances the cases you mentioned would be covered, with others only partially and others not at all. This will depend on your concrete contract and you will need to show someone the contract who can answer your questions based on the small-print. Good luck!

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Posted

 

And can I ask my doctor in Germany for a prescription and with the prescription get the drugs elsewhere?

Prescription drugs are generally over priced in Germany as there is little incentive or method to get the costs down.

Doctors can and will prescribe generics where available and/or re-imports so you should ask for that.

 

Getting a German issued prescription redeemed by a pharmaicst outside of Germany is probably very difficult though have a look at the online phamracies in Holland. DocMorris ???

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Posted

 

On public health insurance you pay 10% of the cost of the prescription per item.

But there is a minimum of €5 and a maximum of €10.

 

So if the retail price of the tablets is € 60 youwill pay € 6.

I've been paying more than €10 each time! Is something wrong? I am right now looking at the pharmacy receipt from the previous illness, it says €15,40.

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Posted

Then you must be a private kasse patient.

 

I just checked the federal health ministry site for public patient rules and it says:

 

Grundsätzlich wird bei allen Leistungen eine Zuzahlung von 10 Prozent der Kosten erhoben.

Höchstens allerdings 10 Euro, mindestens 5 Euro. Wenn die Kosten unter 5 Euro liegen, wird der tatsächliche Preis gezahlt.

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Posted

No, Techniker Krankenkasse.

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Posted

Right, thought that answer might be coming. :)

 

What I SUSPECT has happened is that your deoctor has prescribed You a medicine that is NOT covered by the public health system.

 

This is generally either "prescribed" on a (blue I think) prescription a medicine that is also available as an OTC.

ie it's more of a reccomendation. Some of these products were previously available as prescriptions but no longer.

Top of my head, anti-histemines, cures for common cold, cough syrus etc.

 

Or it's a medecine for which you legally need a prescription but is NOT covered by the public health system.

these are prescribed on green (I think) slips but I can't think of a type of medicine that falls in this category off hand and I myself have manbe experienced this once.

 

So if you got a prescription charge at the Apotheke for a single item of EUR 15,35 then it must have been in one of those categories.

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Posted

Ah thank you.

 

2 items, on a green slip. For sore throat. So which is the colour that I should not be paying more than 10 euros for? Good to know so I can keep a look out for it. Fact is that I am always ill.

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Posted

Prescriptions for which the "10%, minimum €5, maximum € 10" rule apply are all pink.

ie, they MUST be prescribed by a doctor and they are covered by the public health system.

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Posted

Thanks.

 

The green one came from a doctor too...at least I thought so :o I may be off to see him again today, another sore throat coming.

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Posted

Sing, I'm not having a go at you, I'm a nice guy really. :)

If you are often going to the doctor and getting these prescriptions then something is wrong.

 

Either you are always running to the doctor a bit too often and costing the system money and resources when you could just swing by the pharmacy yourself.

Or you have a deeper in the HNO, sorry ENT area that needs a better look at.

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Posted

:) No offence taken.

 

It's a recurring illness that at one time I even thought it could be cancerous. But ENT / HNO specialists here and at home, tell me it's just due to stress. I see the same doctor, as in I do not jump around, so the doctor should know how often it comes back.

 

But I don't quite understand the part about costing the system money. I think I pay quite a bit of money for the premiums, something close to 300 eur (my share) so I try to see the doctor as often as I can :)

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Posted

alot of cold meds are not covered by Kasse, just as nosedrops or cough syrup. So, you may get a prescription but the Kasse doesn't cover it like MT said.

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Posted

 

But I don't quite understand the part about costing the system money. I think I pay quite a bit of money for the premiums,

something close to 300 eur (my share) so I try to see the doctor as often as I can

For every visit you make to the doctor, the kasse pays the doctor X Euros.

Yes, you are "getting your money's worth", but that visit to the doctor "isn't necessary" and that X Euros x each visit is removed from the system

and worsens the already shaky finances of the public health system.

 

Like I said, not a personal go at you. :)

If it is a previous, serious condition, maybe it makes sense to go to the doctor but the medication is not covered by the public scheme.

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Posted

Ok, thank you :)

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