Health Care Hell in America

Maxed out drug benefit explained

The reason insurance companies will never up your pharmaceutical benefit is that they would like anyone who reaches your $1500 a year prescription benefit level to switch to another insurance carrier. They are hoping to antagonize you into leaving them. Reaching the pharma cap is a good indicator of a person on whom they are less likely to profit. Their ideal customer does not use this benefit (or any benefit, for that matter) at all. Unlike someone who breaks a leg and has big one-year costs, but probably nothing the next year, those with chronic health conditions take meds regularly, and scare the bejesus out of the profiteers.