In the surreal world of Health Insurance Math

I spent a big chunk of my afternoon yesterday in an alternate universe where all the math rules we learned in elementary school no longer apply, and trust me: you don't want to go there, but someday you probably will. It goes something like this:

Me: I switched all our prescriptions from a 30-day supply at Pharmacy A to a 90-day supply at Pharmacy B, as instructed, but my husband's cholesterol medication went from $16 a month at the old pharmacy to $214 for three months at the new pharmacy. That doesn't add up.

Cheerful Health Insurance Person (hereafter CHIP): Well why would you make the switch if it costs more?

Me: Because I was told we were REQUIRED to switch to a 90-day supply at Pharmacy B.

CHIP: Well, you're not actually REQUIRED to switch. You have to switch only if you want your prescriptions to be covered by your health insurance plan.

Me: And why wouldn't I want our prescriptions covered by our health insurance plan?

CHIP: Because some of them will cost more.

Me: Then what's the point of having health insurance?

CHIP: The deductible! If you pay $214 for a 90-day supply at Pharmacy B, it counts toward your annual deductible, but if you pay $16 each month at Pharmacy A, it doesn't.

Me: Listen, if you add up my husband's medical expenses for his whole entire life, they wouldn't add up to our annual deductible. You want me to pay that much more for a prescription on the off chance that this is the year that he'll get hit by a heart attack or a brain tumor or a crosstown bus?

CHIP: Well, I may be able to get the price lowered with a coupon. I'll call the pharmacy and see what I can do.

[Time passes. I still can't do the math. The phone rings again.]

CHIP: I figured out the problem: you would pay less if your husband took more.

Me: Um, what?

CHIP: I have this coupon that allows Pharmacy B to lower the cost of the 20-milligram tablets to $55 for a 90-day supply. Unfortunately, your husband is taking the 10-milligram dosage, which is still $214 for a 90-day supply.

Me: So a 10-milligram tablet costs four times as much as a 20-milligram tablet?

CHIP: That's correct.

Me: Four times the cost for half the dosage?

CHIP: Right. I asked them whether he could get the 20-milligram tablets and cut them in half, but they said he can't.

Of course he can't. That's the kind of math we teach in elementary school: Cut this large thing in half and you get two things, each half the size of the original thing. We need to start telling kids that each half is worth four times the value of the original or they'll never make it as far as Health Insurance Math, which I'm convinced is designed to deter customers from ever asking questions about anything.

In the end we moved the prescription back to Pharmacy A, where he will continue to pay $16 a month that won't count toward our annual deductible. Then again, out-of-pocket medical expenses can be deducted on our taxes, provided that we itemize...and here we approach the surreal world of Tax Math, and trust me: you don't want to go there.