Thursday’s column: Lies could help seniors lower drug costs
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Midnight Wednesday was the deadline for Medicare recipients to sign up for their annual Part D insurance plans. That covers prescription drugs.
If you’re a senior or you’re close to one, you’ve heard about the frustrations with Part D. There are 30 different plans sold throughout the valley, and there’s the confounding “doughnut hole” that costs some seniors thousands of dollars every year.
Betty Price’s concern is different. Beginning next year, her medicine will cost more with her insurance than it would without it. It’s a 50-year old medication and her insurance company has jacked her out-of-pocket cost 419 percent.
They also raised the price of her insurance. So in terms of rip-offs you could consider this one a two-fer.
READ THE REST OF THE COLUMN HERE.
December 8, 2011 - 6:00 AM
While we agree that it is crazy that the price for a drug is higher with insurance, I disagree with you saying people have to lie. It is completely honest and 100% ethical to simply say “I am going to pay for this out of pocket.” Having insurance does compel one to use it providing you are willing to pay for service or medicine yourself.
The situation does debunk the myth that the government mandating all citizens have insurance will fix our healthcare problems. Not to mention, it is a testament to how the market, free of government interference, will lead to lower costs. Perhaps we should try applying market forces to a broader section of the healthcare system.
83 bucks a month for synthroid? I’ve been taking this for eight years and even without my insurance co pay it would be only about 15 bucks a month,
and it’s easily one of the most widely prescribed and commonly manufactured pills on the market.
Why lie, Dan? Just say you’re not billing your insurance for a service (works for doctor visits, chiropractic, prescriptions, etc.) It’s a more valid option than lying. The provider still gets the money and the patient doesn’t violate personal ethics.
Come on, Dan, this is obviously completely and entirely the fault of the government. If government would just step aside, insurance companies and manufacturers would voluntarily cut their profits and give everybody an incredible deal. It’s only the involvement of government that makes these private entities want to screw people over.
And BTW, those private manufacturers are probably getting real tired of the feds funding basic research that sometimes leads to big profits for them. That’s also got to stop.
. . .trying to remember who created Part D . . . and who ruled that Medicare couldn’t negotiate with Big Pharma on name brand drugs . . . and who gave birth to the doughnut hole.
Darn it! I just can’t rembember!
The good news is that he doughnut hole will be gone by 2019, for any seniors who live that long. Thanks to the Affordable Care Act.
Dan, as you know, I am employed by one of the evil health insurance Companies. Just for kicks, I checked the price for Synthroid on our Medicare D plans. The copay for 25 mg is $6.12. It pays to shop these plans as they all have different formularies and costs.
I’ll jog your memory on who brought about Medicare D plans – President Bush. Granted, they aren’t perfect but better than the alternatives before Part D.
My wife takes the generic version of Synthroid. It’s on the $4 list at both Kroger and Walmart…her dose is 112mg.
Not sure why someone would actually insist a patient take the name brand version, unless there is a filler in the generic the person has a noted allergy to, or the doctor is getting some sort of incentive to push the name brand version.
But to think that a prescription would cost more with insurance than without, amazing. I wonder how many people don’t realize that and wind up paying way more than they should? Who pockets that?
Ditto on the cost of generic version of Synthroid.
OTOH, my insurance has raised the co-pay on the “class” of some of mine 600% over the last five years.
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No need to lie. Simply tell the pharmacy you do not want to fill the Rx under your drug plan or have the prescription filled at a pharmacy where you do not use your drug plan. Simple.
Is it widely known that you can say, I do not want this on my insurance? I did not even know you had an option. At chains, like CVS, they KNOW if you have insurance from past purchases. Are you sure you can “just say no” to the agreed upon price for your plan? Bill Perdue, do you know if we can?
Sandi, I’ve done that a couple different times when the prescriptions I was getting filled were on the $4 list, but they rang up higher with the insurance. I simply asked ‘Why is it not $4 if it’s on the list?’ and then asked if they could run it without insurance, and they did. Now, it may have been a system glitch at that pharmacy, I’m not sure, because it’s come in at $4 every time since, with insurance.
I also had to run the purchase without insurance on the same Synthroid Rx for my wife, because the refill bottle got misplaced and we needed a replacement. Under the insurance, they wouldn’t cover it or authorize the refill because 25+ days had not passed since the previous refill, so Kroger ran it through without insurance so we could get it…thankfully, it was a $4 Rx either way…and not one of mine which runs $35 with the insurance co-pay, or $390 without insurance.
This article barely says anything