A trillion here, a trillion there

Crash

"...And pretty soon, you're talking about real money." https://www.cnbc.com/2019/08/13/a-1-trillion-us-budget-deficit-could-lead-the-fed-to-cut-rates.html

Numbers without context are just numbers. In the context of a workingman's world, or a typical retiree's world, this is nuts and utterly irresponsible--- especially given the destination for the lion's share of the money: the pockets of CEOs and tax cuts for the already-wealthy, not to mention the monstrously obese Pentagon. Single Payer? Sure, the government will screw it up. But it couldn't be any worse than the non-system we use now. (I'm new on Medicare. My drug costs are INSANE. )

catch22

You may have missed or forgotten this.
The below "GoodRx" really does reduce by a large amount, many Rx prices.
Scroll to the top, as this MFO link didn't save to the top of the thread.

GoodRx

msf

Senior drug coverage unlike the rest of Medicare is provided exclusively by private companies, not by the government. The theory is that they will compete for your business.

However, they rely for the most part on just three PBMs (70%+ of market share): Caremark, ExpressScripts, and Optum. I don't believe that these negotiate for the lowest prices. Does anyone think that Caremark would select Rite-Aid as its preferred pharmacy if it offered lower prices than CVS (which owns Caremark)? Or that UnitedHealthcare would use ExpressScripts if it offered a better deal than Optum (which UNH owns)?

GoodRx is a good start. There are other drug discount cards as well. I find WellRx better on some drugs (and worse on others, of course).

Sometimes one can do even better without coupons. Costco is a particularly good place to check. Their warehouse prices may be significantly lower than their mail order price.

Crash

Ah, but my drug plan (WellCare, Massachusetts) has me going to CVS to allegedly get the best price on prescriptions. I got slammed hard, the first time, because I had to meet their deductible. Anyone know anything about stand-alone drug plans on Oahu? Zip code 96744, Kaneohe. Thanks. All those drug plans are State-specific.

Crash

I've got one! I carry the Good Rx around in my wallet now. Thanks, @Catch22. Just picked it up on what is hopefully my last visit to my local doctor HERE, unless I get sick.

Crash

.....Just checked Good Rx. My ridiculously pricey inhalers are even a bit more costly, with Good Rx. I suppose that I ought to remain aware that I get SOME of my meds with a ZERO co-pay, now, on WellCare Part D/Medicare. In that sense, it doesn't hurt so bad. Still, the prices are what would otherwise be termed "extortion."

Ted

@Crash: Check out Express Scripts.
Regards,
Ted

Crash

Ted said:

@Crash: Check out Express Scripts.
Regards,
Ted

Thanks, @Ted. I'm here for just 2 more months, then I'm moving out-of-State, and the Part D drug plans are all State-specific. I hope to get the same kind of help in my new town as I got from the local Senior Center here, after the move. At least I won't have to worry about WINTER anymore!

msf

You can find Part D standalone plans on Medicare.gov:
https://www.medicare.gov/find-a-plan/questions/home.aspx

There are 24 plans for the zip code you gave, including three Express Scripts plans: Choice ($79/mo premium), Saver ($23.90/mo), and Value ($31.50/mo). Each of course with different copays and deductibles. The cheapest plan with $0 deductible is SilverScript Choice ($24.50/mo), though with higher copays. Obviously you want to pick a plan that reduces your overall cost, whether that means higher premiums and lower copays, or higher deductibles but lower premiums, or whatever works best.

Crash

msf said:

You can find Part D standalone plans on Medicare.gov:
https://www.medicare.gov/find-a-plan/questions/home.aspx

There are 24 plans for the zip code you gave, including three Express Scripts plans: Choice ($79/mo premium), Saver ($23.90/mo), and Value ($31.50/mo). Each of course with different copays and deductibles. The cheapest plan with $0 deductible is SilverScript Choice ($24.50/mo), though with higher copays. Obviously you want to pick a plan that reduces your overall cost, whether that means higher premiums and lower copays, or higher deductibles but lower premiums, or whatever works best.

@msf Much appreciated. I think I've got one picked. Honestly, they ALL suck. Costs are absurd, though the monthly premium on the one I think I'll go with is under $14.00. We can all take comfort together, though, knowing that we are ALL taking it in the shorts, in the good ol' USA--- eh?

davidrmoran

I am (surely incorrectly) inferring that people on Medicare have use these outboard discount plans, but they do not apply at all in that situation, is my understanding and experience? Does anyone here have an MC PDP and uses GoodRx, say?

msf

Not enough time now to find references, so trust me (yeah, sure). Programs like GoodRx, WellRx, etc. can be used by anyone. Of course they don't count toward your deductible or maximum out of pocket payments. But the payments can still be deducted as medical expenses (for people still able to itemize, and who have medical expenses exceeding the current floor - 10%? of AGI).

What I believe you're thinking of are discount programs offered directly by the drug companies, which they coordinate with your insurance. You'll often see something like: pay as little as $X for people with commercial insurance. These are the programs that cannot be used if you have a PDP or MAPD plan. I've got a link somewhere (will post later) explaining why these programs effectively make medical care more expensive for everyone in the aggregate. That's why the government won't participate in them.

davidrmoran

this is what I was trying to grok

https://q1medicare.com/q1group/MedicareAdvantagePartDQA/FAQ.php?faq=Can-I-use-a-Drug-Discount-card-with-my-Medicare-Advantage-plan-or-are-these-programs-excluded-from-people-with-Medicare-&faq_id=659&category_id=157

msf

Here's an example of discount programs offered directly by drug companies, what your article calls a pharmaceutical assistance program: https://www.orthorxaccess.com/

This offer is not valid for any person eligible for reimbursement of prescriptions, in whole or in part, by any federal, state, or other governmental programs, including, but not limited to, Medicare (including Medicare Advantage and Part A, B, and D plans), Medicaid, TRICARE, Veterans Administration or Department of Defense health coverage, CHAMPUS, the Puerto Rico Government Health Insurance Plan, or any other federal or state health care programs.

(Almost forgot to add: these programs are illegal in Mass., period, Medicare or not)
https://www.pcmanet.org/repealing-brand-drug-copay-coupons-ban-increases-costs-by-750-million/

In contrast, GoodRx and the like are not coordinated with insurance. For example, GoodRx states:
https://support.goodrx.com/hc/en-us/articles/115004959366-My-pharmacy-said-I-can-t-use-GoodRx-because-I-have-Medicare

You can use most GoodRx discounts instead of your Medicare Part D or Advantage plan if the GoodRx price is less than your co-pay. ... As long as you are not using your Medicare or an InsideRx Brand Discount, pharmacies are contractually obligated to accept the coupons under most circumstances, so you shouldn't run into any issues.

More on how the drug company copay coupons raise the cost of healthcare for everyone:
https://www.nytimes.com/2017/09/25/upshot/when-a-drug-coupon-helps-you-but-hurts-fellow-citizens.html

Crash

Around and around it goes, eh? All of them playing both ends off the middle. A real Cluster-flop.

Ted

@MFO Members: The late Illinois Sen. Dirksen is noted as saying, "A billion here, a billion there, pretty soon, you're talking real money." Although there is no direct record of the remark, he is believed to have made it during an appearance on The Tonight Show Starring Johnny Carson.
Regards,
Ted