Here's a statement of the obvious: The opinions expressed here are those of the participants, not those of the Mutual Fund Observer. We cannot vouch for the accuracy or appropriateness of any of it, though we do encourage civility and good humor.
It must be a regional thing. Ours seems to be fine here. Occasionally, when we get a sub, he delivers junk mail to the same address number on a parallel block. But, not a big issue.
"Navigating drug coverage demands brain power in our DIY retirement system, and it isn’t getting any easier. For retirees, the stakes are high for one’s health and financial well-being. Seniors can expect to spend about 15% of their overall budget on healthcare costs. For those who take generic drugs for common conditions like high cholesterol, medications represent a small share of spending. For those who mainly take brand-name drugs or medications not covered by insurance, it can be much higher."
WEEKLY BUSINESS DIGEST 2 For those without or poor PRESCRIPTION coverages, there are discounted-prescription programs: GoodRx (a broad coupon-program), TrumpRx (a limited coupon-program for only 44 popular brand-name drugs even if cheaper generics are available), special prescription programs for Amazon/AMZN, Costco/COST, Walmart/WMT members; Mark Cuban’s Cost Plus for generics, special programs by pharma companies for lower-income patients. US government is also working on drug-pricing for Medicare. RETIREES should annually review their drug coverage under Part D or Medicare Advantage (MAPD) & pay attention to the drug formulary list, not just the premiums. #PersonalFinance #Barrons https://ybbpersonalfinance.proboards.com/thread/1027/weekly-business-digest-march-2026
Thanks to the Inflation Protection Act of 2022 the donut hole has been closed and out of pocket drug expenses are capped (at $2100 for 2026).
Because of the cap, for some people it may make more sense to use Part D rather than pay using a discount card, even if the latter costs less. Say you've got four prescriptions that each cost $600/year with a discount card or $1500/year through Part D. You'd be better going through insurance because your OOP cost would be $2100 (the max), vs. $2400 with the discount card.
Is the system corrupt? The participants not benefitting from this cap might say yes. They've being forced to subsidize your high expenses with premiums higher than they might be without that cap in place. Insurance traditionally is designed to spread risks. It's not there to subsidize expected expenses.
But that's the way, to some extent, insurance is being deployed. When health care is viewed as a right, it's a cost that's spread over society. Those that need more health care receive it at less than cost. The rest of us share that cost.
A pure insurance system where people pay more (in copays, coinsurance, premiums, deductibles) if they are higher risk is not corrupt. A pure "healthcare as a right" system where everyone pays into the system and everyone gets the healthcare they need is not corrupt. And a system such as ours that falls between the two extremes is not intrinsically corrupt.
That is a great post @msf very informative and helpful. I also agree with your logic.
I looked up a few details:
So, an individual could theoretically pay the cap of $2100 plus Part D premiums, and any non-covered medications could go through goodRX.
The Part D "base premium" being $38.99 per month. The Part D cap covers "deductibles, copayments, and coinsurance for formulary drugs". The Part D deductible is $615 annually for 2026.
That sounds about right. Also, if a drug isn't covered and there is no reasonable (whatever that means) alternative, I think the insurer is required to cover it. Though I haven't been in that situation so I'd have to check this rule to be sure.
The Part D deductible is no more, than $615. The insurer can set a lower deductible - it depends on the policy. Same as MA OOP maxes being capped, though the more expensive polices typically set a lower max OOP.
I almost forgot about the Medigap discount that someone mentioned. Depending on how the policy is priced, it may not be permitted to adjust premiums for your age. So what it does to get around this is offer an age-based discount that gradually declines as you get older. Similar to gas stations not being allowed to charge a CC surcharge. So instead they post the 'all in" CC price, and then offer a cash discount.
How can I determine whether purchasing Eliquis through this Canadian pharmacy is safe and legitimate? Also, I thought there wasn’t a generic version of Eliquis.
One would think that a generic is exactly the same, but less expensive. In many cases it probably doesn't matter. I do know that some generics cause side effects that the original doesn't. Mainly these things are only discovered when individuals take them and are monitored by a physician. One could certainly Google and see what/if problems are occurring to what sample size, as a starting point.
The wife switched from a name brand blood pressure med to a generic. She developed a cough that went away when she switched back, for example.
"Generic Eliquis (apixaban) is available in Canada, with Health Canada-approved versions from manufacturers like Apotex and Sandoz launched in 2022. These generics are available in 2.5 mg and 5 mg tablets, serving as bioequivalent alternatives to the brand-name medication to treat blood clots and reduce stroke risk." FDA has not approved for U.S.
I'm not sure if you're concerned about the generic drug or the Canadian pharmacy or both. Here is some info regarding Canadian pharmacies excerpted from an article linked above.
"Fake 'Canadian pharmacy' websites abound, and it can be hard to tell what’s legitimate. One red flag is if the site says no prescription is necessary, since a legitimate pharmacy will always require a prescription. A good sign is if it the web address ends with .pharmacy. The National Association of Boards of Pharmacy offers that only to vetted pharmacies, including those in 10 Canadian provinces."
"The Canadian International Pharmacy Association certifies the safety of online pharmacies; its red seal with two maple leafs is often misappropriated by rogue sites, so cross check any pharmacy’s participation directly on the association’s site."
@Observant1, Thank you. If I had comfort with the Canadian pharmacy, I would have comfort with the generic drug. If did not have comfort with the Canadian pharmacy, I would not have comfort with the generic drug or brand name drug.
@Observant1, Thank you. If I had comfort with the Canadian pharmacy, I would have comfort with the generic drug. If did not have comfort with the Canadian pharmacy, I would not have comfort with the generic drug or brand name drug.
I used a Canadian pharmacy which was reliable and trustworthy. They were careful about having a valid 'script from my doctor, and that it was not outdated. The Call Center is in Winnipeg. I stopped using them only because the Orange Idiot decided to tariff EVERY package coming into the USA from outside, even those with de minimus value. So, the pharmacy wanted to charge me for the tariff.
The tariffs are illegal, but the Orange regime invented another pretext, and is delaying acting on the court's order to refund tariff money. Dragging their feet. Sometimes, the call center agents are difficult to understand. I can't guarantee that they work for the Winnipeg office, but actually reside in The Philippines or India or Pakistan.
And I dunno how they make the business model work, but they do: 1) we call from the States. 2) they ask you to get your doctor to fax them a script. OR, you can tell them to do it. 3) with an email address you provide, they send a confirmation re: the Order. 4) when it ships, you get an email about that, separately. 5) they do not take your money until shipping is complete and the item is on its way.
* The lovely and fabulous bean counters throughout Canada have discovered how to make an extra 3% or so from every customer: by not allowing the use of credit cards, which would require them to pay the standard fee to Visa or M/C or Amex. Now, they want to take the cost of your order straight from your bank account. But they don't reduce the cost of your order 3%. ORK!
Mind you, using this service, the cost is a retail purchase which does not count toward your drug plan's deductible. Until the tariffs, it was nevertheless cheaper for me.
It's been many years since I used a Canadian pharmacy, but what I vaguely recall is that I (not my doctor) sent the prescription to the pharmacy. Probably via scan/email but i don't recall.
And at least at the time some did take credit cards, but only Amex(!). The reason was that the US was trying to impede these online purchases and had persuaded Visa and MC to refuse to process these charges. That left Amex. This PharmacyChecker piece from a decade ago goes into details about this policy.
Comments
"When Postmaster General David Steiner began his tenure at the U.S. Postal Service last July..." Anyhow, when it comes to mail delivery, it's not getting any better.
https://thehill.com/opinion/congress-blog/5768230-postal-service-losses-steiner/?__vfz=medium=conversations_top_pages
"Navigating drug coverage demands brain power in our DIY retirement system,
and it isn’t getting any easier. For retirees, the stakes are high for one’s health
and financial well-being. Seniors can expect to spend about 15% of their overall budget
on healthcare costs. For those who take generic drugs for common conditions
like high cholesterol, medications represent a small share of spending.
For those who mainly take brand-name drugs or medications not covered by insurance,
it can be much higher."
https://www.msn.com/en-us/money/insurance/prescription-drug-prices-can-break-the-bank-how-to-get-the-best-deals/ar-AA1XyI5h
For those without or poor PRESCRIPTION coverages, there are discounted-prescription programs: GoodRx (a broad coupon-program), TrumpRx (a limited coupon-program for only 44 popular brand-name drugs even if cheaper generics are available), special prescription programs for Amazon/AMZN, Costco/COST, Walmart/WMT members; Mark Cuban’s Cost Plus for generics, special programs by pharma companies for lower-income patients. US government is also working on drug-pricing for Medicare. RETIREES should annually review their drug coverage under Part D or Medicare Advantage (MAPD) & pay attention to the drug formulary list, not just the premiums.
#PersonalFinance #Barrons
https://ybbpersonalfinance.proboards.com/thread/1027/weekly-business-digest-march-2026
Because of the cap, for some people it may make more sense to use Part D rather than pay using a discount card, even if the latter costs less. Say you've got four prescriptions that each cost $600/year with a discount card or $1500/year through Part D. You'd be better going through insurance because your OOP cost would be $2100 (the max), vs. $2400 with the discount card.
Is the system corrupt? The participants not benefitting from this cap might say yes. They've being forced to subsidize your high expenses with premiums higher than they might be without that cap in place. Insurance traditionally is designed to spread risks. It's not there to subsidize expected expenses.
But that's the way, to some extent, insurance is being deployed. When health care is viewed as a right, it's a cost that's spread over society. Those that need more health care receive it at less than cost. The rest of us share that cost.
A pure insurance system where people pay more (in copays, coinsurance, premiums, deductibles) if they are higher risk is not corrupt. A pure "healthcare as a right" system where everyone pays into the system and everyone gets the healthcare they need is not corrupt. And a system such as ours that falls between the two extremes is not intrinsically corrupt.
Some other discount cards:
https://capitalrxadvantage.com/
https://www.rxsaver.com/
https://www.pharmacychecker.com/
https://www.communitycaresrx.com
https://rx.com/
https://www.webmdrx.com
https://www.buzzrx.com/
https://www.cheaperrx.org/
https://www.wellrx.com/
I've bolded a few that I've found on occasion do better than goodRx. Some others are virtually useless. YMMV
I looked up a few details:
So, an individual could theoretically pay the cap of $2100 plus Part D premiums, and any non-covered medications could go through goodRX.
The Part D "base premium" being $38.99 per month.
The Part D cap covers "deductibles, copayments, and coinsurance for formulary drugs".
The Part D deductible is $615 annually for 2026.
The Part D deductible is no more, than $615. The insurer can set a lower deductible - it depends on the policy. Same as MA OOP maxes being capped, though the more expensive polices typically set a lower max OOP.
I almost forgot about the Medigap discount that someone mentioned. Depending on how the policy is priced, it may not be permitted to adjust premiums for your age. So what it does to get around this is offer an age-based discount that gradually declines as you get older. Similar to gas stations not being allowed to charge a CC surcharge. So instead they post the 'all in" CC price, and then offer a cash discount.
https://www.ncoa.org/article/weighing-the-pros-and-cons-of-medicare-advantage/
https://www.discountcanadadrugs.com/drugs/prescription/blood-thinner/eliquis
The wife switched from a name brand blood pressure med to a generic. She developed a cough that went away when she switched back, for example.
"Generic Eliquis (apixaban) is available in Canada, with Health Canada-approved versions from manufacturers like Apotex and Sandoz launched in 2022. These generics are available in 2.5 mg and 5 mg tablets, serving as bioequivalent alternatives to the brand-name medication to treat blood clots and reduce stroke risk." FDA has not approved for U.S.
I'm not sure if you're concerned about the generic drug or the Canadian pharmacy or both.
Here is some info regarding Canadian pharmacies excerpted from an article linked above.
"Fake 'Canadian pharmacy' websites abound, and it can be hard to tell what’s legitimate.
One red flag is if the site says no prescription is necessary, since a legitimate pharmacy
will always require a prescription. A good sign is if it the web address ends with .pharmacy.
The National Association of Boards of Pharmacy offers that only to vetted pharmacies,
including those in 10 Canadian provinces."
"The Canadian International Pharmacy Association certifies the safety of online pharmacies;
its red seal with two maple leafs is often misappropriated by rogue sites, so cross check
any pharmacy’s participation directly on the association’s site."
The tariffs are illegal, but the Orange regime invented another pretext, and is delaying acting on the court's order to refund tariff money. Dragging their feet. Sometimes, the call center agents are difficult to understand. I can't guarantee that they work for the Winnipeg office, but actually reside in The Philippines or India or Pakistan.
And I dunno how they make the business model work, but they do:
1) we call from the States.
2) they ask you to get your doctor to fax them a script. OR, you can tell them to do it.
3) with an email address you provide, they send a confirmation re: the Order.
4) when it ships, you get an email about that, separately.
5) they do not take your money until shipping is complete and the item is on its way.
* The lovely and fabulous bean counters throughout Canada have discovered how to make an extra 3% or so from every customer: by not allowing the use of credit cards, which would require them to pay the standard fee to Visa or M/C or Amex. Now, they want to take the cost of your order straight from your bank account. But they don't reduce the cost of your order 3%. ORK!
The drugs themselves are filled by pharmacies out of England or India or Mauritius or Timbuktu or the South Pole. Somehow, I would get all the stuff sent to me by Royal Mail or the German or the Belgian Post.
https://www.canadianpharmacystore.com/contact-us
https://www.canadianpharmacystore.com/
Mind you, using this service, the cost is a retail purchase which does not count toward your drug plan's deductible. Until the tariffs, it was nevertheless cheaper for me.
Good luck. Break a leg!
And at least at the time some did take credit cards, but only Amex(!). The reason was that the US was trying to impede these online purchases and had persuaded Visa and MC to refuse to process these charges. That left Amex. This PharmacyChecker piece from a decade ago goes into details about this policy.
https://pharmacycheckerblog.com/visa-policies-curtail-consumer-access-to-safe-medicines-online-reminiscent-of-china-or-north-korea
Here's a page I found showing the tariffs imposed on drugs manufactured in various countries and how they are applied (as of Oct 7, 2025)
https://www.canadaonlinehealth.com/links/keeping-medications-affordable-amid-tariff-changes-our-commitment-and-plan