In other words, by shopping around, somebody with no health insurance coverage can find a lower price on their meds at retail outlets than a Medicare Part D plan enrollee in certain situations.
We thought wow.
And so did some of the media, which featured our report in stories all over Florida, where we did the study.
The fact that retail can beat Part D in certain situations reinforces one of our legislative goals: getting Congress to lift the prohibition on Medicare negotiating lower prices with the drug companies. Currently Congress allows only private plans to deliver the new benefit. Medicare can't offer its own plan and negotiate lower prices.
If you are in the "donut hole," we don't generally recommend that you run out and pretend you aren't in a plan, because if you shop outside of the plan, you won't get credit for those purchases, and will not emerge at the other end of the "donut hole."
Nevertheless, our report adds another angle to the debate over the program. Congress should let Medicare offer its own Part D plan that could negotiate lower prices.
2 Posted by Dan Liddy at 11/01/06 01:52 PMWhy is it that those that need it the most continue to get taken advantage of when a government plan goes bad?
3 Posted by Earl Egdall at 11/01/06 04:10 PMLast month my Social Security check was precisely $71.00 more than my cost for drugs in the donut hole.
I worked very hard through my working life, made the mistake of putting a little faith in my government, now based upon this, I have three chioces. Bankruptcy, starvation , or DEATH !
I'd be happy to take a proactive part in communications with Congress and the administration.
4 Posted by baileyna at 11/01/06 06:16 PMI used to have insurance through BC/BS on my wife's plan, so I paid copays only for all drugs. I only take four meds, but recently I ordered a refill and found out that I had exceeded the $2250 limit and had to pay $500 for a three month supply through a mail-order firm. I have cut down one med in half in order to make it last until next year, because it will cost me $1K for a 3-month supply. I had absolutely no idea how much the retail cost was until I went on Plan D, because before I was never charged anything but very low copays. Now,we are experiencing severe financial stress, not to mention the emotional stress, trying to figure out how to pay for this. It is just ridiculous! I guess next year, if nothing changes I will get into the catastrophic range. I really don't want to. So now I'm going to do what my brother suggested and begin ordering from Canada or wherever I can get the meds cheaper.
5 Posted by Bob Musselman at 11/02/06 06:22 AMEarl -- Talk to your pharmacist and see if there generic medications that you can take in place of any brand meds. You may not be able to get this advice from the mail order pharmacy. Then talk to your doctor about this problem. If all else fails purchase from Canadian Phamacies. You will not be able to spend your way out of the donut hole.
6 Posted by Liz at 11/02/06 10:27 AMNeither my wife nor myself have a "Donut Hole" problem. I knew that we would both be spending enough for prescriptions in 2006 that we would both be well into the "Donut Hole". Through utilization of the Medicare.gov site I was able to find a plan that provided coverage for drugs prior to entering and on through the donut hole. In 2005 we spent nearly 9,000 on prescriptions! Through the first 10 months of 2006 we have spent 3600, and that includes the Medicare D insurance premiums. I estimate we will be saving at least 4,000 this year. I love the Medicare D drug program!
I think too many people were poorly advised on which drug policy to obtain. The monthly insurance premium and whether or not a deductible is waived are not important. It is your total out of pocket expenses for premiums and drug copays that matter. Nov 15 to Dec 31 is the new sign-up period. If you do not know how to determine which program is best for you, get some help from someone who does. Last year I helped eleven people find the right program for themselves or their parents. I also found a Humana rep at a Sam's Club to be very helpful.
7 Posted by ed at 11/02/06 01:42 PMAlso Earl, make sure you talk to your doctor about your problems paying for your medications. He may be able to help you, by prescribing generic alternatives or by giving you samples of your medications.
Lots of people like yourself would be helped if Medicare was allowed to negotiate with drug companies for lower prices. It's common sense. You should also write to your Representatives about your situation: https://secure.npsite.org/cu/site/Advocacy?cmd=display&page=UserAction&id=1245
8 Posted by Leonard Freedman at 11/02/06 08:36 PMi believe medicare part D should be repealed when the people take back the country. and they need to start over from scratch.
This is for Earl. If a pharmacy has a brand name here, only, you'll find a generic in Canada. Our generics here in the US are about the same price, usually. You can check on line the governing body of that Canadian pharmacy to see if they are ligit. I usually order through a pharmacy that also has a brick and morter place. I usually save my Medicare Part D for medicines I can't get over seas.
