CU report: 80% of the time the lowest retail price beats Medicare Part D “donut hole” prices

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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.