Prescription drug costs are way up

For whatever reason (and I have a few opinions on this), drugs cost are up if you have a Medicare plan. I remember only about 8 years ago, premiums for stand alone drug plans were only $7 a month. Now the cheapest is $15 and it may not give you the coverage you want.

If one has a Med Advantage plan then most likely the drug component is baked into the policy – so there is no further monthly premium. Sometimes the premium is zero for both the health and drug plan. That can be good.

But beware – what insurance companies give with one hand they usually take with another. So watch your co-pays and maximum out of pocket costs. Not all Advantage plans are the same.

But back to the prescription plans. This year, a brand name generic can carry a hefty co-pay every month where it did not before. And sometimes very inexpensive maintenance drugs can cost zero. Meanwhile, in the background, Brand name drugs (the expensive ones advertised on TV) costs vary from MONTH TO MONTH. Lantus, a diabetic insulin, for instance, can cost $350 one month and $450 the next (this is the total cost, not your co pay), making it impossible to calculate when someone will hit the Coverage Gap (another topic.) Because your co pay remains stable through the year at say, $35 or $45 a month for this one drug, you don’t think about it much until the cost almost doubles when you land in the Coverage Gap. So, the pharmaceuticals can CHARGE WHAT THE MARKET WILL BEAR every month. And they do. The more of a certain drug is needed through the year, the scarcer it gets and the cost goes up. This is criminal and punishes older people on a fixed income.

Here are some ways to lower your cost:
1. Look at sites like to find the best cash price on your generics and only use your plan for the expensive ones.
1a. Then have your doc write a prescription for double the dosage and cut the pills in half.
2. Are you a Veteran? If so, see if you qualify for VA drug benefits. That will keep you out of the Coverage Gap if you purchase through the VA.
3. If you earn below a certain amount (Medicare calls this “LIS”) and you have limited savings then you may pay a minimal amount for your drugs. You can call 1-800-Medicar to check on this.
4. Check with sites like to see if you qualify for low payments on high cost drugs like Lantus.
5. Check with the manufacturer of the drug to see if they can give you the drug for free.

Hope this helps –


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