A Bittersweet Prescription

A Bittersweet Prescription

OPEN enrollment for Medicare Part D drug plans ended this past Sunday, but my thoughts about them linger. Our website www.MedicareDrugpPlans.com received about 150 ratings of part D plans in 2014 – most of them highly critical, and some of them downright scathing! Whether it’s a plan’s horrible customer service, lack of coverage of many brand name drugs, or dropped coverage, we’re hearing from many irate seniors. At the same time, some studies have shown most seniors are happy with their plans. Why all the contradictions about Part D? To understand, please join me on a trip down Part D memory lane.

When PharmacyChecker.com was founded in 2002, American seniors did not have pharmacy benefit plans through Medicare. While most seniors had some drug coverage through private health insurance or Medicaid, 25% were without any drug coverage and, thus, vulnerable to a pharmacy’s highest retail price. Just eight months after our website launched in April 2003, Congress passed and the president signed the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA), which created a pharmacy benefit opportunity for all Medicare enrollees known as Part D.

It’s amazing and sad to report that, today, the problem of high drug prices for Americans overall is worse than the problems existing before the MMA was born. In 2001, the Commonwealth Fund reported that 28 million Americans did not fill a prescription due to cost. That number shot up to 50 million Americans in 2012!

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PhRMA Criticizes Obama’s New Budget For Requiring More Rebates on Prescription Drugs

“President Obama just released next year’s budget proposal and it has already sparked fierce criticism from the pharmaceutical industry. That’s because the plan would require Big Pharma to give an additional $156 billion in drug rebates over the next decade.” 
 
This news comes from RxRight.org’s latest blog post, entitled Big Pharma balks at President’s proposed budget. Not surprisingly, as articulated by its president, John Castellani, the Pharmaceutical Research and Manufacturers of America is against the rebates and other reforms found in Obama’s budget. One point championed by Mr. Castellani as a reason to criticize President Obama is that the “Medicare Part D is working well for seniors.” While Part D has certainly helped many seniors afford needed medication, the RxRights post, and empirical data, show that millions of seniors still struggle to afford necessary, and sometimes life-saving, prescription drugs because of costs – despite Medicare Part D drugs plans. 
 
In fact, the failure of Medicare Part D is one reason that reputable international online pharmacies remain a lifeline for Medicare enrollees. It appears if Obama’s budget is approved, without changes to his prescription drug rebate requests, then more Americans will forgo the international option in favor of domestic pharmacies. 
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American Medical News reported last week, “Pharmacists have called on the agency overseeing the Medicare program to allow patients to switch their prescription drug plans outside of the normal open enrollment season after beneficiaries say they were misled by insurers.” This would mean a second chance for patients who feel they were not given all the details of the plan they are now stuck with for a year.

A large proportion of ratings and reviews found on our site – MedicareDrugPlans.com – certainly demonstrate the frustration of Medicare enrollees who are not happy with their plans. We would support such a “second chance” to find a better plan. (more…)

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Part D Open Enrollment Ends Today

Today is the last day for the Medicare Part D open enrollment period. For most Medicare enrollees, those who do not have a plan by midnight tonight will face a penalty charge, which will be added to future Part D monthly premium payments.

The Medicare drug plans have certainly frustrated many seniors, who’s experiences can be found in the ratings and reviews on www.MedicareDrugPlans.com. Some of the most frequent problems with plans communicated by seniors are drugs being dropped by plan formularies mid-year; information on drug coverage was not initially made clear; co-pays were higher than expected; and customer service was often inadequate.

On the other hand, some seniors were completely satisfied with their plans. The bottom line is that you need to pick a plan now or you will pay more later.

Sharing her optimism for Medicare Part D benefits, and the discounts provided under the Affordable Healthcare Act, Secretary of Health and Human Services Kathleen Sebelius commented on Medicare.gov’s official blog: “Through the end of October, 2.65 million people with Medicare have received discounts on brand name drugs in the donut hole. These discounts have saved seniors and people with disabilities a total of $1.5 billion on prescriptions – averaging about $569 per person.”

If you’ve yet to choose your plan, you can easily compare reviews on MedicareDrugPlans.com before making the final decision. If you want to share your experiences with others then please rate your plan.

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Medicare Part D Drug Plans – Find the Best Plan For You

If you are eligible for Medicare Part D (Drug Plans), you should be aware that 1) open enrollment starts tomorrow, October 15th and 2) you can now research Medicare Part D plans on our site MedicareDrugPlans.com. On the site you find out which plans are rated best (or worst) by people enrolled in them. You’ll also get the 2011 pricing information for every plan in each U.S. state and territory. The information is completely objective – we are not affiliated with any plan.

If you are already enrolled in a Part D plan, MedicareDrugPlans.com allows you to rate and review your current plan, so others can learn from you.

To actually sign up for a plan, we recommend using the government’s website, Medicare.gov – at which you can best determine which plan covers all the prescription drugs you take. Comparing costs and features can be crucial to your health and your finances. Annual deductible, monthly premium and drug coverage (especially in the “doughnut hole”) are important to consider when choosing or changing your prescription plan.

This year the average premium nationally is $55, actual $1 lower than last year! The standard deductible, on the other hand, increased from $310 to $320. Less than ten plans offer coverage through the doughnut hole. However, under the new health care law, brand name drugs are now 50% off through this coverage gap period.

As open enrollment begins, Medicare enrollees interested in a drug plan are urged to research carefully. Whatever plan you choose will go into effect starting January 1st, 2011 and last for one full year – so get it right! Go to www.MedicareDrugPlans.com now.

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In Medicare “Doughnut Hole” 3.4 Million Stop Taking Their Medication

New research shows that the Medicare drug plan “doughnut hole” seriously endangers not only the pocketbook, but also the health of our nation’s seniors and other Medicare enrollees. Two separate studies released this month show that patients who reach the coverage gap are more likely to stop taking their medication than they are to switch to a cheaper drug: the Public Library of Science published Changes in Drug Utilization During a Gap in Insurance Coverage: An Examination of the Medicare Part D Coverage Gap, and the Kaiser Family Foundation Program on Medicare Policy published Understanding the Effects of the Medicare Part D Coverage Gap in 2008 and 2009.

The putative reason for the coverage gap is that the threshold will teach consumers to be aware of drug costs. Jennifer Polinski, ScD, MPH, the author of PLoS study says, “there is an expectation that people will seek less expensive drug options when they enter the donut hole.” However, these studies reveal that this is clearly not the case. Research from 2006 and 2007 shows that beneficiaries were 40% less likely to switch a drug if they did not receive financial assistance, as opposed to those beneficiaries who did. Likewise, the Kaiser study reveals that about 3.4 million, or 12%, of Part D enrollees who reached the gap in 2008 and 2009 discontinued their medication. (more…)

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Besides the obvious – access to cheap generic alternatives for once exorbitantly priced prescriptions – this year’s patent expirations on blockbuster brand-name drugs means even more good news for American consumers. A U.S. News and World Report article suggests the Patent Cliff as one of the reasons for the forecasted Medicare savings. Access to low-cost generics on popular drugs like Lipitor cuts spending significantly for plan sponsors, and U.S. officials have announced that enrollees paying for prescription drugs through Medicare Part D will not see an increase in premiums, in contrast with prior years. Rather, the yearly fees will decrease slightly – from an average of $30.76 in 2011 to $30.00 in 2012. All current plan premiums can be found on MedicareDrugPlans.com – Compare Costs and Features.

Moreover, plan enrollees are now receiving a 50% discount on brand name drugs purchased through the coverage gap. However, brand name drug prices continue to increase, which means the discount’s importance is less pronounced. (more…)

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More Chain Stores Pick Up $2 Generic Medicare Drug Plan Option

Earlier this month we reported on the UnitedHealthcare Pharmacy Saver plan for Medicare Part D. This plan offers enrollees many of their generic prescriptions for just $2 (some 30- and some 90-day supplies) at Kroger and Safeway chain stores. Our research found that although a few popular generics were not covered by the plan, there was a fairly low co-pay anyway, so cost-wise, UnitedHealthcare has presented a solid Medicare drug plan.

One of our concerns was that those individuals who do not live near a Kroger or Safeway chain will not have easy access to their prescriptions. Well, we have good news to pass on – last week, DrugStoreNews.com announced that Bloom, H-E-B, Hy-Vee, Food Lion, Harveys, Publix Super Markets, Sweetbay Supermarket and Target chains have all joined as participating pharmacies.

This expansion is great, though we still encourage you to compare this plan with others on MedicareDrugPlans.com. It’s important to fit all plan variables to your needs. And remember, just ten more days until open enrollment closes!

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Just in time for the 2011 open enrollment period, UnitedHealth Group Inc. has announced that it will allow its AARP MedicareRx and AARP MedicareComplete Medicare Advantage prescription drug plan participants to purchase 30-day supplies of many generic drugs from Kroger and Safeway chain stores for just $2; 90-day supplies may cost just $4. Between these two pharmacy groups, 397 generic drugs are covered in the program, and both chain stores offer the program via mail-order pharmacy (Prescription Solutions) as well.

Simvastatin, the generic for Zocor – a cholesterol lowering drug, and Metoprolol succinate, the generic of the high blood pressure drug Toprol, are just two of many $2 drugs found on the monthly supply list. You can find a 90-day supply of Ibuprofren 400 – 800mg for just $5. To see which other generics are listed, visit the Pharmacy Saver information and search page. (more…)

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Low Premiums Could Mean Low Value When Choosing a Part D Medicare Drug Plan

Many Medicare enrollees shopping for drug plans this open enrollment season may be lured in by the offers with the lowest premiums, when in fact these plans can make for poor choices. What’s most important when choosing a Part D plan is that the drugs you need are covered; and if the plan doesn’t cover your meds, then plain and simple, it is not a good option for you. To find out which plans include the drugs you take, you can use the government’s website, found here: Medicare Plan Finder.

Blindly choosing the plan with the lowest monthly premium means you’re more likely to neglect researching drug coverage and other crucial factors about your Part D drug plan. For instance, if your plan is linked with a preferred drugstore, location could be a problem. This worry is highlighted in a recent AP article, as the Humana/Wal-Mart plan with the lowest premium on the whole Medicare list is causing trouble for some. While the competitive premium prices from Humana and other Part D providers are drawing attention as factors in picking a plan, accessibility, co-pays, deductible and coverage in the doughnut hole must be considered in addition to the most critical factor – the drugs covered on a plan’s formulary. (more…)

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