There's a big drug problem in this country
@1creekgirl (40529)
United States
July 5, 2022 6:54pm CST
I know drugs are a huge problem that results in lives lost and families destroyed.
But I'm talking about legal prescriptions and insurance.
We pay a premium every month for Part D (drug) Medicare coverage.
Each fall we learn which plan and company meet our needs according to the medicines we take. Thankfully neither of us needs a lot of meds.
But lately it's become cheaper to pay out of pocket for drugs than to use our insurance.
If it's a really expensive med, the cost goes toward our $480 deductible. Unless we have a really life threatening illness, we'll never even meet that deductible. And most of the meds don't even apply to the deductible.
So, my question is: why are we paying for a drug plan?
Has this been a problem you've encountered?
12 people like this
11 responses
@DaddyEvil (137142)
• United States
6 Jul 22
Not yet, but... I just found out that the Xolair that the doctor prescribed for me costs over $3,000 for each shot. I'm supposed to have this shot once a month for the foreseeable future. I got a letter in the mail today that said the total price and then also said "in case your insurance doesn't pay, this is the total you'll be liable for each month", That's more than I make in a month... It should be interesting to see what happens.
3 people like this
@DaddyEvil (137142)
• United States
6 Jul 22
@1creekgirl When I left Walmart in 2021, my insurance stopped covering my epi-pens, my blood pressure meds and my thyroid meds, of course. When we started pricing them at different pharmacies, we found that, all together, my meds would cost us $200 each month instead of the $22 I'd been paying.
I'm not old enough yet for Medicare, so we applied for Medicaid when Missouri finally put it into effect here. Thankfully, we qualified for that. So my out-of-pocket now is $0. But if they deny any part of that, I'm liable for the entire amount.
2 people like this
@1creekgirl (40529)
• United States
6 Jul 22
@DaddyEvil I'm glad to hear you could get Medicaid. I'm considering getting most of my prescriptions at Walmart because they are cheaper than our local pharmacy. I'm also learning to ask how much out of pocket verses using my insurance. And GoodRX is really helpful.
2 people like this
@1creekgirl (40529)
• United States
6 Jul 22
Oh my goodness! That's why I'm afraid to drop our insurance in case that happens. My Botox for migraines is absolutely unaffordable without my insurance.
2 people like this
@JimBo452020 (42629)
• United Kingdom
5 Jul 22
I have absolutely no idea about how it works in America Vicki.
1 person likes this
@1creekgirl (40529)
• United States
6 Jul 22
Are all your meds covered by your government?
1 person likes this
@JimBo452020 (42629)
• United Kingdom
6 Jul 22
@1creekgirl
We pay into the NHS
Free treatment
And in Scotland free prescriptions
1 person likes this
@1creekgirl (40529)
• United States
6 Jul 22
@JimBo452020 That's wonderful. Do you get to see your doctor of choice?
1 person likes this
@kaylachan (57699)
• Daytona Beach, Florida
6 Jul 22
Happy to say, no. but I've come to expect little for free. Yes, I'm on the free plan and I pay no co-pays for it.
1 person likes this
@kaylachan (57699)
• Daytona Beach, Florida
6 Jul 22
@1creekgirl Yes, and some I don't want.
1 person likes this
@1creekgirl (40529)
• United States
6 Jul 22
I'm glad for you to have free meds. Do you get all that you need?
1 person likes this
@LadyDuck (458233)
• Switzerland
6 Jul 22
We have National Healthcare System here, it is mandatory to be covered, we pay an annual premium but all medications as well as doctors, hospital, therapies and so on are covered. We choose the deductible, the higher the deductible the less our annual premium. I choose the highest deductible as I do not take medications and I do not even need to see my doctor.
1 person likes this
@LadyDuck (458233)
• Switzerland
7 Jul 22
@1creekgirl - I really am, my husband is not so lucky, but he does not have too many health problems either.
1 person likes this
@1creekgirl (40529)
• United States
6 Jul 22
You are blessed to have such good health.
1 person likes this
@RasmaSandra (73444)
• Daytona Beach, Florida
6 Jul 22
For these reasons I say my prayers every day that I do not need any medications,
1 person likes this
@1creekgirl (40529)
• United States
6 Jul 22
@RasmaSandra You have some healthy genes plus God's blessings.
1 person likes this
@1creekgirl (40529)
• United States
6 Jul 22
It's really a racket. Can't afford it and can't afford to not have it.
1 person likes this
@1creekgirl (40529)
• United States
6 Jul 22
@JudyEv So far, Medicare with a supplement works well, but our deductible keeps going up.
1 person likes this
@JudyEv (325818)
• Rockingham, Australia
6 Jul 22
@1creekgirl Private health insurance here is a bit like that. We had top cover when we were miles from health resources but now we're not game to stop it. But those on basic Medicare get good service but often have to wait for ages for operations and procedures.
1 person likes this
@snowy22315 (170003)
• United States
6 Jul 22
Fortunately no, as my meds are low cost.
1 person likes this
@LindaOHio (156276)
• United States
6 Jul 22
We have a lot of meds and wouldn't know what to do without our insurance. I certainly wouldn't drop the plan. You never know what might happen in the future. I would compare pharmacies and use a Good Rx Card.
1 person likes this
@misunderstood_zombie (8142)
• United States
6 Jul 22
I'm sorry that you need to pay so much out of pocket. So far for me everything is pretty cheap. but I don't take a great deal of medication. This just seems very unfair.
1 person likes this
@1creekgirl (40529)
• United States
6 Jul 22
It's really cheaper to not use the insurance, but can't take a chance on really needing it.
@porwest (78761)
• United States
6 Jul 22
I have not yet encountered this problem as I am luckily only on one medication currently. But at some point I am sure I will run into this more.
It's the way the insurance is structured which is designed to pay out as little as possible. It really depends on the med. For some the coverage is needed more than for others.
I pay $10 for mine and don't use our insurance to pay. Our insurance is through my wife's work.
1 person likes this
