Medication Savings

[jcam222]

It’s highly variable as to what I found discounted and what not. My wife is on Medicare and she gets a better deal on everything compared to ACA…but she has to do the mail order to get the with her plan

From what I've gathered preparing to sign up for an ACA plan most all them suck for meds.

 

[Smoke-Chem BBQ]

If you have a high-dollar prescription for which a generic isn't available, and which is poorly (or not) covered by insurance, I feel your pain. I'm taking one of those.

You may find comfort if you do a web search on 'patent expiration for (insert your med here)'. My expensive drug comes off patent next year, and with luck, much, much cheaper generics will be available soon. Patents are good for 20 years, but usually the first 7-10 years of patent life is burned up while the drug is in preclinical and clinical trials.

When a valuable drug is nearing patent expiry, a couple of things always happen. The generics manufacturers start gearing up to have their cheaper clones ready to sell as soon as the patent expires, and the Pharma company with the patented drug starts looking for ways to extend the patent life, perhaps by combining it with another drug or developing a better delivery system. Not always possible; the patent office (and the courts) won't allow an extension unless it's a real improvement.

 

[Fueling Around]

John that is the plan Medicare.gov gave me. In the first 2 or 3 months it will cost me 1980 something dollars and since there's a $2000 out of pocket max the rest of the year will be zero out of pocket. The wife is much easier no meds for her

That sucks Jerry.
My mom had blood clot issues, but appears not passed on to me. I had an episode a few years ago with severe leg pain. Got tested for clot and came through with clean slate. It was only a Baker Cyst rupture meaning synovial fluid had leaked out of my knee. That stuff is not welcome in other parts of your body and holy ugh it hurts, but it eventually clears.

My wife went to an Insurance Agency that didn't push supplement or advantage, but simply laid out the facts with positive & negatives of either path. She chose a supplement and Wellcare is what they recommended for part D. I think there is 2 or 3 levels of the coverage.
I'm younger and healthier and decided to not get a supplement or go on a (dis) advantage plan, but also went with Wellcare for part D.
Here's the part I don't understand. Part D is supposedly optional Medicare coverage, but they penalize you for not signing on a plan? I guess the optional means which plan to choose?

Writing this out makes me rethink checking out an advantage plan. It may pay the part of Medicare premium for me currently coming out of my pocket.
Our lovely politicians have made everything supplemental for the peons. I don't remember what I have to pay per month for my Medicare coverage. Invisible to many as it is often just a reduction in their Social Security (SSI) monthly deposit.
I'm not "retiring" for another 8 months as I surpass the poverty level income for continuing to work while drawing SSI.

 

[Fueling Around]

...
When a valuable drug is nearing patent expiry, a couple of things always happen. The generics manufacturers start gearing up to have their cheaper clones ready to sell as soon as the patent expires, and the Pharma company with the patented drug starts looking for ways to extend the patent life, perhaps by combining it with another drug or developing a better delivery system. Not always possible; the patent office (and the courts) won't allow an extension unless it's a real improvement.

Ah another enlightened person.
The one that irritated me the most is a NON VALUABLE drug commonly called the blue pill.
It is neither a life saving or life extending medication, but they jumped over all the stipulations to get it included in Part D at a hugely inflated price over the 2¢ cost as a moderately valuable high blood pressure medication.

 

[jcam222]

Another idea on expensive meds is to visit th manufacturers website. Some of them offer savings cards

 

[sandyut]

From what I've gathered preparing to sign up for an ACA plan most all them suck for meds.

that's pretty much it. I can get some on mail order, but I hate mail order meds. Kroger is much easier to get anywhere in the US and FAR more reliable.

Ive been on ACA for 4 years, 2025 will be year 5. Ive always used the Kroger Health Savings Club. Its just the one med im on thats about $100/month at Kroger, 2-3X that with ins. that I am looking for another option on.

Overall, im pretty pleased with ACA ins. Just keep expectations in check. its not work ins. I made a few spreadsheets to compare use cost. I went with a lower deductible/copay plan. worked great every year but the one I had 3 surgeries and maxed the OOP. but those years should be rare.

 

[bill ace 350]

My prescriptions are free as a military retiree.

That's a great deal of you belive in Ranger Candy.

 

[jcam222]

that's pretty much it. I can get some on mail order, but I hate mail order meds. Kroger is much easier to get anywhere in the US and FAR more reliable.

Ive been on ACA for 4 years, 2025 will be year 5. Ive always used the Kroger Health Savings Club. Its just the one med im on thats about $100/month at Kroger, 2-3X that with ins. that I am looking for another option on.

Overall, im pretty pleased with ACA ins. Just keep expectations in check. its not work ins. I made a few spreadsheets to compare use cost. I went with a lower deductible/copay plan. worked great every year but the one I had 3 surgeries and maxed the OOP. but those years should be rare.

Yep I am pretty much looking at it as cheap PCP visits and protection against catastrophic cost over the out of pocket $8800

 

[sandyut]

Yep I am pretty much looking at it as cheap PCP visits and protection against catastrophic cost over the out of pocket $8800

that's pretty much what I do. I get office visits for $45, that includes: orthopedics, PCP, COVID check, etc. all preventatives are free including colonoscopy. coverage for my cardiologist is decent - my out of pocket wasn't near as much as I expected for 3 visits and a few tests. If it helps, Anthem BCBS is pretty good there in CO, lots of providers take it. I really have no complaints...except the meds suck - but has been the case since I retired early. in UT we I was on Intermountain (a big provider out there), same deal. That's where I got on the Kroger plan and stayed on it here. excluding drugs from the search for a plan makes it WAY easier. removes a ton of mud.

hope that helps. a broker can help too, they are free and do all the enrollment. I found once enrolled it was easier to navigate and didnt need them to spoon feed it to me. feel free to reach out if I can help.