Medicare is trying to stop an industry practice that tends to push up costs for folks in Medicare Part D prescription drug plan. Without going into details, insurers often pay pharmacy benefit managers a locked-in price even if that price is much higher than what the drugs really cost at the pharmacy. Guess who is lobbying to keep this practice in place.
This gets really nasty when the person on Part D hits the infamous "donut hole". Part D insured patients pay the first 100% of the first tier of Rx costs to $275, then 25% of the next tier of costs to $2,510 total cost, then 100% of the next tier up to $5,726 total costs, then 5% of everything beyond that tier. The tier between $2,510 and $5,726 is the donut hole. More like a black hole, but whatever.
Best strategy? Shop around. Costco or Wal*Mart may sell Rx drugs for less than the patient's share under Part D. Especially consider paying cash at those places for your lowest cost generics to keep the Part D coverage for more expensive branded meds.
The WSJ article is locked for subscribers only ... let me know if you want a copy.
This gets really nasty when the person on Part D hits the infamous "donut hole". Part D insured patients pay the first 100% of the first tier of Rx costs to $275, then 25% of the next tier of costs to $2,510 total cost, then 100% of the next tier up to $5,726 total costs, then 5% of everything beyond that tier. The tier between $2,510 and $5,726 is the donut hole. More like a black hole, but whatever.
Best strategy? Shop around. Costco or Wal*Mart may sell Rx drugs for less than the patient's share under Part D. Especially consider paying cash at those places for your lowest cost generics to keep the Part D coverage for more expensive branded meds.
The WSJ article is locked for subscribers only ... let me know if you want a copy.
