Medicare Drug Shopping

Health Care

  Pearl River     The drug lobby in all its facets is whipping our butts in the US.  It looked like there was an opening to have the government negotiate better pricing for prescriptions, but that seems to have faded as the lobbyists and donors mobilized to push Congress into the quicksand where we are all forced to wallow.

There’s probably no better example of this than the horror that awaits the elderly in trying to sort out their self-interest as the Medicare open enrollment process rings its annual bell from now until early December.  In fact, according to surveys, most don’t bother and just go along to get along hoping for the best.  As reported in the Times:

For 2019, 71 percent of beneficiaries said they didn’t compare plans during the open Medicare enrollment period, according to a Kaiser study. The rate was even higher among Black and Hispanic beneficiaries, people over 85 and those with lower income and fewer years of education — precisely the groups most likely to require more medical services and drugs, and least able to pay high costs.

Let me admit, being old as dirt, I’m right there in that number, perhaps even worse.  When I ended up taking over the payroll and insurance matters for our organizational staff this year, I blithely assumed that since there was a supplemental Blue Cross Blue Shield policy being paid for me by the organization, the fact that Humana also was sending me some bills was a double-dipping scam on their part.  Only later did I find, when I tried to pay for my one little bitty prescription, that I no longer had Plan B or D or whatever it’s called, because the Humana folks had canceled me at my request, thinking I had outsmarted the bastards.  This was a bought lesson for me now that I’m paying for out of pocket, even if it’s less money than I would have been paying those bums.  For the small savings, it could have been a risky bet.  I promised myself to try to finally understand this mess for next year since I was bamboozled this year.

Not that I know any better.  The same Times article dives deep into comparative shopping, and we all end up close to drowning.  The insurance and drug companies are part of the equation, while where you pick up your prescription is another part of the package, especially if it’s the big boppers like CMS, Walgreens, or Walmart.  A retired nurse got a volunteer navigator, but in narrowing the choices for her script everyone was lost in high water.  He found an…

estimated total yearly drug and premium costs (“the magic number,” he said) would be $301 a year if she used a CVS or Giant pharmacy — but $1,125 if she took the same prescriptions to a Walmart. Conversely, a Humana plan would cost $525 a year through a Walmart pharmacy, but more than twice that at CVS. With a Cigna plan, the best deal involved a mail-order pharmacy.

What the heck!?!

I hope our electeds were well-paid, because the rest of us are pretty much just marks and out of luck!