Drug prices

[clifffaith]

Because my Anthem plan was discontinued at the end of 2019, I went with a Blue Shield plan for the next 11 months before qualifying for Medicare in December. My entire last year of drugs from Anthem was at no charge, when the Rx had averaged $30 - $40 for 30 and 60 day supplies the previous year. Being nervous about what the new Blue Sheild plan would charge for drugs, I did some research on GoodRx. Looked like Vons had the best prices, with the exception of two where CVS was $15-25 less. But before I could fill my prescriptions I needed new paper prescriptions from my doctor, and as long as I was there I went downstairs to my old pharmacy. Less than $5 total for all three prescriptions I needed refilled that particular day -- fabulous, I'd just as soon stay with them! So I am a happy camper so far with my new insurance.

Cliff also changed plans this year. From Healthnet which he thought made him wait way too long (3 months) for each of the skin cancer surgeries he needed last year, to Aetna. All his doctors were on both plans, so he thought he'd give Aetna a try with its included dental coverage of $1275 and $300 annually of "free stuff" from CVS. His urologist wrote him a new prescription last month. Aetna works semi-exclusively with CVS, so he presented his prescription there. $300. No thank you. Came home and I gave him the GoodRx price for his drug. Vons wanted $27, but when he got there it turned out that was a generic and he wanted to go back to his doctor first. He saw his doctor Monday, and was given a new prescription to shop around for the generic and was assured that would be fine. Back to CVS -- $99 with his insurance. He just came home from Vons, where he had to struggle to make himself understood that he wanted the $27 GoodRx price when they tried to charge him the $99 insurance price, but eventually he was charged $27.

What a racket! The "guy off the street with the coupon" pays $27, and the insurance price is $99. SMH. About five years ago I had a migraine medication go from $15 to $30 to $75 to $180 over the course of a year. I had been paying $15 for 8-10 years. Everyone said "go to Costco". So we did and the drug was $75. Great, sign me up! Two months later they seemed to have figured out I had insurance and the price was back up to $175. Story was that like gold and silver there was a "market" for drugs and the price was now higher. BS! At that point I went back to my doctor and we changed to another drug that did the job for $15.

 

[WinniWoman]

And the health care insurance nightmare continues...

 

[CPNY]

Because my Anthem plan was discontinued at the end of 2019, I went with a Blue Shield plan for the next 11 months before qualifying for Medicare in December. My entire last year of drugs from Anthem was at no charge, when the Rx had averaged $30 - $40 for 30 and 60 day supplies the previous year. Being nervous about what the new Blue Sheild plan would charge for drugs, I did some research on GoodRx. Looked like Vons had the best prices, with the exception of two where CVS was $15-25 less. But before I could fill my prescriptions I needed new paper prescriptions from my doctor, and as long as I was there I went downstairs to my old pharmacy. Less than $5 total for all three prescriptions I needed refilled that particular day -- fabulous, I'd just as soon stay with them! So I am a happy camper so far with my new insurance.

Cliff also changed plans this year. From Healthnet which he thought made him wait way too long (3 months) for each of the skin cancer surgeries he needed last year, to Aetna. All his doctors were on both plans, so he thought he'd give Aetna a try with its included dental coverage of $1275 and $300 annually of "free stuff" from CVS. His urologist wrote him a new prescription last month. Aetna works semi-exclusively with CVS, so he presented his prescription there. $300. No thank you. Came home and I gave him the GoodRx price for his drug. Vons wanted $27, but when he got there it turned out that was a generic and he wanted to go back to his doctor first. He saw his doctor Monday, and was given a new prescription to shop around for the generic and was assured that would be fine. Back to CVS -- $99 with his insurance. He just came home from Vons, where he had to struggle to make himself understood that he wanted the $27 GoodRx price when they tried to charge him the $99 insurance price, but eventually he was charged $27.

What a racket! The "guy off the street with the coupon" pays $27, and the insurance price is $99. SMH. About five years ago I had a migraine medication go from $15 to $30 to $75 to $180 over the course of a year. I had been paying $15 for 8-10 years. Everyone said "go to Costco". So we did and the drug was $75. Great, sign me up! Two months later they seemed to have figured out I had insurance and the price was back up to $175. Story was that like gold and silver there was a "market" for drugs and the price was now higher. BS! At that point I went back to my doctor and we changed to another drug that did the job for $15.

You sometimes have to tell the pharmacist to run the Rx through as cash. So if you ran it through as cash and then ran a refill especially if it was 90 day supply or needed a whole new prescription it will always default and go back through insurance. Next time just tell pharmacist to re run it as cash then use a coupon like good rx. That should help alleviate the situation

 

[bogey21]

In the past I used GoodRx a number of times but now find that my Medicare Prescription Drug Plan gives me decent prices on the drugs I use with little to no hassle. Note that I have traditional Medicare plus Parts B and D plus a Plan F Supplement. I have no idea how drugs are handled with Medicare Advantage Plans...

George

 

[Luanne]

Just for grins I checked prices with Good RX for Eliquis. The prices were about 4 times as high as what I pay through my Medicare Part D.

 

[CPNY]

Just for grins I checked prices with Good RX for Eliquis. The prices were about 4 times as high as what I pay through my Medicare Part D.

Good rx doesn’t always work and in most cases insurance is better. Since you have Medicare part D you wouldn’t be able to take part in any manufacturer coupon.

 

[rboesl]

Just for grins I checked prices with Good RX for Eliquis. The prices were about 4 times as high as what I pay through my Medicare Part D.

I had a similar situation with one of medications. Checked GoodRx which listed it as $325 at a local grocery chain drugstore. My CVS charged me $51.

 

[Passepartout]

I can't stay ahead of 'em. All last year, my Xarelto blood thinner was something like $45 (co-pay) a month, then in January it was $210 (my part), then when I refilled the 'script in Feb, it was like $35. If they'd told be ahead of time I'd have bought 90 days' supply!

 

[geekette]

Yep, totally whack. My meds also are cheaper now than when insured. It is alarming how much shopping around you have to do but that it can save So Much in just one year. It's like, dang, how much money did I not have to pay in those years that I didn't shop around, just dutifully went to pharma in-network... ? oh well, water under the bridge, pills down the gullet...

 

[b2bailey]

And the health care insurance nightmare continues...

I've had a Plan D for several years for which I paid $35/mo. My one prescription cost me $10/mo copay. That upset me because I used to get it for $5/mo without drug plan. (Didn't think to pay cash and take insurance off refill.) Got notice my plan went up to $60/mo. That pushed me to shop for a new Plan D. Okay, now down to $25/mo. Happy with that but what is my new co-pay going to be?

Drum roll please...
-0- copay. Picked up refill and paid $0.

So now I am paying less per month premium and 0 copay. Go figure.

 

[Talent312]

My Part D plan (starting in March) should result in -0- for my generics.
But for Jardiance (brand), I currently use a discount card w/ a -0- copay.

If the discount stops working, I'm facing a $435 deductible up front.
But... Medicare+Supplement+Plan D still saves me a ton over my employer's plan.
So, I ain't gonna sweat it, either way.

 

[CPNY]

I can't stay ahead of 'em. All last year, my Xarelto blood thinner was something like $45 (co-pay) a month, then in January it was $210 (my part), then when I refilled the 'script in Feb, it was like $35. If they'd told be ahead of time I'd have bought 90 days' supply!

You may have a deductible you have to hit. Sort of like the end of the year for med D. If you exhaust your benefit amount you hit a Donut hole and have to pay out of pocket.

 

[CPNY]

My Part D plan (starting in March) should result in -0- for my generics.
But for Jardiance (brand), I currently use a discount card w/ a -0- copay.

If the discount stops working, I'm facing a $435 deductible up front.
But... Medicare+Supplement+Plan D still saves me a ton over my employer's plan.
So, I ain't gonna sweat it, either way.

The copay card you’re using now with your commercial insurance will not work if you put jardiance through med D plan. If you’re carrying both commercial and part D, run it through whatever will get you the least expensive.

 

[Timeshare Von]

Just for grins I checked prices with Good RX for Eliquis. The prices were about 4 times as high as what I pay through my Medicare Part D.

I'm also on Eliquis! I hate that it is over $450/month WITH insurance. Fortunately there is a manufacturer's discount program to bring the co-pay down to just $10 . . . until the maximum benefit of $3,800 is reached in any given year. I did find a source through Canada Drugs for about $200/month for my last three month's supply in 2019.

 

[Timeshare Von]

P.S. About Eliquis, the FDA did recently approve TWO generics, so hopefully we'll see prices come down very soon!

 

[Luanne]

I'm also on Eliquis! I hate that it is over $450/month WITH insurance. Fortunately there is a manufacturer's discount program to bring the co-pay down to just $10 . . . until the maximum benefit of $3,800 is reached in any given year. I did find a source through Canada Drugs for about $200/month for my last three month's supply in 2019.

Wow! I am paying $138 for 3 months supply of Eliquis.

And for my first pack (the starter pack) I paid nothing! I think that was a huge fluke but I wasn't going to argue about it.

 

[dayooper]

I can't stay ahead of 'em. All last year, my Xarelto blood thinner was something like $45 (co-pay) a month, then in January it was $210 (my part), then when I refilled the 'script in Feb, it was like $35. If they'd told be ahead of time I'd have bought 90 days' supply!

I was on Xarelto a couple of years ago and they paid my copays. Check with your doctor fo a coupon. I was on it for less than a year, but he said they would renew the program.

 

[Luanne]

I was on Xarelto a couple of years ago and they paid my copays. Check with your doctor fo a coupon. I was on it for less than a year, but he said they would renew the program.

I was also on Xarelto for awhile. My doctor gave me a coupon that would have reduced my co-pays to something like $10.00. But, since I'm on Medicare and have a Part D plan I wasn't eligible.

 

[dayooper]

I was also on Xarelto for awhile. My doctor gave me a coupon that would have reduced my co-pays to something like $10.00. But, since I'm on Medicare and have a Part D plan I wasn't eligible.

Yeah, I’m not on any Medicare, still a little too young.

 

[Timeshare Von]

Wow! I am paying $138 for 3 months supply of Eliquis.

And for my first pack (the starter pack) I paid nothing! I think that was a huge fluke but I wasn't going to argue about it.

Yes I too got the "first month free" starter . . . but since that time, I've been on the Bristol Squib Myers' $10 copay discount to offset the high insurance copay. What I wouldn't give to "only" pay $138 for 3 months. The BSM program is to a max "benefit" (or discount) of $3,800/year. So last year, I had exhausted the program in Sept. So I would have technically been on the hook for roughly $1,400 through my insurance had I not found a deal (with first time buyer's discount of 25%) to get it down to just at $600 for the last 3 months of 2019.

 

[easyrider]

I started using the Health Warehouse to our prescriptions. It is an online pharmacy. I thought is was odd that I could private pay at the Health Warehouse for our drugs for substantially less than using our insurance. Substantial meaning 1/3 the price of our pharmacy for a 90 day supply.

Bill

 

[isisdave]

Some of the variance when you have Part D comes from your insurer's Tier policy, and whether you've met your deductible ($435 this year). My current WellCare plan, the very cheapest, pays 100% for generic Tier 1 and Tier 2, and it's therefore cheapest for blood pressure meds and statins, etc. But DW's Evista is Tier 3 and because we have never exceeded the deductible would be over $200 for 90 days; GoodRx price is $62 at Ralphs.

So if you pay hundreds one time and $35 the next, it's probably because you've paid more than your $435 deductible the second time.

Also, if you're going on a trip and need an early refill, you might have to get your insurer to allow that. GoodRx doesn't care.

Faith, one very nice thing about Ralphs' computer system is that they can load your insurance and at least one other plan like GoodRx into it, and it will automatically find the cheapest price. And very nice people. Maybe other Kroger stores have the same system. Also, like some other pharmacies, they have a list of 400 or so free or cheap drugs.

 

[rboesl]

We got quite the shock yesterday. My wife is on lanzaprole, a generic, and always gets a 90 day supply. She also recently changed her Advantage Plan from WellCare to BCBS. The pharmacy got the notice from WellCare, but wife forgot to give the pharmacy her new BCBS card info. When I went to pick up a refill they told me $900 because they didn't have any insurance info. Once we got them the new card info the price dropped to $51.

 

[bogey21]

It is a hassle but unfortunately it is up to us, the consumer to stay on top of what we pay for prescriptions. Watch them like a hawk. Otherwise we will be subject to surprises...

George

 

[simpsontruckdriver]

In terms of pharmaceutical discounts, either your doctor or pharmacist should know. For those with Humana (which I sell in FL, NC, and WA), their online/mail-order pharmacy will check for discounts without you asking. So, let's say you have Humana and you sign up. You or your doctor sends in an Rx for Elliquis. As soon as they get it, they will look up the manufacturer and get you signed up for the program. Then, it is handed to the pharmacists. One pharmacist enters it, pharmacist #2 verifies that it is correct (prevents errors). Then it is sent out every 3 months. JD Power ranked Humana's online pharmacy #1 in 2019.

TS