Prescription Drug Discount Plans

[Glenn MacGrady]

Many of us here are older with medical problems we have discussed as they relate to our canoeing and general lifestyles. Those medical issues include prescription medications that we need to take on our canoe trips.

Having been in so many different prescription drug plans here in the U.S. over the past two decades, which have so many different prices for the same drugs—some "high tier" drugs being essentially unaffordable—I thought I'd mention some discount plans that are independently available to anyone in the U.S. regardless of your medical or drug plan, especially Mark Cuban's new Cost Plus Drug Co.

I first encountered unaffordable drugs not covered by my Medicare drug plan when I needed a steroid drug for an intestinal disease. I resorted to THIS so-called Canadian pharmacy, which actually seemed to be centered in the Philippines with drugs sourced from India. It was 1/10 the U.S. retail price and cured my disease.

Walmart also has a list of $4 per month ($10 per 90 days) drugs it sells, and I believe Target and some other big companies have similar plans.

I've used GoodRx coupons at local pharmacies for other prescription meds that are were not covered by my Medicare Part D drug plans.

Most recently, after I was forced by my retirement company from Original Medicare onto a Medicare Advantage Plan this year, I found that Mark Cuban's Cost Plus Drugs to be about a third of the price for my Tier 2 drugs on my Medicare Advantage plan, and it was also cheaper than GoodRx. Cuban gets factory prices on a limited list of generic drugs, marks them up 15%, and then mails them for $5 shipping in the continental U.S. It's a great service he's providing, and is surely a wallet-saver and even a life-saver for many folks on limited incomes who have either no drug plans or Swiss cheese drug plans that have large deductibles or co-pays.

 

[Paddlinhal]

I have checked out Mark Cuban's plan and it does seem to be quite cheap. I don't take any prescriptions though so I haven't taken advantage of it. The big thing is that you have to get a written prescription rather than have them call it in to your pharmacy, which they do by default without asking.

 

[Glenn MacGrady]

The big thing is that you have to get a written prescription rather than have them call it in to your pharmacy, which they do by default without asking.

Not sure what you're saying. All doctors I use fax prescriptions to U.S. pharmacies whether it's a local pharmacy or any mail order pharmacy such as Mark Cuban's.

In my case, for example, I now get prescription meds from three different pharmacy sources—three tier 1 meds from my Medicare Advantage Plan mail order pharmacy, three higher tier meds from Mark Cuban's mail order pharmacy, and one controlled substance med from my local Walmart that I have to personally pick up with an ID because of Connecticut law. All those prescriptions are electronically faxed to the relevant pharmacies by my various doctors.

The drugs I (or anyone) get from Mark Cuban or GoodRx are wholly independent of and unconnected with my Medicare drug plan, so they don't count against that drug plan's caps and holes and aren't subject to that plan's quantity limitations.

 

[GeoBoy]

We are currently using Medicare Advantage Choice by United Healthcare and the drug prices aren’t too bad, but what I found was the pharmacy chain you use make a BIG difference in costs. You also need to shop prices between the drug chains on the different medications, and when you get in or out of coverage gaps. It’s a little bit of a challenge but hey we’re retired and have the time to research.
We also check prices with Good RX too.

 

[Glenn MacGrady]

the pharmacy chain you use make a BIG difference in costs.

The mail order pharmacy that all the Medicare plans have is almost always cheaper than any of the local retail pharmacies. I too have a United Healthcare Medicare Advantage Plan, and I pay $0 for my tier 1 meds from their mail order pharmacy, OptumRx, which is less expensive than any retail pharmacy such as Walmart. However, Mark Cuban is 1/3 the price of OptumRx for tier 2 meds and one tier 4 med.

 

[GeoBoy]

The mail order pharmacy that all the Medicare plans have is almost always cheaper than any of the local retail pharmacies. I too have a United Healthcare Medicare Advantage Plan, and I pay $0 for my tier 1 meds from their mail order pharmacy, OptumRx, which is less expensive than any retail pharmacy such as Walmart. However, Mark Cuban is 1/3 the price of OptumRx for tier 2 meds and one tier 4 med.

Glenn, I find the mail order prices aren’t worth the little difference in price. We travel in our camper, sometimes all the way to the left coast and like the option of going to Walmart, Rite Aid, etc. if we need prescriptions.

 

[Glenn MacGrady]

That makes sense, GeoBoy, if you're on the move.

 

[yknpdlr]

The best medical choice I ever made years ago was to join the military and stay until retirement. I am thus now covered by the Tricare For Life program with no medical insurance premiums to pay ever, and non-immediaetly needed scripts are sent by mail within a couple of days via Express scripts. $12 flat rate for all prescribed drugs. Immediate need scripts from my local pharmacy are massively reduced in price.

 

[snapper]

Well, unlike @yknpdlr, I didn't join the military but did work for NYS over the course of 45 years in the SUNY system. One of the benefits upon retirement was to be able to "cash in" my unused sick days for a reduced rate in post-employment health insurance. Since I had the full 200 days saved up, I've been able to save quite a bit on the drugs I need for my cardiac issue; A-fib. I feel incredibly fortunate to be in this position as I know of many who struggle with paying for their life saving meds.

That's all for now. Take care and until next time...be well.

snapper

 

[Glenn MacGrady]

I am thus now covered by the Tricare For Life program with no medical insurance premiums to pay ever

If retired, you pay the Medicare Part B premium, which for most people this year is $165 month, don't you?

 

[Boreal Birch]

Smartest thing I did was go to work for the State of Alaska, didn’t know diddly squat about insurance, retirement. I did know I got paid to go camping, fishing, boating and flying. The state bought the tents, boats, gear, food and paid for the chartered flying. Turned out that I was also what was later called a tier I employee. I was medically insured for life at age sixty five I had to go on Medicare, what Medicare doesn’t pay my state insurance does. All medications are paid by the state. Also got hooked up to a 401 that the state matched my contributions. The retirement check seems like a bonus, now that everyday seems like Saturday.
I’m not to sure about wanting my meds coming through the mail. The rural mail carrier where I live is maybe dyslexic or worse, our mail always contains someone else’s mail or things we are expecting never show up. Mail thefts are also a problem. So, all is not not a bed of roses here in the far North. Important mail and packages go to a son’s PO Box in town.

 

[yknpdlr]

If retired, you pay the Medicare Part B premium, which for most people this year is $165 month, don't you?

Yes I do, but Tricare takes care of everything else and anything not covered by Medicare, there is no need to have any other kind of "medicare advantage". I am so sick of seeing those stupid commercials every fall open season. I had a surgery and follow up that was listed approaching $150K. I paid nothing for it out of pocket, other than the relatively minor fraction for $165 Medicare that I don't even notice coming out of my Social Security check.

 

[Glenn MacGrady]

Tricare takes care of everything else and anything not covered by Medicare, there is no need to have any other kind of "medicare advantage".

No plan or combination of plans covers everything. Some things are just not covered at all, such as hospital stays beyond a certain number of days, nursing homes, and certain medical procedures. But Medicare + Tricare is certainly a very strong combination.

Many Part C Medicare Advantage Plans, which are run by private insurance companies, have no premiums other than the Part B premium, which is given by the federal government to the insurance companies. Many Medicare Advantage plans also include drug coverage, dental coverage, optometry coverage, gym coverage, and slush funds for drug store purchases. However, most such Medicare Advantage plans (not mine) limit you to a geographic area for doctor and hospital coverage—unlike Original Medicare, which allows one to go to any doctor or hospital in the U.S. that accepts Medicare—and they do have varying copays for doctor visits, hospital visits, and drugs.

Other MA plans that have richer benefits, such as more hospital and rehab days and lower copays, have a monthly premium in addition to the Part B premium.

There's no doubt that federal and state employees historically have gotten and still get some of the best and least expensive medical plans available.

 

[dramey]

I get all of my meds through VA. I don’t even bother with Medicare. Medicare wants $170/month and VA is free, so I dont have Medicare part b.

 

[ppine]

I would not join the military if you paid me.
Yes. Drug prices in this country make no sense. I use generic versions of most drugs, but one of my blood thinners is still expensive. Last month my drug charges out of pocket were $665 for a 90 day supply. That will go down once "deductible is met." Famous last words. I have a whole pile of discount cards in my wallet. Some work and some don't. The US is one of the only countries in the world that has health care for profit. It shows. The hospital bill for my heart procedure last summer was $441,000. Insurance covered nearly all of it.

My social security check pays for my health insurance and drugs and little else. Some day will have socialized medicine and a single payer system, but the lobby against it is very strong.

It reminds me of a visit to Bolivia back in the 1990s. My wife at the time went into anaphylactic shock from bee stings near La Paz. In my bad Spanish I requested Medico. Within 20 minutes a doctor with a little black bag knocked on the door of our hotel room, made a diagnosis and called the Pharmacia. A kid delivered the injection within minutes. She had relief within 30 minutes. The whole experience cost $40 cash. It changed my perception of a country we think of as being backward.

 

[billconner]

Sounds like we're on same or similar oral anti-coagulant. I'm switching from Eliquis to Xarelto for convenience if once a day rather than twice. Was on Pradaxa originally - when it was the only one. You could switch to warfarin and save a bundle - probably in the few dollars a month category - but there are reasons you might not.

Not pro-national health. I think we get better care faster and more innovations because of the profits, and I'm ok with that.

I was curious what the providers received from your heart procedure. I was in intensive care for a week after a PE, and bill was around $72,000. Insurance paid $11,000 and I paid $1,000. My sense is the list prices are pure fiction. My surgery, when I checked in, offered 2/3 off for self pay. Big sign on counter. I'm sure they would have been thrilled to get that much, and not what they agreed to accept from Blue Cross.

Pure goofy, but I generally find very good health care.

 

[yknpdlr]

I had a cardiac incident in 2016 due to what was soon diagnosed as a Patent Foramen Ovale (PFO), a hole between the upper chambers of the heart that is there from pre-birth. A flap is supposed to close upon birth, but does not in 26% of people. Normally it is not cause for big concern in most. But in my case with age and athletic events (mountain biking, backpacking, canoe racing), it can sometimes be a problem causing a stroke. My first cardiologist put me on Xeralto and told me to never stray more than two hours from a hospital for the rest of my life. Right. No chance of that with my lifestyle. Turns out two of my Yukon race partners work for a cardiologist who could surgically fix my problem remotely with a special probe through my chest side wall with sutures within my heart without inserting any permanent foreign device or opening up my sternum. This got me off of the need to take blood thinners permanently. I was soon in surgery on the very date the first cardiologist originally had me scheduled for my second visit with him. My recovery time was just 6 weeks instead of 6 months that open chest butcher surgery would take before resuming athletic activities. Since then I have raced the Yukon twice and the Adirondack 90 miler and other canoe races each year, and participated and led teams in several SAR incident searches.

With the combination of Medicare and my free to me military retirement health insurance (Tricare for life), I paid exactly zero extra dollars ( beyond the inexcapable monthly Medicare) for the procedures that were finally total billed for well over $100K.

I have an interesting and strange mix of medical personnel canoe race partners. I have raced with a pathologist (services not needed), a combat medical nurse specialist (services not needed), a cardiology surgical operating assistant, a surgical suite coordinator, a professional ambulance EMT, a hospice care giver (services not needed), and my family practice physician. I guess I should be ready for anything.