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View Diary: Medicare: Shifting Costs to Patients (61 comments)

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  •  It's confusing (6+ / 0-)

    I know people who have been hit by that outpatient not inpatient admission, which meant they didn't get the skilled nursing facility paid for while they went through rehab, as they would with an inpatient admission.  The cost totally shifted to the patient.  I have a medicare C plan.  I'm just figuring out how the drug benefit works.  It's very confusing.  I just started using it and nowhere near the donut hole, but one drug was around $85 and I paid something like $47 for it as my "co-pay."  The entire $85 goes to the donut hole.  Another generic drug was $6.  I paid $5 and the insurance company paid $1.  All of it goes toward the donut hole.  The donut hole is supposed to offer $50% drug cost relief, but from what I can tell about the cost of the drugs so far, I'm paying 50% or more of the cost already.  If I had a straight Medicare D plan, I don't know how I'd be saving.  Like I said, it's all confusing.  I'm just hoping I don't have to deal with hospitals at all.  They have too many ways to rig the system so the patient gets stuck with the bill.

    Shine like the humblest star.

    by ljm on Sun Jul 28, 2013 at 03:32:30 PM PDT

    •  I don't think Part D would help much (2+ / 0-)
      Recommended by:
      ljm, Cassandra Waites

      if at all. It was designed to funnel money to the insurance companies. Unless you're exceptional in some respect you are probably better off paying out of pocket and shopping at Walmart or similar for your drugs.

      I'm a Type 1 diabetic and the copays plus deductable make them worthless. I'm better off relying on cheap generic Walmart drugs and ordering the expensive ones from pharmacies in Canada over the internet.

      Part D was brought to us by the drug companies in tandem with a Republican administration and I seriously doubt that it would be any better if Obama came up with it.

      Both parties are working for the corporations and only for the corporations and the sooner we realize it the better off we might be, but I'm not sure what options we are left with other than overthrowing this sad excuse for a government.

      The only trouble with retirement is...I never get a day off!

      by Mr Robert on Sun Jul 28, 2013 at 07:20:14 PM PDT

      [ Parent ]

      •  Thanks (3+ / 0-)
        Recommended by:
        Mr Robert, MsGrin, Cassandra Waites

          I've given up thinking insurance is much better than a price rigging scheme that makes a better price for those having insurance than those who don't.  I keep my fingers crossed that I don't need something more expensive than what I take now.  I have to tell  my doctor not to give me something new and name brand.

        Shine like the humblest star.

        by ljm on Sun Jul 28, 2013 at 07:25:41 PM PDT

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      •  Recombinant insulin is expensive (1+ / 0-)
        Recommended by:
        Mr Robert

        I think the cost runs from about $4,000 to $9,000/year in the USA on average for an insulin user.

        •  That sounds about right (0+ / 0-)

          It used to be possible to purchase drugs like Humalog and Lantus from Canada for about 1/3rd the price, but keeping it cool during shipping is impossible because it has to go through US customs and that takes over a week. Even if it's in a cooler it gets too warm after a few days and the pharmacies were having to give too many refunds so they raised the prices to match those here in the US.

          I recently paid $365 for 15 ml of Humalog (5 x 3ml) at Walmart. That's the cash price w/o insurance. I used to get it free of charge directly from Lilly through their Patient Assistance Program. But, once I turned 65 I was no longer eligible.

          I use very little Humalog so that will last me about four months, but many diabetics would burn through that amount in a month. So the cost just for fast acting insulin would come to $4,272 per year.

          The cost for long acting (24 hour basal) insulin would be about the same. So the yearly cost would be over $8,000.

          When I looked at Medicare Part-D policies I found that the premium + deductable + copay was so high that it didn't save me any money as compared to paying cash so I'm going w/o a Part-D policy at least for now.

          The only trouble with retirement is...I never get a day off!

          by Mr Robert on Mon Jul 29, 2013 at 11:01:54 AM PDT

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    •  I have parts C & D (3+ / 0-)
      Recommended by:
      AllisonInSeattle, SingleVoter, ljm

      ...and for my reg'lar meds, it costs me less at my pharmacy to pay the whole price out of pocket than to pay the co-pays if I did it IN my insurance.

      "This is the best bad idea we have by far..." ~Argo

      by MsGrin on Sun Jul 28, 2013 at 11:38:07 PM PDT

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    •  You choose a privatised (0+ / 0-)

      Medicare plan and it sounds like you didn't shop all the details. Different plans have different copays for even the same drugs.

      Try to always use generics where you can. And if you use a med all the time order it for 3 months at a time.

      I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

      by samddobermann on Tue Jul 30, 2013 at 03:45:26 AM PDT

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