Thursday, August 6, 2009

Why Medicare is going broke

Bits and pieces...

So I get this new BP med see and the Doc says buy a 30 day supply and let's see... So I go to Walmart and since it's a generic I get a 30 day supply for $4.00... Now that would be $12.00 for 90 days.... (remember that)...

So I just happen to note that my spouse uses the same drug and has ordered a 90 supply through Right Source who is the 100% owned mail order pharmacy of Humana.. And the price is $31.00 and change..

So I play the dummy and call Humana and say, "Why?" (I have left out all the repeating of membership numbers, birth dates, home address, etc., etc.)

And, of course, everyone knows the answer but no one will say it. "Because that's what we charge."

Someone did point out that my wife paid zip so it was free. I noted that since the $31.00 and change was charged to the account it wasn't free. Walmart's price would have gotten my spouse $12.00 closer to the doughnut hole where Humana pays NOTHING while Humana's Right Source price got my wife $32.00 plus change closer to the doughnut hole where Humana pays NOTHING... and of course Humana keeps on collecting the premium...

Get all that??

Someone did tell me that Right Source had charged me the "Average Retail Price." I didn't catch on when I heard that but I'll bet it is the Feds who set "Average Retail Price..."

Anybody besides me starting to see why Medicare is going broke faster and faster??

2 comments:

  1. Somthing is wrong. Generics are 0 cost to the customer in Humana if purchased by mail order (rightscource) The best way to stay out of the DN hole is to purchase ALL your generics through Walmart and not use your drug card at all. This saves money for the more expensivve drugs.

    ReplyDelete
  2. Yes, no and maybe... They are zero cost if you are outside the doughnut hole or if you have purchased the expensive plan that pays for gnerics, but not brand or preferred brand, if you are inside the doughnut hole.

    The charge, even if you paid nothing, is charged to the account. That means it counts towards the approx $2700 max for the doughnut hole qualification.

    There is no best way to stay out of the doughnut hole given that some drugs go for $900 for three months supply and you need those drugs. When the sum of what Humana and you (in copays) hit the $

    You are correct that a careful analysis needs to be done to see who has the best plan for you. So far I haven't found one that differs much from the other.

    But my point was simply that if Walmart is selling something for $12.00 and the "Retail Avg" is almost three times higher then something is wrong.

    ReplyDelete