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Medicare Rx drug plan
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Pumbaa
medicine forum Guru Wannabe


Joined: 05 May 2005
Posts: 107

PostPosted: Tue May 16, 2006 10:20 pm    Post subject: Medicare Rx drug plan Reply with quote
I was talking to my local Wal-Mart Pharmacist today. He said he noticed
that since people have the new Medicare Rx cards that doctors are
prescribing expensive medication for them that they could otherwise not
afford to purchase. He said as soon as the doctors find out that the patient
has a Rx card that the doctor says "since you don't have to pay for it", "I
want to try out this new medication."

He said a lot of people purchased the cheapest Medicare plan they could and
there is no coverage for the "donut hole". He said if you think you have
problems now just wait until these people are asked to pay 400 to $500 a
month for their Rxs. It is sure not like the $3 co-payment that a patient
pays if he has Mississippi Medicaid. Then a lot of plans want to tell
people that the drugs they have been paying for since January will be
dropped from the formulary.

Did someone pass or propose some legislation to keep the insurance companies
from dropping medications from the formulary that were originally covered
when the patient signed up?
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Repeating Rifle
medicine forum Guru Wannabe


Joined: 04 May 2005
Posts: 141

PostPosted: Wed May 17, 2006 1:15 am    Post subject: Re: Medicare Rx drug plan Reply with quote
On 5/16/06 3:20 PM, in article lesag.47395$Kn4.25463@bignews2.bellsouth.net,
"Pumbaa" <pinkertonjames@hotmail.com> wrote:

Quote:
I was talking to my local Wal-Mart Pharmacist today. He said he noticed
that since people have the new Medicare Rx cards that doctors are
prescribing expensive medication for them that they could otherwise not
afford to purchase. He said as soon as the doctors find out that the patient
has a Rx card that the doctor says "since you don't have to pay for it", "I
want to try out this new medication."

He said a lot of people purchased the cheapest Medicare plan they could and
there is no coverage for the "donut hole". He said if you think you have
problems now just wait until these people are asked to pay 400 to $500 a
month for their Rxs. It is sure not like the $3 co-payment that a patient
pays if he has Mississippi Medicaid. Then a lot of plans want to tell
people that the drugs they have been paying for since January will be
dropped from the formulary.

Did someone pass or propose some legislation to keep the insurance companies
from dropping medications from the formulary that were originally covered
when the patient signed up?


I reluctantly signed up with the cheapest plan I could get, Humana at about

$5.40/month. That way, I will not be hit with the 1%/month penalty that is
based, not upon the $5.40, but upon the much higher AVERAGE premium of plans
in my area.

I plan to get most of my drugs from Canada. At my current consumption level,
I will probably end up with about the same out of pocket cost or less than
under the plan. I am primarily interested in catastrophic coverage and am
lucky enough to be able to take care of my deductibles and co-payments. I
would have been happy with a plan that would cover my potential high costs
if I ever needed them.

This Bush drug plan is an outrage. It is a sop to the big drug companies and
the insurance companies.

I am sorry for the independent pharmacist and even some of the large chains.
By favoring the large companies, these pharmacists are put into a lousy
competitive situation.

Bill

-- Ferme le Bush
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Bob G.
medicine forum addict


Joined: 09 May 2005
Posts: 62

PostPosted: Wed May 17, 2006 2:13 pm    Post subject: Re: Medicare Rx drug plan Reply with quote
Quote:

I reluctantly signed up with the cheapest plan I could get, Humana at about
$5.40/month. That way, I will not be hit with the 1%/month penalty that is
based, not upon the $5.40, but upon the much higher AVERAGE premium of plans
in my area.

I plan to get most of my drugs from Canada. At my current consumption level,
I will probably end up with about the same out of pocket cost or less than
under the plan. I am primarily interested in catastrophic coverage and am
lucky enough to be able to take care of my deductibles and co-payments. I
would have been happy with a plan that would cover my potential high costs
if I ever needed them.

This Bush drug plan is an outrage. It is a sop to the big drug companies and
the insurance companies.

I am sorry for the independent pharmacist and even some of the large chains.
By favoring the large companies, these pharmacists are put into a lousy
competitive situation.

Bill

-- Ferme le Bush

================================================================

I am a retired (semi) Pharmacist aged 63, and on Social
Security...not yet eligible for Medicare ... and have Health and Rx
coverage thru my retired wives employer.. which will end the Month
she turns 65 (she is my age)

That Said....

I definitely do not think the current plan is an Outrage... far from
it...

BUT I do think it is overly complicated for anyone to sift thru the
plans that are offered in each State..(47 are offered in my home
State) . All of which at least meet the minimum Federal requirements.
And all but one locally Most offer much more...

What I do not like is the fact that all Rx Drugs are not covered... at
least all the plans do cover "some" drugs" in each therapeutic class..

I honestly saw no reason for extending the deadline ...anyone could
have made the same choice you did and picked the cheapest plan
now to avoid any penalty especially since in November you can switch
again...

As far as purchasing drugs from Canada... That's a personal sore
point... I do not blame anyone from using Canadian Pharmacies to save
money... BUT the fact is Canada has Price Controls ... The US could
just as easily set price controls IF they wanted too...

I spend close to $300.00 a month for health Insurance... and still
spend $400 a month on Co pays for my own medications...Plus
10 percent co-pays for office visits and Hospital charges... ($3,500
co pay in March for a short hospital "visit"..

I can afford (at least for now) my health care expenses.. but I sure
am worried about just how long I can continue to do so...

Just my opinion...

Bob G. .
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P T
medicine forum addict


Joined: 29 Apr 2005
Posts: 67

PostPosted: Thu May 18, 2006 3:08 am    Post subject: Re: Medicare Rx drug plan Reply with quote
Bob, the (semi) retired pharmacist wrote

Quote:
I can afford (at least for now)
my health care expenses.. but
I sure am worried about
just how long I can continue
to do so...
Just my opinion...

I see an attitude like that among some retail pharmacists. Okay, at
least one guy I know for sure.
Sort of hypocritical: All these welfare patients and unisured patients:
LET THEM WORK.
Suddenly when the shoe is on the other foot, and THEY have health care
expenses, THEY deserve to have their expenses paid. Sometimes I think
ALL health care should be cash-and -carry.

[Okay Bob, I'm not saying you're in this category.]
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Bob G.
medicine forum addict


Joined: 09 May 2005
Posts: 62

PostPosted: Thu May 18, 2006 9:22 am    Post subject: Re: Medicare Rx drug plan Reply with quote
Quote:

I see an attitude like that among some retail pharmacists. Okay, at
least one guy I know for sure.
Sort of hypocritical: All these welfare patients and unisured patients:
LET THEM WORK.
Suddenly when the shoe is on the other foot, and THEY have health care
expenses, THEY deserve to have their expenses paid. Sometimes I think
ALL health care should be cash-and -carry.

[Okay Bob, I'm not saying you're in this category.]

Thanks....
I'm glad you did not include me ...LOL

Bob
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