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Medical Forum / General / Pharmacy / June 2006Self-Employed looking for (a good) Prescription Drug Card/Plan!!
Hi, I was wondering if any of you pharmacists know of prescription drug cards/plans I can subscribe to at a monthly rate (say $50/month) to get % off or set copays ($10/$15/$30). I am going to get BCBS BlueOptions health insurance, but I was told it doesn't really cover prescription drugs. Any leads would be a tremendous help. Searching for prescription drug plans usually yields many medicare related queries, and others are related to group health plans! Very frustrating. Kyle On Wed, 14 Jun 2006 17:33:04 -0700, cartesiankyle wrote: > Hi, > [quoted text clipped - 9 lines] > > Kyle Before you waste time looking for a separate drug plan, I'd suggest first looking into the details of the BlueOptions plan you will be getting, since you don't sound certain about what coverage the plan offers. There are exceptions, but I would be willing to bet the plan has Rx coverage. All BCBS plans of which I am aware do have Rx coverage, but my exposure is limited, and there are 60+ BCBS organizations out there, each with multiple plans, so anything is possible. If you find the current plan you have selected doesn't have Rx coverage, it would probably be less expensive to add it to the plan than to purchase a stand-alone Rx plan. > On Wed, 14 Jun 2006 17:33:04 -0700, cartesiankyle wrote: > [quoted text clipped - 19 lines] > my exposure is limited, and there are 60+ BCBS organizations out there, > each with multiple plans, so anything is possible. this is not at all true Blue Cross Medicare supplement plans...at least here in Calif have TWO options that have Rx coverage (which is quite limited..and increases the monthly cost a lot) for instance Blue Cross Senior Classic J costs 320 a month Blue Cross A, C and F do NOT have any Rx coverage...F costs 132 a month.. this is what we got when hubby went on Medicare.... he has NO Rx coverage...but excellent other coverage.. Medicare Part D is a huge scam in my eyes many seniors have reached the "donut hole" in just 4 or 5 months...now they have to pay a huge cash outlay before the Rx coverage kicks in again...not to mention the monthly premiums for a coverage that isn't giving them anything for about 3 months... > If you find the current plan you have selected doesn't have Rx coverage, > it would probably be less expensive to add it to the plan than to purchase > a stand-alone Rx plan. On Thu, 15 Jun 2006 17:48:59 +0000, Hawki63 wrote: >> Before you waste time looking for a separate drug plan, I'd suggest >> first looking into the details of the BlueOptions plan you will be [quoted text clipped - 5 lines] > > this is not at all true How it it "not at all true"? I clearly said that the plans _I am familiar with_ do have Rx coverage (referring to individual and group BCBS plans, as there was no talk of Medicare), but there are a large number of plans, so it is possible that some do not. > Blue Cross Medicare supplement plans...at least here in Calif > have TWO options that have Rx coverage (which is quite limited..and > increases the monthly cost a lot) for instance Blue Cross Senior > Classic J costs 320 a month There was no mention of Medicare. The OP says he is self-employed and looking for Rx coverage. Its not surprising that most Medicare supplement plans won't have Rx coverage since part D is available. > Blue Cross A, C and F do NOT have any Rx coverage...F costs 132 a > month.. [quoted text clipped - 9 lines] > again...not to mention the monthly premiums for a coverage that isn't > giving them anything for about 3 months... Then they should have selected plans that better suited their needs. There are a number of them that have no coverage gap (AKA "Donut Hole"). > On Thu, 15 Jun 2006 17:48:59 +0000, Hawki63 wrote: > [quoted text clipped - 19 lines] > > There was no mention of Medicare. actually there WAS a mention of Medicare....I just mistakenly assumed the poster was of Medicare age > The OP says he is self-employed and looking for Rx coverage. Its not > surprising that most Medicare supplement plans won't have Rx coverage > since part D is available. I did not see a mention in the original post of being self employed... >> Blue Cross A, C and F do NOT have any Rx coverage...F costs 132 a >> month.. [quoted text clipped - 12 lines] > Then they should have selected plans that better suited their needs. > There are a number of them that have no coverage gap (AKA "Donut Hole"). they "they" should have noticed that such "better suited plans" can cost at least $60 a month...ie...$720 a yea spoken like a working stiff who has "copay" only drug coverage... On Fri, 16 Jun 2006 00:13:36 +0000, Hawki63 wrote: > actually there WAS a mention of Medicare....I just mistakenly assumed the > poster was of Medicare age I sit corrected. The context of his mentioning medicare was that he was not looking for a medicare plan though. > I did not see a mention in the original post of being self employed... Then you didn't read the Subject > they "they" should have noticed that such "better suited plans" can cost > at least $60 a month...ie...$720 a yea Sheesh... I take it you are one who thinks the government should simply pay for everything. You complain that they have a donut hole, then complain that the plans without donut holes cost more. Free drugs for everyone, after all its our right!! > spoken like a working stiff who has "copay" only drug coverage... Actually, I have no medical insurance except for some catastrophic coverage. I pay out-of-pocket for Rxs, and I, for one, don't expect the government, or rather other tax payers, to foot the bill for me. Nor do I like being forced to pay for anyone elses. I'm not totally heartless. There are cases and situations where I think it is fine, even commendable, but all of this "gimme gimme gimme" has gotten to me. <Snip> > Sheesh... I take it you are one who thinks the government should simply > pay for everything. You complain that they have a donut hole, then [quoted text clipped - 9 lines] > There are cases and situations where I think it is fine, even commendable, > but all of this "gimme gimme gimme" has gotten to me. I do expect that our FDA (alias the government) get off of its collective rear end and approve all the generic drugs that are waiting in the pipe line. All the new drugs that are getting approved will help some people (and help kill some) but most of them will be priced over the cost of a similar generic drug. I finally got covered by Medicare because I am disabled due to an automobile accident. Before Medicare I was paying BC-BS about $415 a month for health insurance. After the MVA, I had to get into the State health insurance pool as a regular insurance company would not cover me. My regular BC-BS plan dropped me like a hot potato. I had only purchased the plan a few months before and my hospital bill for a month in ICU was about one hundred thousand dollars. The insurance company did get a discount from the hospital as they never pay "retail" prices. Good luck and get insurance! . My regular BC-BS plan >dropped me like a hot potato. I had only purchased the plan a few months >before and my hospital bill for a month in ICU was about one hundred >thousand dollars. The insurance company did get a discount from the hospital >as they never pay "retail" prices. Good luck and get insurance! ========================== I would NOT call it a discount....its a negotiated "price" between the Physician / Hospital/ and yes Pharmacy.... This "price" is however one major reason that "cash customers" see their bills inflated to make up the difference... Just finally had BC cover a procedure I had done in March.... They rejected it initially and I received a bill of $36,000 from the hospital.....(ok that only about 2 years worth of my Social Security Checks ...I am only 62 therefore not eligible for Medicare yet) ... after appealing and lots of hair pulling frustration they paid the Hospital IN FULL ... $9,000 or which they "contributed" $8,100 and I "only had to pay my 10 percent...$900.... That's one hell of a "discount" the Hospital gave BC... ! Slight difference between what a Hospital accepts from BC and what they will accept from a cash customer... in this case $25,000 ! I am a retired Pharmacist... BTW. and the same Discounts are offered Drug Stores on a take it or leave it basis...and believe me in most towns the Hospitals, Doctors, and drug stores accept the terms mostly because if they did not...they would have exactly zero patients... about the ONLY Health Industry that does not have to accept MAJOR discounts I believe are the Drug Manufacturers... and they can pass thru price increases every day if they desire... Just my thoughts.. Bob G. > about the ONLY Health Industry that does not have to accept MAJOR > discounts I believe are the Drug Manufacturers... and they can pass [quoted text clipped - 3 lines] > > Bob G. It would seem that if we had a free capitalist society, that the cash patient would get the lowest price. Cash in the hand is worth a lot more than having to wait several months to get paid, if you get paid, by the insurance company. Pharmacists recently got a law passed in Mississippi to force the insurance companies to pay the retail pharmacies faster for charges under Medicare. The State's Attorney General says he will enforce it. A pharmacy should not have to provide interest free loans to a big insurance company while waiting until they decide they will pay for the medication. Doesn't the VA gets MAJOR discounts from the Drug Manufacturers. Did you read about the group of Amish up North? They do not believe in insurance and they take care of their own. They have negotiated with the local hospitals and they receive a discount similar to insurance companies whenever they use the hospitals. The group then pays the hospital in cash. >> about the ONLY Health Industry that does not have to accept MAJOR >> discounts I believe are the Drug Manufacturers... and they can pass [quoted text clipped - 8 lines] > than having to wait several months to get paid, if you get paid, by the > insurance company. actually this works but ONLY if said providers..ie docs and hospitals are approached PRIOR to said procedure... we have a Turkish friend who did this with UCLA for his sibs cataract and open heart surgeries...in all cases he met with the billing gurus PRIOR to the surgeries..asked how much for cash..and how much if I pay you TODAY in cash?? in all instances he received a discount (so to speak) amounting to over a third off....funny how money talks!! btw..surgeons,,anesthesia etc all accepted same deals... Pharmacists recently got a law passed in Mississippi to > force the insurance companies to pay the retail pharmacies faster for > charges under Medicare. The State's Attorney General says he will enforce [quoted text clipped - 8 lines] > whenever they use the hospitals. The group then pays the hospital in > cash. > On Fri, 16 Jun 2006 00:13:36 +0000, Hawki63 wrote: > [quoted text clipped - 7 lines] > > Then you didn't read the Subject yep...missed that....OK..mutual misreading you and I >> they "they" should have noticed that such "better suited plans" can cost >> at least $60 a month...ie...$720 a yea [quoted text clipped - 12 lines] > There are cases and situations where I think it is fine, even commendable, > but all of this "gimme gimme gimme" has gotten to me. no...am NOT one of those you describe above... myself...age 61...have extended Cobra coverage...currently costing me $944 a month...still with significant copays and coinsurance...so yes...am paying my share problem is with hubby...age 66...when he went on Medicare..I did the checking and discovered that Blue Cross Supplement #F made the most sense....this was prior to Part D...no drug coverage ....but "only" $125 a month...and covers his Medicare deductibles and other things... he is post MI and CABG..so is on those expensive statins and a few other meds...I get his meds from England...realize you probably don't approve of it..but this way I can double his dose and split the pills... do I expect my govt to foot the bill for his meds??? apparently not my concern was that the part D is pretty much a scam... I vote for reducing the patent length...price controls..and then I can get his statins at a local retail pharmacy On Fri, 16 Jun 2006 17:13:04 +0000, Hawki63 wrote: > no...am NOT one of those you describe above... > [quoted text clipped - 10 lines] > meds...I get his meds from England...realize you probably don't approve of > it..but this way I can double his dose and split the pills... In the grand scheme of things, statins aren't that expensive. Heck, a cup-o-joe a day at Starbucks, or a half-gallon of gas per day will cost as much or more as a being on a statin. It's not aspirin cheap, but it doesn't even come close to something like Gleevec or any of the biologics. Yes, I realize on a fixed income any little extra can put a severe strain on the budget. If that were the case here though, I'd be surprised if he didn't qualify for subsidized part D. As far as purchasing meds overseas, I have absolutely no problem with people doing that, as long as they realize the potential risks associated with the practice (increased risk of counterfeits, lost/seized/slow-to-arrive prescriptions, little or no pharmaceutical care, etc), and call that pharmacy with any questions or concerns, rather than the local mom-and-pop shop or chain. It's only fair. I don't see where buying them from a different country has any impact on whether or not you can split the tablets, though. It is done fairly frequently stateside. Some insurance plans and our state's medicaid require it in certain situations, and certainly it's not unheard of among cash customers here. > do I expect my govt to foot the bill for his meds??? apparently not > > my concern was that the part D is pretty much a scam... Have you determined this to be the case through any research on your part, or are you convinced of it through hearsay or what the talking heads may have said? It is far from perfect, and another budget-busting entitlement program (Would you expect any less from the gov't?) but, like it or not, I've seen quite a number of people who have benefited greatly from it. In addition, a significant number of people here who don't qualify for Medicaid still qualify for subsidized part D where they don't pay premiums and have minimal copays. > I vote for reducing the patent length...price controls..and then > I can get his statins at a local retail pharmacy I'd go for a moderate reduction in patent length. I would be extremely surprised to ever see it happen though. Too many corrupt politicians (an oxymoron) and lobbyists. Price controls? May be acceptable, may be a complete disaster. It would depend upon how they are implemented. I think it is inevitable, just a matter of time, that we will go to a nationalized health care system, and I don't see that as a good thing. > On Fri, 16 Jun 2006 17:13:04 +0000, Hawki63 wrote: >> [quoted text clipped - 25 lines] > on the budget. If that were the case here though, I'd be surprised if he > didn't qualify for subsidized part D. luckily..no..cannot qualify for anything subsidized don't know what you are paying for gas....we are paying $3.30 per gallon at Costco.com.....generic Pravachol 20mg.. 69.90. for 30 ..approx $2.15 per pill or get 40mg and split them $132 for 30...thus still $2 per pill at Walgreens.com Pravachol 20 is 83.99 per 30 close to $3 per pill or 40mg for $119....$2 per pill... not to mention the others he is on...all adds up > As far as purchasing meds overseas, I have absolutely no problem with > people doing that, as long as they realize the potential risks > associated with the practice (increased risk of counterfeits, > lost/seized/slow-to-arrive prescriptions, little or no pharmaceutical > care, etc), and call that pharmacy with any questions or concerns, rather > than the local mom-and-pop shop or chain. It's only fair. apparently you missed the special on Dateline...just as likely to get counterfeit meds here in the USA.... don't need questions answered...am an NP..so can write scripts..ie know a bit about meds > I don't see where buying them from a different country has any impact on > whether or not you can split the tablets, though. It is done fairly > frequently stateside. Some insurance plans and our state's medicaid > require it in certain situations, and certainly it's not unheard of among > cash customers here. his doc will NOT write for any dose other than what he actually takes per day... when he had drug coverage..once the doc wrote for 40 mg tabs..take half a tab per day..insurance co only gave him 15 pills!! >> do I expect my govt to foot the bill for his meds??? apparently not >> [quoted text clipped - 3 lines] > or are you convinced of it through hearsay or what the talking heads may > have said? again...as an NP I get a load of journals..have a bunch of working friends..and until recently..worked myself...I know the facts... > It is far from perfect, and another budget-busting entitlement program > (Would you expect any less from the gov't?) but, like it or not, I've seen [quoted text clipped - 14 lines] > matter of time, that we will go to a nationalized health care system, and > I don't see that as a good thing. On Sat, 17 Jun 2006 18:07:26 +0000, Hawki63 wrote: > don't know what you are paying for gas....we are paying $3.30 per gallon > [quoted text clipped - 3 lines] > at Walgreens.com Pravachol 20 is 83.99 per 30 close to $3 per pill or > 40mg for $119....$2 per pill... Ok, sorry. ~0.58 gallons of gas splitting the generics... > not to mention the others he is on...all adds up > [quoted text clipped - 7 lines] > apparently you missed the special on Dateline...just as likely to get > counterfeit meds here in the USA.... No, I don't watch Dateline, and wouldn't take anything from such a show as gospel anyway without having alot more details than they tend to provide. Besides, like I said, I don't care where you, or anyone, get their meds from, and counterfeits are just one issue. I just don't think its right that the people who order meds from elsewhere want to call a local shop to have any questions or concerns addressed, etc. Most community pharmacists are busy enough with actual customers. > don't need questions answered...am an NP..so can write > scripts..ie know a bit about meds Good for you. You save money purchasing elsewhere, are willing to assume any additional risks, and don't need any assistance from a local pharmacy. More power to you. >> I don't see where buying them from a different country has any impact >> on whether or not you can split the tablets, though. It is done fairly [quoted text clipped - 4 lines] > his doc will NOT write for any dose other than what he actually takes > per day... No, I suppose not. Does CA state law prohibit the pharmacist from substituting #15 pravastatin 40mg tabs if the Rx is written for Pravachol 20mg QD #30? > when he had drug coverage..once the doc wrote for 40 mg tabs..take half a > tab per day..insurance co only gave him 15 pills!! Yes, that is standard practice. There are some plans that do charge lower copays for tablet splitting in specific cases if the pt chooses to do so, but those plans are not the norm. >>> my concern was that the part D is pretty much a scam... >> [quoted text clipped - 4 lines] > again...as an NP I get a load of journals..have a bunch of working > friends..and until recently..worked myself...I know the facts... What facts do you know that show MPD to be a scam, or even "pretty-much a scam"? > On Sat, 17 Jun 2006 18:07:26 +0000, Hawki63 wrote: > [quoted text clipped - 26 lines] > No, I don't watch Dateline, and wouldn't take anything from such a show as > gospel anyway without having alot more details than they tend to provide. actually it was a fascinating expose...prior to seeing it (you can get the transcript at ABC.com) I would have agreed with you...that "we" Americans buying our meds at brick and mortar places were "safe" from counterfeits...apparently we are not... BTW....mucho details provided on the hour long show...scarey...actually > Besides, like I said, I don't care where you, or anyone, get their meds > from, and counterfeits are just one issue. I just don't think its right [quoted text clipped - 23 lines] > substituting #15 pravastatin 40mg tabs if the Rx is written for Pravachol > 20mg QD #30? not sure.....have not tried it...but since the 15 would still cost one month copay..why bother?? >> when he had drug coverage..once the doc wrote for 40 mg tabs..take half a >> tab per day..insurance co only gave him 15 pills!! > > Yes, that is standard practice. There are some plans that do charge lower > copays for tablet splitting in specific cases if the pt chooses to do so, > but those plans are not the norm. ahhh...didn't think ours did that...copays are for a month supply..not number of tabs...so unless med is a PRN type...one gets enuf medication for 30 days..regardless of half or whole pills >>>> my concern was that the part D is pretty much a scam... >>> [quoted text clipped - 8 lines] > What facts do you know that show MPD to be a scam, or even "pretty-much a > scam"? my facts came from reading the brochures that deluged our home prior to part D starting....still cheaper to buy his meds in England...no monthly premiums..no donut hole....believe me I did the math... NOW...agreed that if he was a transplant patient on immunosuppressants..etc..than part D would be cost effective... On Sat, 17 Jun 2006 21:24:16 +0000, Hawki63 scribble the following note: >>> don't need questions answered...am an NP..so can write >>> scripts..ie know a bit about meds Probably not. NP's a clueless and don't have nearly the background to prescribe. I'm in favor of removing th e rpescribing rights of Nurses. More than half the medicine orders from Nurses have some kind of error. Ruben > On Sat, 17 Jun 2006 21:24:16 +0000, Hawki63 scribble the following note: > [quoted text clipped - 4 lines] > prescribe. I'm in favor of removing th e rpescribing rights of Nurses. > More than half the medicine orders from Nurses have some kind of error. sorry about that you should only know how many doctor written orders are found and corrected before very serious errors are made ....esp in teaching facilities where VERY inexperienced folks with "doctor" after their names are doing the patient prescribing we NP's are far from clueless...don't know what you consider "necessary background"...sound more like you are among the jealous pharmacists out there "removing the prescription rights"....dream on.. > Ruben On Tue, 20 Jun 2006 01:26:12 +0000, Hawki63 scribble the following note: > we NP's are far from clueless.. Not that far... On Sat, 17 Jun 2006 21:24:16 +0000, Hawki63 scribble the following note: > my facts came from reading the brochures that deluged our home prior to part > D starting....still cheaper to buy his meds in England...no monthly > premiums..no donut hole....believe me I did the math... No you didn't do the math because the price of Meds after the Medicare Part D have escaled, both at home and internationally. For Pharmacy companies, Medicare Part B is only an excuse to raise prices until the point where without it, you'll be bankrupt. In this regard, they are also squeezing foriegn countries. In addition, such nations have limited formularies. Ruben > On Sat, 17 Jun 2006 21:24:16 +0000, Hawki63 scribble the following note: > [quoted text clipped - 9 lines] > squeezing foriegn countries. In addition, such nations have limited > formularies. your statement above makes NO sense....do you mean part D or part B?? an excuse to raises prices?? my statement stands...part D is a scam.... > Ruben On Tue, 20 Jun 2006 01:28:00 +0000, Hawki63 scribble the following note: > your statement above makes NO sense....do you mean part D or part B?? > > an excuse to raises prices?? > > my statement stands...part D is a scam... Your basic lack of understanding of drug therapy and medical economics doesn't make your "statement stand". Ruben > On Tue, 20 Jun 2006 01:28:00 +0000, Hawki63 scribble the following note: > [quoted text clipped - 6 lines] > Your basic lack of understanding of drug therapy and medical economics > doesn't make your "statement stand". I understand medical enconomics far better than you think as for "drug therapy:...care to elaborate??? or are you one of those pharmacists (who undoubtedly have a much better scientific knowledge of pharmacology than an NP does)...still think that prescribing a med is akin to picking an item of clothing..or perhaps a car pharmacists..or at least many of them..(you?) fail to acknowledge that picking the appropriate med comes AFTER a thorough exam and history taking of the patient.. have never gotten a straight answer from a pharmacist as to HOW they think THEY are qualified to examine etc a patient...you can't ..I can other pharmacists think the system should work by ME doing the exam and assessment..including appropriate diagnostics..then YOU choosing the appropriate drug...that might work in a collaborative setting...but remember..it is MY malpractice that must cover EVERYTHING involved in a patient interaction...if YOU choose the med....I am responsible for YOU... personally I refuse to be responsbile for someone else.. it IS your responsibilitiy to fill my scripts...if I make an error..in dosage,,etc..it IS your responsbility call me and discuss the error... them's the breaks...we have vastly different..but collaborative roles in the healthcare system... you do not see the patients in the exam rooms...I do.. > Ruben > > On Fri, 16 Jun 2006 00:13:36 +0000, Hawki63 wrote: <Snip> > myself...age 61...have extended Cobra coverage...currently costing me $944 a > month...still with significant copays and coinsurance...so yes...am paying > my share Ouch ! $944 a month. You must live in NY or California. In a poor State like Mississippi, I don't see how that insurance would even fly. I think the average income for my area is only about $24,000 a year. Yet these chain drug stores are paying over $100K a year for a full time Pharmacist. When I was first working as a pharmacist I moved to Michigan to get better pay. Now it seems that Mississippi is paying their pharmacists well but I am too sick to work! The cost of living is less down here especially if you can live way out in the country like I do. Zocor statin is due to become generic very soon. It works for me and will become a lot cheaper. The Medicare drug plan has saved me a lot of money. I am paying $66 a month for Healthspring Rx coverage. My drug bill went from cash of $500 a month to about $130 a month. I didn't know you could get medication from England. I have purchased it from Canada and I know that there are on-line Israel Pharmacies. >> > On Fri, 16 Jun 2006 00:13:36 +0000, Hawki63 wrote: > <Snip> [quoted text clipped - 17 lines] > sick to work! The cost of living is less down here especially if you can > live way out in the country like I do. how did you guess?? California...median price of homes over 600 K in our county > Zocor statin is due to become generic very soon. It works for me and will > become a lot cheaper. The Medicare drug plan has saved me a lot of money. > I > am paying $66 a month for Healthspring Rx coverage. My drug bill went > from > cash of $500 a month to about $130 a month. so far he cannot take Lipitor or Zocor due to AE.... > I didn't know you could get medication from England. I have purchased it > from Canada and I know that there are on-line Israel Pharmacies. www.mastersmarketing.com > Hi, > [quoted text clipped - 7 lines] > plans usually yields many medicare related queries, and others are > related to group health plans! Very frustrating. sorry if I misread.... I saw Medicare in the above paragraph ..and mistakenly figured he was looking for a medicare rx plan.... he also did not mention that he was self employed tho > Kyle |
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