After weighing the specific plans available to them under the new benefit, some seniors are concluding that they'll end up paying more for the medications they currently take than if they continue with no coverage at all.
Taking into account monthly premiums and copayments--which under some policies can run as high as 33% to 75% of a drug's retail--seniors think they can get a better or equal deal doing what they've always done: asking doctors for samples, buying generics and ordering from pharmacies abroad.
Both Medicare and the federally subsidized health plans offering the drug benefit suggest seniors use their current list of drugs to calculate their best option. Medicare's online drug-plan finder sorts and compares plans for them the same way. However, making a decision based only on current needs could prove costly because it doesn't take into account future conditions.
In November, I calculated the best option for the drugs I was purchasing monthly and choose a plan effective January 1, 2006. When I went to the pharmacy to purchase the drugs, one prescription drug was disallowed by the health plan's authorization computer. Come to find out, in early-January, Medicare decided that the drug would no longer be covered under their drug benefit plan---leaving me little choice but to pay for the prescription drug at the full retail price of over $100 per month or attempt to find a non-prescription alternative.
It is suggested that everyone considering this government-sponsored program take a close look at the drug lists and then double check to determine if the drugs listed in the plans are now actually covered by Medicare. The devil is in the details of any government-sponsored health care program.
Source: The Wall Street Journal, February 21, 2006