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Author Topic: Insurance "doughnut hole" vs generic drugs  (Read 3019 times)

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Offline justo hernandez

  • Member
  • Posts: 4
Insurance "doughnut hole" vs generic drugs
« on: April 14, 2008, 05:45:26 PM »
Today's paper has a forbidding article about insurance drug rates.  Medicare started the tier pricing system for use by supplement insurance companies for those on Medicare.  The mainstream healthinsurers like it so much that they are adopting it into their plans.  Drugs will be placed on a tired level of 1 to 5 and you will start paying a percentage instead of the 10, 20 35 dollar etc co-payment.  It will range from 10 to 30% of the retail cost of your prescription.  Combivir which retails for about 700.00 will be a tier 4 or 30% co-payment. That's over 200.00 dollars. Then thiers the doughnut hole along witho this where you must pay full retail price for 3 to 4 months, if your on Medicare.
Some of the HIV/Aids drugs are now being offered as generics.  But of course they are not available in the states but must be ordered from Canada or England.  There are dozens of sites on the net of pharmacy's offering Combivir and the cost ranges are dramtically cheaper. IE 300.00 for 3 months.  So it would be cheaper to just pay the online retail price for a year.
But there is absolutely no rescourse information on them.  No list of recommendations for reliable and safe Pharmacies.  I have emailed over 50 advocacy groups across the country and not one of them can supply me with a name of an Online pharmacy.
UCSF thinks it's a great idea for looking into but that all.  Everyone empathises with people like me caught in the doughnut hole of Medicare/AARP etc but can not give me a recommendation.   
Shouldn't someone pick up on this overlooked area of care and start a list. Does anyone have any experience in buying ONLINE Canadian Comibivir etc,  if so please let me know your source and experience.

Offline bearby

  • Member
  • Posts: 41
  • April 2007
Re: Insurance "doughnut hole" vs generic drugs
« Reply #1 on: April 16, 2008, 10:47:51 AM »
I have read many articles about buying meds from other than the reccommend places and am in agreement with most of them about the quality of  the meds .
 I agree with them because for one thing since the us has such strict guidelines for  hiv/aids meds that one can never know exactly what one will be getting from other places  things rangng from placebos to baby laxative therefore using  places other then those recommended  should be taken with a grain of salt because  what  you might be getting across the lines could be an actual med but then on the other hand what  you get might make you even far worse off ( yes both  physically and out of pocket ) .
 Now have you ever bothered to check in to  pparx ?
I know that I made use of it last year after jumping thru all the hoops to be able to get my meds for free directly from the med manufacturer's and altho I had to make  monthly trip to the hospital to get them it was well worth the efforts and all the hoops that I had to jump thru to get them.
 http://www.ppparx.org should take you to the web site then just read read and then read some more to find  any or all of the meds that ya take and  print out the needed paperwork then head to the fr and get all this signatures needed and that should take care if your dilemma .
Have you preformed your random act of kindness today ?

Offline bearby

  • Member
  • Posts: 41
  • April 2007
Re: Insurance "doughnut hole" vs generic drugs
« Reply #2 on: April 16, 2008, 10:51:55 AM »
hummm .
 For some reason when I went to the web site that  I posted I got  some place that I have  never been to before so I went off site and checked again abd got the correct one .
 I hope every ting works out for ya bud !
Have you preformed your random act of kindness today ?

Offline ZCorker

  • Member
  • Posts: 48
Re: Insurance "doughnut hole" vs generic drugs
« Reply #3 on: April 27, 2008, 01:08:15 AM »
I am shocked to find out about what Medicare is doing.  I thought congress was going to fix the donut hole and it looks like they fixed it ok.  Would it do any good for me to contact anyone in congress?  What is the name of the provision that amends Medicare and that requires you to pay these out of pocket costs?  Feel free to ICQ me with the info.

ICQ 118179171

Offline vivyt

  • Member
  • Posts: 565
Re: Insurance "doughnut hole" vs generic drugs
« Reply #4 on: April 28, 2008, 08:15:36 AM »
Is it only Medicare that is doing this? Are ALL insurance companies changing? I have not heard anything from mine.

Offline aztecan

  • Member
  • Posts: 5,517
  • 32 years positive, 60 years a pain in the butt
Re: Insurance "doughnut hole" vs generic drugs
« Reply #5 on: April 28, 2008, 10:38:46 AM »
I know someone whose private insurance has switched to this. He works for a national grocery chain.

His copay for his monthly Atripla is $422.

Keep an eye out. I don't know what incentives employers are being given to switch to such a plan, but probably include reduced premiums or at least premiums that didn't jump by double digits.

The greed of corporations knows no bounds.


"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)


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