Medicare and getting screwed!!!

I feel your pain but it's not Medicare's fault that the pharmaceutical companies are charging outrageous prices for our prescriptions. I understand that there is a small market for IBD drugs vs a cholesterol drug or something like that. Why does it cost $22 each for us to purchase a Canasa suppository! There is nothing generic as no other company is interested in making it because there is such a small market and there is no reason for Aptalis Pharma US, Inc. to lower their sales price as there is no competition. Tack on to that the enormous mark-up of the pharmacy before we receive it and it's more expensive than gold.

Back to your problem and soon to be my problem. I have no advice. I'm receiving Social Security Disability so am on Medicare but have my prescription plan with my husbands insurance plan. When he turns 65 I'm going to have to buy a Plan D too. I don't have any idea who will even sell me one as my monthly prescription drugs cost more than my monthly social security disability benefit is. I pay more than $3,000 a year now so while it is a large amount for you to pay it seems like a great price for a drug plan to me.

I understand the commercials where they discuss elderly people having to decide about purchasing their prescriptions or food. Where they only use half of their medications because of the prices. I can't pass on the Canasa because I have chronic cuffitis. I'm thinking about trying to figure out how to manufacture my own. (It's Mesalamine and hard fat base...... per the package insert.)

Anucort, is only about $15 a month. Have you tried that? It doesn't do much for my cuffitis.

I hope someone has good suggestions for you.

I haven't tried Anucort, but think I might consider calling the doctor for a prescription before I change my insurance company.

Right now I'm not even sure that the Canasa is helping me. I've been on them for almost a month and the inside of my anus is very sore. I'm beginning to think that I have a fissure as well. In actuality, I don't know what the heck is wrong, so all of these meds could be just being thrown into the toilet, literally!!!

Thanks for your suggestions.

Anucort has hydrocortisone in it and it takes down my inflammation faster than canassa. If I am experiencing a lot of inflammation I use it instead of canassa. Neither one stops it in the long run just as Asacol that contains mesalamine, like canassa, didn't work in the long run for my UC and etc.

It's all just symptom treatment at my stage, like it has been since before I was diagnosed and I was treating my pain with the worst thing, ibuprofen!

Hopefully it will help - I'd say it couldn't hurt, but I'm an accountant and not a medical professional. It is a sin what the pharmaceutical companies charge ill people and canassa isn't even that expensive, relatively speaking. We should count ourselves lucky that we are not on a biologic.

Thanks so much for your comments. I just called the doctor for a script for the Anucort and also something for what I think is a fissure. At least I'll be able to check the drug out before I switch insurance companies. Hopefully it will work, and maybe I won't need the canasa. As I said before, I'm not sure what works on me any more. I swear I just take the meds and hope it helps whatever is bothering me at the time. It's almost like the blind leading the blind.

I left you a pm a few weeks ago, not sure that you ever received it.

Hope things are going better for you!!

I checked for my zip code, and Canasa is on the Medicare formulary. I presume that you intend to get Medicare supplemental insurance? Generally, they work in tandem with the Part D drug coverage. My husband and I retired this year and do not yet qualify for Medicare, and it was actually more cost effective to buy COBRA coverage than the marketplace. We have a $3000 deductable that I always eat up in the first month of the year. Then we have copays adding up, but the out of pocket cap is $6000 (excluding premiums). For us, health care is and will be our primary issue.

Who ever dreamt up the donut hole concept makes me crazy. Fortunately for most, they don't land there. All I can suggest is to sock away money for that period, because you are OK once on the other side. Did you check this website for your drug coverage options? There is a tool for figuring out which Part D Plan to get (there are several) http://www.medicare.gov

Another option is oral mesalamine, if you really think you need it. We have to keep in mind that our doctors have mo idea what our coverage and financial challenges are. But, most docs are sensitive to them and are willing to work with us.

Jan

I am 74 and have a part time job to pay for my "drug habit". I spend 1/2 the year, every year, in the donut hole where Medicare rests from its responsibility for paying for my meds. I typically spend up to $500 a month out of pocket from July through December for my meds AND I never seem to reach the ceiling when Medicare kicks back in and covers 100% of the cost of my meds. Guess I should be grateful I can still work and have a job! Oh, it also helps to pay for my Medicare supplement which is considerable since I have a PPO....my choice, I know!

I hit the donut hole end of September. I take two insulins. Would have had to pay 1,129.00 for one and 488.00 for the other. That is for only 30 days. Found out in NY we are considered uninsured and can get EPIC for help. I now pay 20.00 for each for 30 days. Don't know if this is available for other states. Sure saved my butt. This donut hole thing is crazy. I hate to even think of the number of elderly that Can't pay for their meds.

Consider meeting with a health insurance broker-they can help you explore various Part d plans in your area, along with exploring possibilities of buying a Medicare supplement which might help out with drug coverage as well or possible MEDICARE advantage options.

As part of the AFFORDABLE CARE ACT ("Obamacare" legislation) the donut hole has been slowly closing since 2010 and will continue to shrink for 6 more years. You can learn more about discounts you may be eligible for brand name and generic drugs, and the good news is that the discounts still count towards your out of pocket on your way to getting out of the donut hole.

http://www.medicare.gov/pubs/pdf/11493.pdf

Thanks for all of the information. I knew the donut hole was phasing out but also think the Plan D insurers ask for a list of your medications before quoting rates.

Medicare sends an annual "book" that lists the medical plans available in each of our counties.

Good news (imagine sarcastic tone) I heard that social security is increasing benefits 1.3% or so.

Looks like a lot of us are in the same position! I guess when one has a "drug habit" it gets to be very expensive. I appreciate all the information from everyone.

I have been in contact with a program called Shine. Don't know if that's a country-wide program or just one in Massachusetts. They do a formulary for the drugs that you take and then suggest the Medicare program for drugs that best supports your needs, and they've been very helpful as well. Unfortunately, I had no idea of the expense of some of these drugs since I had been covered very well by my existing health insurance. The co-pays were never more than $70 for a three month supply. I got hit in the head when I found out that some of my drugs were going to be out of sight. Will definitely check out the AFFORDABLE CARE ACT. Hopefully that will be something that will be very helpful.

Don't know what I'd do without this site. It's just a wealth of information for everything. Thanks to everyone for your input!