A Medicare Part D horror story

Old Texas Reb

Member
Jul 17, 2018
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I have mild bronchiectasis (basically chronic bronchitis) and have been managing very well using an albuterol inhaler. This spring, my pulmonologist suggested that I add Spirivia to this since that medication reduces the amount of mucus the body produces. I did this and it did improve the condition quite well.

Like most of us on Part D, my main focus was on the copay. When I got my last monthly statement from United Health Care, I was shocked to see that I was only a few hundred dollars short of hitting the "donut hole" in their coverage. When you are in the donut hole, you pay 35% of the "suggested" drug cost. I only take 4 other prescription drugs that aren't that expensive. I got on the phone with them and shortly figured out the problem - Spirivia.

Coverage is figured on "total drug costs" which is the suggested drug cost that the pharmacy charges to uninsured customers. My other medications weren't that much higher than the copay but Spirivia was through the roof! The CVS price for Spirivia was $429.04 meaning my copay would go from $42 to $150 each for the rest of the year.

Luckily, there was a workaround for the situation. Atrovent (a medication similar to Sprivia) is available in liquid ampules to use in a nebulizer. A box of 50 ampules (25 day) supply costs less than $8 at CVS, the nebulizer with mask I bought for about $35 on Amazon. I'll start using this method in about 6 weeks when my Sprivia runs out.

Why the huge difference? The nurse practitioner at my doctor's office explained that the German company making Sprivia has a patent on the DELIVERY DEVICE (inhaler), not the medication. That's how they are hosing the consumer.. For your own sake, if you are on Part D, check your monthly statements carefully to make sure you don't get blindsided by an expensive medication you're taking that could be replaced with a cheaper equivalent.
 
Obama should have left health care alone...he screwed it up good....
 
Moron Part D was Bushes the donut hole closing little by little Obama.
Moron...part D was working great with praise from medicare patients...until Obama fucked it all up....moronic simpleton....

How did he fuck it up? You are one big fucking simpleton.
come on boy lay out the ground work of the transition from bush to obama on Part D. You best do some research before putting pud in mouth.
 
How did he fuck it up? You are one big fucking simpleton.
come on boy lay out the ground work of the transition from bush to obama on Part D. You best do some research before putting pud in mouth.
He caused the cost of health insurance to triple and ran thousands of doctors into early retirement you fucking stupid freak.....He ruined what was the best healthcare system in the world and changed it into a healthcare welfare program....
 
How did he fuck it up? You are one big fucking simpleton.
come on boy lay out the ground work of the transition from bush to obama on Part D. You best do some research before putting pud in mouth.
He caused the cost of health insurance to triple and ran thousands of doctors into early retirement you fucking stupid freak.....He ruined what was the best healthcare system in the world and changed it into a healthcare welfare program....

We were discussing Part D of Medicare, now tell me how he screwed that up? You cannot seem to stay on subject.
 
We were discussing Part D of Medicare, now tell me how he screwed that up? You cannot seem to stay on subject
By raising the cost of everything and placing government ordered limits on drug reimbursement....I know people that can not get the medication their doctor ordered for them due to cost and they earn too much for federal assistance...but we have always known that Obama needed the rich hated the middle class and took from them to cover the poor.....when you tinker with one end of a snake the other end will respond....too bad you and Obama are too stupid to recognize that....
 
We were discussing Part D of Medicare, now tell me how he screwed that up? You cannot seem to stay on subject
By raising the cost of everything and placing government ordered limits on drug reimbursement....I know people that can not get the medication their doctor ordered for them due to cost and they earn too much for federal assistance...but we have always known that Obama needed the rich hated the middle class and took from them to cover the poor.....when you tinker with one end of a snake the other end will respond....too bad you and Obama are too stupid to recognize that....

You could go back pre Medicare act of 2003. Obama slowing closing the donut hole. Pre 2005 or 06 senior's paid full price for drugs, they no longer do that. He screwed nothing up pertaining to Part D only made it better. If you want to blame someone for some drugs not covered or taken from tier 1 to tier 4 for senior protection's you can blame CMS, bush, obama and trump.
 
You could go back pre Medicare act of 2003. Obama slowing closing the donut hole. Pre 2005 or 06 senior's paid full price for drugs, they no longer do that. He screwed nothing up pertaining to Part D only made it better. If you want to blame someone for some drugs not covered or taken from tier 1 to tier 4 for senior protection's you can blame CMS, bush, obama and trump.
The costs of drugs and the cost to insure oneself tripled due to Obamacare...you can put your head in a cloud but it doesn't change that fact...it should not cost $1300 to $1600 to insure one person for a month....its more than tripled and drugs costs and hospital costs have risen right along with it....Obama took it and ruined it....Maybe you are not burdened with it because you have coverage through your husbands work....if that's the case you should do some homework and actually speak with people that fall under the assistance mark....and see how they are fairing before you call someone that knows more than you a moron....
 
You could go back pre Medicare act of 2003. Obama slowing closing the donut hole. Pre 2005 or 06 senior's paid full price for drugs, they no longer do that. He screwed nothing up pertaining to Part D only made it better. If you want to blame someone for some drugs not covered or taken from tier 1 to tier 4 for senior protection's you can blame CMS, bush, obama and trump.
The costs of drugs and the cost to insure oneself tripled due to Obamacare...you can put your head in a cloud but it doesn't change that fact...it should not cost $1300 to $1600 to insure one person for a month....its more than tripled and drugs costs and hospital costs have risen right along with it....Obama took it and ruined it....Maybe you are not burdened with it because you have coverage through your husbands work....if that's the case you should do some homework and actually speak with people that fall under the assistance mark....and see how they are fairing before you call someone that knows more than you a moron....

You can't seem to grasp Part D is not Obamacare and drugs are still going up for under and over 65 people.
 
You can't seem to grasp Part D is not Obamacare and drugs are still going up for under and over 65 people
Debbie what do you think Obamacare is?...just an alternative healthcare plan?...its not it has changed the rules for doctors insurance companies hospitals and pharmaceutical companies...like I said do some research before you speak on a subject you know little about....the regulations within have increased drug costs and ruined what part D tried to fix....Trump has at least shamed the drug companies from raising costs at this time until a fix for Obamacare can be implemented....give him credit for that?.....no I bet you won't...
 
You can't seem to grasp Part D is not Obamacare and drugs are still going up for under and over 65 people
Debbie what do you think Obamacare is?...just an alternative healthcare plan?...its not it has changed the rules for doctors insurance companies hospitals and pharmaceutical companies...like I said do some research before you speak on a subject you know little about....the regulations within have increased drug costs and ruined what part D tried to fix....Trump has at least shamed the drug companies from raising costs at this time until a fix for Obamacare can be implemented....give him credit for that?.....no I bet you won't...


Have you worked in the insurance business for 25 years? Then tell me what you have learned. I'll wait.
 
Have you worked in the insurance business for 25 years? Then tell me what you have learned. I'll wait
I've battled to provide healthcare for my employees for 25 years...and Obamacare almost put us out of business and cost us 10 valued employees without providing better care for any of them...and it also contributed to the death of my neighbor and good friend due to lack of approved treatment....treatment he had before Obamacare....take the Obama blinders off lady and wake up........the media is hiding the truth from you...
 
Have you worked in the insurance business for 25 years? Then tell me what you have learned. I'll wait
I've battled to provide healthcare for my employees for 25 years...and Obamacare almost put us out of business and cost us 10 valued employees without providing better care for any of them...and it also contributed to the death of my neighbor and good friend due to lack of approved treatment....treatment he had before Obamacare....take the Obama blinders off lady and wake up........the media is hiding the truth from you...

Again, obamacare and Medicare Part D are not the same thing. Blame the insurance company for your neighbors approved treatments being cut off and throw in his provider that either said "it won't do him any good in the long run or did not file the correct codes to get the treatments approved. I thought maybe I'd been in the wrong thread and rechecked, sure enough this thread is about Medicare Part D.

You might have served your employees better if you dropped the group insurance and let them (maybe some) receive a subsidy.
 

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