Pebble Beach, CA : Prescription Specialty Tier Drug Costs Can Be Devastating : Caregiver View

Article by Richard Kuehn

Pebble Beach, CA : Prescription Specialty Tier Drug Costs Can Be Devastating : View From A Private Duty Caregiver Serving, Carmel, Carmel Valley, Carmel-by-the-Sea, Gilroy, Gonzalez, Greenfield, Hollister, King City, Marina, Monterey, Pacific Grove, Pebble Beach, Salinas, San Juan Bautista, Seaside & Soledad California

The cost of prescription drugs can be devastating. At Family inHome Caregiving, we have seen many of our senior Clients reporting co-pays doubling, tripling and quadrupling. In the unfortunate event that they need some type of experimental treatment, Medicare often won’t even pay for it. And the cost of drugs being placed on “specialty tiers” (rare drugs which are normally new to market and very expensive) can really break the bank. I have written before on my blog about the importance of filing for Medicare as soon as you are eligible because there is a penalty if you don’t. So even if you continue to work past your retirement age and have insurance through your employer, filing for Medicare makes sense. But even that may not be enough insurance if you require specialty drugs. USA Today on August 23 profiled 63 year old Judy Ariba who has a rare form of leukemia and saw her prescription cancer drug soar from $ 10 to $ 1,700 per month after her employer switched to a new health plan requiring employees to pay 25% of the cost of prescriptions. Such plans, unfortunately, are becoming increasingly common as companies move to slash costs, including employee benefits. Surveys show that 17% of employers have added a specialty category to their drug plans in order to reduce costs. For seniors, the problem is often more difficult. About 85% of Medicare drug plans include such tiers, according to Avalere Health. Ms. Ariba’s cancer treatment, Tretinoin, costs almost $ 7,000 per month at retail. “No one has $ 1,700 a month,” Ms. Ariba told USA Today. “I’ve gone through all this, and now I will get sicker and die,” she told the reporter. One question is what is going to happen if President Obama’s health care reform law passes. Lawmakers in a dozen states are already proposing barring or restricting specialty drug tiers. At the national level, the government is going to have to decide what it will require of those selling plans via the online auctions when they start in 2014. Already, five drugs in this specialty tier category are among the top 10 welling drugs worldwide by revenue, so something must be done to address this problem. People shouldn’t be dying because their drug plan is increasing out of pocket expenses, particularly those on Medicare.

About Richard Kuehn & Family inHome Caregiving of Monterey:After more than a decade of caregiving, both in a professional environment and for a 97 year old family member I was dissatisfied with service from local caregiving agencies. I became convinced of the need for a service which provides very personal assistance to the elderly and founded Family inHome Caregiving serving the Monterey Peninsula. Please visit my blog where I talk about important senior issues at:

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