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Old 01-25-2016, 07:00 AM
 
Location: Coastal Georgia
37,155 posts, read 45,704,508 times
Reputation: 61887

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Quote:
Originally Posted by Robyn55 View Post
Now that is really funny for someone like me who has been wearing glasses since age 7 or so .

Note that there is hope for you . When you need cataract surgery (and you will need it unless you die pretty young) - you can get a lens implant that will correct your vision back to where it was when you were a kid (OTOH - last time I looked - Medicare didn't pay for these new zippy lenses ). Robyn
Actually, DH and I were told that laser surgery, done at the same time as cataract surgery is covered by Medicare. He has worn glasses his whole life, so eagerly awaits this.
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Old 01-25-2016, 07:09 AM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,950,422 times
Reputation: 6717
Quote:
Originally Posted by biscuitmom View Post
ER, if you had been following the ups and downs of prescription drugs the last several years, you'd know that their cost is about more than insurance.
I'm on 3 prescription meds - thyroid, statin, hormone. The 1st two are relatively stable in price but the hormone over the past several years has ranged from a co-pay of $40 quarterly to $280 quarterly - with no relation to our insurance plan (we've had several). It continues to this day to wildly fluctuate, in December the co-pay was $80.

DH and I have discussed this at length with our MD, pharmacist, and various insurance providers and long story short, it's all about how US drug companies follow a policy of chasing short term profits, complicated by US patent issues, which creates artificial shortages. These seem to be issues mainly in the US. Prices in other countries remain stable for the same drugs manufactured by the same companies.
I can afford and live with the wild cost fluctuations for my hormone med. The tragedy is that these same conditions affect life-threatening drugs.
I have found little rhyme or reason to the pricing of various drugs. Seems like different drugs all have different stories.

When it comes to statins - many are extremely cheap (mine costs about $1/month under my Part D plan). But a new very expensive alternative to statins just came out:

New cholesterol lowering drug much more expensive than statins | Fox News

Whether this new drug makes sense for any particular patient? I don't know.

Female HRT has been under attack from the medical establishment for a long time. And it is taking its toll on the availability of these drugs on Medicare Part D formularies. This year - AARP UHC dropped Premarin tablets from its formulary. The remaining tablet on the formulary - Estradiol - is only available with prior authorization - comes with a high risk warning - and is a "class 3" drug (monthly co-pays of $23).

A drug like colchicine (Colcrys) - which I take - has its own somewhat unusual story:

Colchicine price increase: how drug companies are taking advantage of the FDA's Unapproved Drugs Initiative.

Where the FDA seems at least partially responsible for the huge price jump.

Note that I have heard doctors starting to complain about the crazy quilt of (ever changing) prices when it comes to various groups of drugs. Ranging from antibiotics to topical dermatological meds. I recently needed one of the latter. The list price of the drug my doctor prescribed was ridiculous. But I was able to find a great hugely discounted price/coupon on this website:

Prices, Coupons and Information - GoodRx

Note that the price was only available at one local pharmacy that I had never used before (CVS). But - since I wound up saving > $150 using the coupon - it made sense to shop around.

I think the bottom line is that everyone - patients and doctors - has to start paying more attention to drug prices so we don't wind up with sticker shock when we go to fill our prescriptions. Robyn
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Old 01-25-2016, 07:27 AM
 
Location: Asheville NC
1,612 posts, read 1,317,837 times
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My co pay for Estradiol with Cvs Silverscripts part D is less than $5.00 for three months supply. It is the only med I take so far. I don't know if it has to do with zip code. Many of my husband's meds have no copay at all.
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Old 01-25-2016, 08:18 AM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,950,422 times
Reputation: 6717
Quote:
Originally Posted by funisart View Post
My co pay for Estradiol with Cvs Silverscripts part D is less than $5.00 for three months supply. It is the only med I take so far. I don't know if it has to do with zip code. Many of my husband's meds have no copay at all.
Premarin isn't covered by this plan - same as AARP UHC. Robyn
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Old 01-25-2016, 08:23 AM
 
Location: Asheville NC
1,612 posts, read 1,317,837 times
Reputation: 4203
Quote:
Originally Posted by Robyn55 View Post
Premarin isn't covered by this plan - same as AARP UHC. Robyn
My plan has Premarin. But it is very expensive. So I changed to what my doctor takes herself. No problems --now all hrt's com with high risk warnings for those over 65. The Dr does have to do some paperwork saying it is medically necessary.

Last edited by funisart; 01-25-2016 at 08:28 AM.. Reason: Add
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Old 01-25-2016, 10:26 AM
 
Location: Toronto, Ontario, Canada.
2,540 posts, read 3,277,305 times
Reputation: 6774
Robyn.


You asked some very insightful questions, about how Ontario deals with seniors who need to have expensive drug therapy. Here is a link to the Ontario Ministry of Health website about that subject. I think that it will answer many of your questions.


link. The Ontario Drug Benefit (ODB) Program - ODB for seniors- ODB if you live in a Long-Term Care homePublic Information - MOHLTC


Note the line about what happens when a person in Ontario reaches age 65. That is a huge difference between our system, and the US.


A few points about how health care works in Canada.....


It is Universal, which means that everyone who is either a Canadian citizen, or a legal Permanent Resident in Canada is covered. There are no restrictions about age, race, income or a lack of it or "pre-existing conditions " . You cannot be denied service. No one can be "cut off ". We ALL PAY FOR IT through our incomes taxes, and when we buy things that have a sales tax on them. Even people who are "low income " help when they buy things that have a sales tax on them.


Each of the 10 Provinces and 3 Territories operate their own system, under the general guidelines et out in the Canada Health Act , which is Federal legislation. Canadians may, if they choose to do so, buy private extended health insurance, that covers things that the Provincial program doesn't cover, like dental, eyeglasses, and chiropractic. My wife is a retired employee of the University of Toronto, and as a part of her pension benefits, she has a wide ranging coverage from Greenshield, for a fixed cost of $ 90 a month, for the rest of her life. As her spouse I am also covered in that plan.


I was born in Canada, and I in all my years here, I have never , ever been given a bill for hospital services. I have paid for a rental TV in my room, and before I had a cell phone, I paid for a phone in my hospital room. Because we have a single payer system ( which is the Provincial or Territorial Government ) we never see a bill, for hospital, laboratory, Doctor services, and or other required medical service. Obviously, a MD in Canada doesn't need to have a collection clerk, as they are paid by the Provincial Ministry of Heath, 60 days after they submit their monthly billing, by electronic means. They are also paid by electronic payment, too. Did I mention that mal practice insurance in Canada is about on tenth of what it costs in the USA ? Why ? Simple, if you sue some on in Canada, and you loose, YOU pay your costs, plus theirs, as well. That keeps the stupid stuff out of the court system.


In June of last year, my wife rolled our car in a rainstorm on the highway, when a car cut her off. She was seriously hurt ( fractured sternum, ribs, and neck cuts from the seat belt ). She took out one of those roadside information signs, as she went into the ditch. She spent 4 days in the hospital, the car was a write off and the sign cost about $3500 to replace. Our cost ? Zero.


The auto insurance paid for the towing, and the replacement of the information sign, they made a cash offer us to replace the 4 year old car, the EMS crew was covered by the OHIP benefits, the medical care at the Milton hospital was great, and covered by OHIP. The auto insurance policy, as required by law in Ontario, provided complete physio therapy, which is continuing to this day, and also provided a weekly house cleaner for six months. Brenda is also still getting weekly massage therapy, paid by our automotive insurance coverage. Did our car insurance policy increase ? Not at all.


If you were to suggest that any Canadian political party was going to do away with the health care coverage that we all enjoy here....it would be political suicide for them. Our system is NOT perfect, but it is certainly miles ahead of the mess that US citizens have to put up with.


Because we all contribute to the funding of our system, we know that it is going to be there when we need it.


Jim B.

Last edited by canadian citizen; 01-25-2016 at 10:37 AM..
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Old 01-25-2016, 02:19 PM
 
Location: The Carolinas
2,008 posts, read 2,022,107 times
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@Canadian Citizen. Sounds great. I have heard that under the Canadian health plan it can take some time to get in to see a doctor or that some tests (CAT scan)might take months. What has been your experience?
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Old 01-25-2016, 03:37 PM
 
6,653 posts, read 3,764,565 times
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Quote:
Originally Posted by Escort Rider View Post
Until a few days ago I had never paid more than $10 for a prescription drug. Then my doctor switched me to an extended release version of the same drug I had been taking, and the cost was $30. Three times cheap does not equal horribly expensive of course, but it is still triple the cost, so it caught my attention.

I do realize that talking drug prices is more about the medical coverage one has than about the actual prices of the drugs themselves on the open market. The prices cited above are my co-pays, and the $30 was for a three-month supply. Still, I used to get a three-month supply for $10.

I also realize that my topic may be of no interest to many folks because they are not on any prescription drugs, but I have a genetically substandard body in a bunch of respects and at 71 I have been on one drug since my 50's with a second one added four or five years ago. I don't like it, but it is what it is, namely a consequence of aging in my particular case. But I feel like a freak of nature.
Have you researched your drug to make sure the extended release is worth the extra cost? Extended release drugs are under investigation by the govt, some having been pulled off the market in recent years for being not as effective as their regular (cheaper) counterparts, not dissolving correctly, and other things.

Yes, I know that with age comes drugs and high cost. I already encountered that with my hormones. I had to give them up when I got on Obamacare, since the plans in my price range didn't cover my hormones (unlike birth control pills, which anyone can get for FREE!). Hormones are birth control pills taken for a different reason.

I will be one of those who resists taking drugs as I get older. I have so far, and will cont. to do that, taking them only when there is no other way to handle the issue (and after I have tried a holistic way). All drugs have side effects and mess with your system. Still, there are times when there is no choice, as long as it improves health, quality of life, or extends life significantly.
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Old 01-25-2016, 04:21 PM
 
Location: NC
6,575 posts, read 8,008,745 times
Reputation: 13495
Quote:
Originally Posted by canadian citizen View Post
Under our Federal law on prescription drug sales, there is a national "price list " that sets out exactly what the cost of each drug will be, to the retail buyer, at their local drug store. The only thing that varies is the small fee that the druggist can charge, for filling the prescription. Typically that fee is about $5 per script.

On average, the retail price of prescription drugs in Canada, compared to the same drug in the USA, is 50 to 80 percent less....

The Trillium Fund is directly funded by the Ontario Lottery and Gaming Commission, who operate the casinos and lotteries in Ontario. So, every two months when I get my infusion, I silently thank those who gamble, as they are paying from my medical treatment.
In addition to thanking those who gamble for keeping your prices low, you should also thank those in other countries who pay a higher, non-negotiated price, because they are bearing the brunt of the research and discovery costs. I would be all in favor of everyone world wide paying the same amount for the same thing. But we know that very poor countries would not be able to afford the higher prices, so that would not help fund the discovery of new drugs nor would it help the citizens of that country. That is why there is tiered pricing.

However, it wouldn't hurt if all the people in one country paid the same negotiated price, which would probably relate to how much business that country does with that drug company. The total amount paid to the drug company per year from all sources would need to remain the same, so some end up paying more and some less. If the US paid the same amount the Canadians paid in this example, the Canadian cost would need to go up to compensate for the US price going down. Living in the US, that would suit me fine.

Just out of curiosity, is it possible to know what part of your Canada taxes go to health care costs? The Canada system sounds pretty good, but in the US there is so much controvery over "Obama-care" that it is hard to imagine people accepting how much your system would raise their taxes.

Last edited by luv4horses; 01-25-2016 at 04:38 PM..
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Old 01-25-2016, 05:09 PM
 
Location: Tucson for awhile longer
8,872 posts, read 13,569,320 times
Reputation: 29034
It's utterly ridiculous that Medicare is not allowed to negotiate for the cheapest drug prices. It's something that needs to change. Anyone who is on Medicare and paying more than drugs would cost OTC in Mexico or Canada should NOT be voting for politicians in the pocket of the insurance companies and pharmaceutical industry.
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