• The KillerFrogs

Any insurance guys out there?

wes

wes

KIllerfrog Emeritus
It appears that I have crossed over into the coverage gap, which is a new term to me, but all of a sudden my meds are 3-4 times more expensive and the explanation I am being given is the coverage gap.

Can someone tell me what that is?

I’m lost
 
MadFrog

MadFrog

Active Member
It is called the doughnut hole. I am in the "initial stage" until I reach $3820 in total drug costs. Then my copay cost goes significantly higher (like you must be in). When I get to $5100, I go into what they call Catastrophic Coverage. Once there, there are really cheap copayments. So, $5100 is the key number. You should get statements from your Drug plan that lays this out for you.

This is a typical government program to raise costs on the elderly.
 
wes

wes

KIllerfrog Emeritus
MadFrog said:
It is called the doughnut hole. I am in the "initial stage" until I reach $3820 in total drug costs. Then my copay cost goes significantly higher (like you must be in). When I get to $5100, I go into what they call Catastrophic Coverage. Once there, there are really cheap copayments. So, $5100 is the key number. You should get statements from your Drug plan that lays this out for you.

This is a typical government program to raise costs on the elderly.
Click to expand...
Well they’re doing a hell of a job on it.

When I took that last cycle of Lomustine, my out of pocket was $47.00, which I thought was great.

Yesterday I picked it up and the same dosage 260 mg, was $379.00

This is crazy
 
Bizarro Frog

Bizarro Frog

Active Member
MadFrog said:
It is called the doughnut hole. I am in the "initial stage" until I reach $3820 in total drug costs. Then my copay cost goes significantly higher (like you must be in). When I get to $5100, I go into what they call Catastrophic Coverage. Once there, there are really cheap copayments. So, $5100 is the key number. You should get statements from your Drug plan that lays this out for you.

This is a typical government program to raise costs on the elderly.
Click to expand...
This sums it up pretty well.
 
narly1

narly1

Active Member
I believe we were all told this when the previous admin told us to take a pill for that and that they fixed all the problems with Insurance.
 
satis1103

satis1103

DAOTONPYH EHT LIAH LLA
It's really sad, the whole thing. Coming from a previous background in healthcare I assure you, if we figured out how to remove all the artificial price inflation in healthcare, we would all be able to afford it from start to sunset whether it was publicly or privately funded.
 
SnoSki

SnoSki

Full Member
Wes,

Be sure to look into goodrx.com for your prescriptions too. You can use your phone to look up your drug name on there, they'll show you a coupon you can then show to your pharmacy and get a discount.

My son needed some antibiotics recently and goodrx reduced the cost by 50%.

Edit: it appears lomustine isn't available on there but perhaps some of your others will be?
Edit 2: Viagra is available for 96% off retail... (hey now)
 
B

bleedpurple

Active Member
SnoSki said:
Wes,

Be sure to look into goodrx.com for your prescriptions too. You can use your phone to look up your drug name on there, they'll show you a coupon you can then show to your pharmacy and get a discount.

My son needed some antibiotics recently and goodrx reduced the cost by 50%.

Edit: it appears lomustine isn't available on there but perhaps some of your others will be?
Edit 2: Viagra is available for 96% off retail... (hey now)
Click to expand...
This l. They also have an app in the iTunes Store. I am not sure how many pills a day you have to take but I recently discovered a company called “PillPack”. I think they are a subsidiary of amazon. You give them your prescriptions over the phone and your doctors (all of them. My dumbass forgot two of them) and they ship you your meds already packed and labeled. So much better than having to sort them yourself, at least for me. Negu
 
Eight

Eight

Member
satis1103 said:
It's really sad, the whole thing. Coming from a previous background in healthcare I assure you, if we figured out how to remove all the artificial price inflation in healthcare, we would all be able to afford it from start to sunset whether it was publicly or privately funded.
Click to expand...

the only problem is healthcare, biotech, and pharma are all considered growth areas

when you have people who have never had to work in real jobs and live in a bubble write laws with unchecked lobbyists in their ears what do you expect?

not being political, jefferson was right about career politicians
 
HToady

HToady

Full Member
satis1103 said:
It's really sad, the whole thing. Coming from a previous background in healthcare I assure you, if we figured out how to remove all the artificial price inflation in healthcare, we would all be able to afford it from start to sunset whether it was publicly or privately funded.
Click to expand...
You do realize that the standard operating procedure for insurance companies is to deny all claims and force physicians to occupy most of their time defending their claims instead of taking care of patients. Doctors are lucky if they get 25% of what they submit, so they jack up the prices 400% in hopes to get 100%.

Single payer is looking better every day.....
 
M

Moose Stuff

Active Member
Eight said:
calf gap okay or are you a solid contact to the ground type of guy
Click to expand...

Never really pondered the calf gap. The thigh gap almost always goes hand in hand with “too skinny”. Give me the athletic girl with some muscle in her legs 100% of the time.

Wes, are you finding any of this helpful?
 

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