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Eldercare
Reply to "Medicare - Can't afford medication"
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[quote=Anonymous]If every drug in the category works for her, then her Part D plan should cover at least two of them — the law says a plan must cover at least 2 drugs per category/class. And every plan must submit their formularies to the government for review and approval every year. If she is paying $6000 for a drug that is on her plan formulary, then it must be a VERY expensive drug and she is getting benefit from her plan, including a 70% manufacturer discount during the gap phase and 5% cost sharing once she hits the catastrophic cap, which she should reach very quickly at an out of pocket cost of $6000. She would then pay the reduced amount for the rest of the year. In 2025 the cap will be $2000 after which she will pay nothing, so positive change is coming. [/quote]
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