Last week Grandpa Jake was prescribed a new medication for his heart. His doctor recommended that he start taking “Plavix.” Plavix is a blood clot reducing agent that is commonly prescribed to senior citizens with heart problems to reduce the risk of heart attack and stroke.
Grandpa has Medicare Part D health insurance with one of the Medicare provided prescription plans. From what he tells me, he pays a monthly premium to Medicare of around $30. On top of that he needs to pay an almost $300 deductible before Medicare starts to pay for his medication. After he meets his deductible Medicare will pay 25% of the total cost of his covered drugs until the total reaches about $2,500. After he reaches that number Medicare pays 50% of his drug costs. Ok, that’s better, but that only lasts for the next $3,000 or so then they drop down to 5% coverage I know that Grandpa is on several medications, it can’t be too long before he reaches the 5% mark. It is also November next week. Does this whole deductible maze start again in January? This sounds so confusing… No, this IS confusing!
They did a study in 2005 that showed a large difference in how the Department of Veterans Affairs (VA) and Medicare pay for their subscribers medication costs. “For Plavix (75 mg.)… the best VA price is $887.16 per year, compared to the best Medicare drug discount price of $1,230.36—a difference of $343.20, or 38.7 percent.”
Grandpa was never in the armed forces, he wears glasses and always has, so they wouldn’t let him in. He doesn’t deal with the VA. He’s got Medicare. Shouldn’t that be enough?
Thankfully Grandma and Grandpa own their own home, it took them 30 years, but it’s theirs. Despite that, they have a lot of expenses. They both get small pensions, but while they aren’t struggling, they aren’t very far into the “comfortable” end of the spectrum.
I did find one possible solution for them both. There are several assistance programs available for people who need help paying for their prescriptions. Most large pharmaceutical companies have their own programs and there are also many privately run programs.
There is a website, that I have used myself, that helps people in need of assistance find programs that they can apply for. The site is called NeedyMeds. Some of the programs they list are run by the pharmaceutical companies, while other are community based. The resources listed on their site include Patient Assistance Programs, Disease-Based Assistance, Free and Low- Clinics, government programs and many other types of assistance. The company is funded by small grants, donations and sponsorships. NeedyMeds also works with some of the patient assistance programs run by the pharmaceutical distributors.
I’ve looked up some programs for Grandpa and will help him apply for them. It looks like it’s going to take a little time and a little more effort, but if it saves them some money it’s worth it. I also looked up how much it costs for all of us to emigrate to Canada… I think we’ll try this first.
Please share your thoughts with us below or on our Caregiver Forum.
We hope this was helpful. If you have any questions or if you know of a senior who could benefit from our vast array of home care services in the Fairfax area , please call us at 703.750.6644, or email us. We accept most long term care insurance as payment and have a full time staff of trained and certified home care personnel covering the Fairfax County, Virginia area.