A recent article in Consumer Reports contains disturbing information about the costs of prescription medicine for seniors.
Seniors are more likely to need multiple medications. A survey conducted by Consumer Reports found that three-fourths of Americans 65 and older are taking 6 or more medications. With people under 65, only half of them regularly take medication, and those who do take approximately 4 drugs.
Even with Medicare coverage, about a third of seniors reported price hikes in the last 12 months and paid an average of $53 for at least one medication. The other drugs that they take may have increased in price, too.
With this “perfect storm” of need for medication, price hikes, and fixed income, seniors are especially likely to feel the pain of paying for medication. The president of the Medicare Rights Center, a nonprofit that helps people with Medicare, says that: “We hear stories about people mortgaging their house just to afford their medications.”
Seniors also worry about hitting the “donut hole.” In 2016, once the patient and Medicare have paid together $3,310, coverage shifts to a complicated formula for “cost sharing” on brand name and generic pharmaceuticals. When spending reaches $4,850, the costs drop back down.
The good news is that, because of the Affordable Care Act, the donut hole is gradually closing and will completely close in 2020.
Certain very expensive drugs are another problem. In 2016, drugs to treat cancer, hepatitis C, multiple scleroses, and rheumatoid arthritis can cost a person on Medicare $4,000 to $12,000 for one drug alone.
Finally, depending on the Medigap policy that a senior may have purchased, payment for a single drug can vary dramatically. Studies show that out-of-pocket costs for 10 commonly prescribed brand-name medications were up to 14 times higher with some plans than with others.
During the open enrollment period, which is October 15 to December 7, 2016, be sure to consider not only the premium, but how well a particular plan covers your particular health condition and medications.