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Medicare "Donut Hole" Scam?
11/14/2023 | Tnoldman

Posted on 11/14/2023 1:34:59 PM PST by TNoldman

I am taking Prescribed Eliquis 5 mg Blood Thinner. With my UHC Advantage Plan I can get a 90 day supply(180 pills) for $95. The Drug cost is shown a $1780. My "Donut Hole" account is charged almost $1700. I can't believe UHC is paying Pfizer $1700. UHC must get a big discount??

After about $4800. in the "Donut Hole" account I must pay 25% of the full cost - about $450.

I am able to buy Eliquis(apixaban) via a Certified Canadian Pharmacy from India for $95. (120) pills. My Doctor has approved and they results are the same.

Medicare or Medicare participants are getting ripped!

Can anyone explain or suggest a solution.


TOPICS: Health/Medicine
KEYWORDS: donuthole; eliqus; medicare; prescription; vanity
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1 posted on 11/14/2023 1:34:59 PM PST by TNoldman
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To: TNoldman

My Humana agent talked to us about this. Talk to your agent and if she/he’s like mine, they’ll work with you and the doctor or else set you up with a Canadian co... to get the med at a savings.

This could work


2 posted on 11/14/2023 1:39:57 PM PST by SMARTY ("A lie which is half a truth is ever the blackest of lies." Tennyson)
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To: TNoldman

Change doctors——find one with a prescription plan.

Pharmacy raised a $40 presc/on to over $1000.

New doctor has his own presc/on plan......same one now costs 90 cents.


3 posted on 11/14/2023 1:44:32 PM PST by Liz (Women have tremendous power — their femininity, because men can't do without it. Sidney Sheldon)
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To: TNoldman

Get rid of the donut hole.

It was a dumb idea to start with.


4 posted on 11/14/2023 1:48:06 PM PST by Adder (End fascism...defeat all Democrats.)
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To: Liz

Holy cow.


5 posted on 11/14/2023 1:54:01 PM PST by moovova ("The NEXT election is the most important election of our lifetimes!“ LOL...)
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To: TNoldman

I don’t takes any medication that is not available as a generic.

Why are you not on a generic blood thinner?


6 posted on 11/14/2023 1:58:40 PM PST by P-Marlowe (Do the math. L+G+B+T+Q = 666)
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To: SMARTY

I must tell you the Canadian pharmacy is excellent. You have chosen well.


7 posted on 11/14/2023 1:59:13 PM PST by scottiemom (As a former Texas public school teacher, I recommend home school)
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To: scottiemom

Which Canadian pharmacy?


8 posted on 11/14/2023 2:02:21 PM PST by joesbucks (It's called love-bombing. Claiming he's saving the world. This is a cult. Just back away. )
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To: Adder

What is the donut hole referring to?


9 posted on 11/14/2023 2:03:48 PM PST by DesertRhino (Dogs are called man's best friend. Moslems hate dogs. Add it up..)
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To: TNoldman

This is why I am taking the State Employees Supplement. It’s expensive but keeps you on “work” medical insurance.

Medicare is expensive.


10 posted on 11/14/2023 2:04:24 PM PST by AppyPappy (Biden told Al Roker "America is back". Unfortunately, he meant back to the 1970's)
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To: SMARTY

Sorry Smarty. That post was meant for Tnoldman.


11 posted on 11/14/2023 2:05:58 PM PST by scottiemom (As a former Texas public school teacher, I recommend home school)
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To: TNoldman

I was on Xarelto and when I fell into the donut hold my doctor gave me enough samples to make it through to the end of the year. This fall no more samples and he has put me on eliquis. I have samples enough to get me to January but who knows after that. With Medicare I was paying 38.00 a month co pay. Its a huge rip off.


12 posted on 11/14/2023 2:06:27 PM PST by MomwithHope (Forever grateful to all our patriots, past, present and future.)
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To: DesertRhino

When you’re in the donut hole, you have a much larger copay.


13 posted on 11/14/2023 2:06:28 PM PST by Flaming Conservative ((Pray without ceasing)
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To: TNoldman

To get a drug certified for sale in the US the manufacturer must agree to supply a certain amount to price controlled economies like India and Canada. In exchange they get to charge Medicare or US insurance companies whatever they want. The reason drugs like common heart medications are in short supply in places like Canada is that the pharmacies that get them in Canada can resell them at a higher price to Americans than they are allowed to charge in Canada. Thus, they all get sold on the Internet leaving Canadians wanting. When you get those drugs, yes, it’s a great deal when compared to the artificially supported US price, but it means the country you get them from will run out quickly.

This happens to any price-controlled commodity. You’d think governments would know this, but they do it anyway because...politics.


14 posted on 11/14/2023 2:08:46 PM PST by Gen.Blather (Wait! I said that out loud? )
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To: DesertRhino
What is the donut hole referring to?

Re: https://www.verywellhealth.com/understanding-the-medicare-part-d-donut-hole-1738872

15 posted on 11/14/2023 2:10:14 PM PST by JesusIsLord
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To: TNoldman

Most/all “health” “insurance” is a scam of price and availability manipulation and lack of transparency.


16 posted on 11/14/2023 2:22:33 PM PST by old-ager
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To: TNoldman

I’d seriously have your PCP look at a generic. Most have been around for years and have proven to be safe and effective.


17 posted on 11/14/2023 2:24:36 PM PST by RetiredTexasVet (Biden not only suffers fools and criminals, he appoints them to positions of responsibility. )
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To: Nailbiter

Fl8r


18 posted on 11/14/2023 2:25:26 PM PST by Nailbiter
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To: RetiredTexasVet

When I see an ad for a new drug, the required warnings of potential side effects (while they show people smiling) takes up at least half the commercial time.

That’s why I don’t take any drug that hasn’t been on the market long enough for the patent to run out. That and the fact that under my plan generics are free and most of the new meds are either not covered or the deductible is more than my monthly premium.


19 posted on 11/14/2023 2:32:18 PM PST by P-Marlowe (Do the math. L+G+B+T+Q = 666)
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To: Flaming Conservative

Yes, larger and I could not afford 418.00 a month versus 38.00 before I hit the donut hole. Thats why I asked for samples to carry me to January.


20 posted on 11/14/2023 2:42:02 PM PST by MomwithHope (Forever grateful to all our patriots, past, present and future.)
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