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Tuesday, December 30, 2008  

Medicare Drug Plan Pricing Criticism

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We were really impressed by an article we came across today in the Palm Beach Post about Medicare plans.

It really hit the nail on the head.

Medicare drug insurance pricing is confusing, and the complaints are piling up with no relief in sight.

"The system, known as reference-based pricing, is used by dozens of plans offering coverage through Medicare's Part D drug-insurance program.

Under reference-based pricing, patients who insist on certain brand-name drugs when a cheaper generic version is available are charged a much higher price - typically representing the difference between the cost of the two drugs, plus a copayment.

By contrast, people buying a brand-name drug when there is no generic equivalent are charged just a copayment." (emphasis ours)
We're not doctors and don't even play doctors on TV, so it's not for us to say what this really means, but in some cases doctors and patients want brand names. That's easy enough, but regardless of the reason why a brand name is wanted, when it comes to checkout time, what it amounts to for seniors is more irritations and more confusion. Here's why:

The real rub here isn't just the pricing per se, but that it's just so hard to figure out what's what. "Next year [2009]," the Post article goes on to say, "30 insurers will use reference-based pricing in 63 separate drug plans, which represent nearly 10 percent of all Part D plans, according to the Centers for Medicare and Medicaid Services...."

No matter where you are in your quest to understand the prescription drug pricing, you can always benefit from a look at other Medicare Supplemental Plans.

As always, we'd love your feedback on this if you're a senior or are someone helping a senior sort things out, so please feel free to comment.

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