Xarelto Costs Went Through the Roof

[TrvlBug]

Has anyone else experienced 100++% cost increase for their Xarelto or other meds under Plan D?

Other than the first refill of the year, the quarterly costs have been $132 or thereabouts since forever. Just refilled DH's Rx and the cost is $352 for the 90 day supply . We have CVS Caremark this year. Costs were $132 last year under Humana. I plan on calling them Monday for an explaination.

 

[RetiredHappy]

Probably due to donut hole.

 

[Sunset]

Did you use medicare.gov and input your meds to see what the costs would be, before switching plans ?

I've always wondered how solid those estimates are.

 

[RetiredHappy]

Did you use medicare.gov and input your meds to see what the costs would be, before switching plans ?

I've always wondered how solid those estimates are.

We do use the medicare.gov site to pick drug d plan for my husband and the estimated costs seem to be pretty accurate. He has a drug which costs him about $280 every 3 months for the first 2 refills and jumps to almost to $800 in q3 due to entering the donut hole. We are used to it.

 

[TrvlBug]

Did you use medicare.gov and input your meds to see what the costs would be, before switching plans ?

I've always wondered how solid those estimates are.

Yes we did and in years past we've never had this problem.

 

[TrvlBug]

Probably due to donut hole.

Interesting. So depending on how much the company charges for the drug, you could theoretically, pay the same copay at first, however, depending on the cost of the drug, hit the donut hole at different times with different companies. I wonder if Medicare.gov takes that into account when it spits out the info on the various plans. If my thinking is correct, Humana last year charged less for the drug than CVS Caremark is charging this year...charged meaning the total cost of the drug. Of course, that info is nowhere to be found on the printout that comes with the mail order. IIRC it is located on the info sheet when picking up at the pharmacy. Me thinks I will change to pharmacy pickup (the cost is the same) for all drugs.

I always assumed the donut hole was based on your costs of the drug and not the total cost of the drug (what you and the insurance company pay), but that apparently is not the case.

 

[Sunset]

This part D thing has other interesting quirks.
I've noticed my plan is not the cheapest if I stray to a non-preferred pharmacy.
This was annoying with my FIL as he wanted to go to 1 pharmacy every year. It was not his cheapest choice.

 

[TrvlBug]

This part D thing has other interesting quirks.
I've noticed my plan is not the cheapest if I stray to a non-preferred pharmacy.
This was annoying with my FIL as he wanted to go to 1 pharmacy every year. It was not his cheapest choice.

We always switch to the preferred pharmacy/ies or mail order for the lowest co-pay cost. His other meds are mostly $0 or $15 co-pay for 90 days, but then who knows how much they actually charge for the drug.

 

[Koolau]

My Eliquis is never the same price twice. I think my first 90-day batch was $700+ and latest was $400+ It's all over the place. Everything else I get is trivial. I got 450 capsules of one drug and I think it was $14 or some such. You can't outguess 'em.