Expensive Prescriptions, The Donut Hole, and Wal-Mart

A year ago we were charging copay costs every three months:
CRESTOR TAB 20MG  $315.13
NAMENDA TAB 10MG (2 times a day) $458.25
CARVEDILOL TAB 12.5MG $57.95
PLAVIX TABLETS 75MG $405.53
EXELON PATCH DIS 4.6MG/24 (we have since switched to the pill) $547.73
LOTREL CAP 5-40MG $285.84
ACTOPLUS MET TAB 15/850MG (two times a day) $561.32

You do the math. With limited income, both of us on Social Security, and my not being able to make unlimited money until I turned 66, we eventually paid off the mounting credit card dept on a line of credit on our house.

This past week the government sent us $250 with this letter.

The Affordable Care Act, a new law passed by Congress and signed by President Obama on March 30, 2010, provides a one-time rebate to help with your drug costs. The rebate is sent automatically to most people enrolled in Medicare Part D who reach the Medicare drug plans coverage gap ("doughnut hole") in 2010.

What does that donut hole mean? Kind of like you are half-way to "catastrophic coverage". I got this e-mail from our AARP plan to explain.

Your plan, AARP Medicare gives you a prescription benefit allowance per year $2,830. If you go over $2,830 before the end of the year, Medicare send out a one- time, tax free check for $250. Now that you are in the doughnut hole, you are responsible 100% cost on each of your medication. Medicare will not cover your prescriptions until you paid out of your pocket up to $4,550, then your generic medication is $2.50 or 5% of the cost of the medication, and brand medication is $6.30 or 5% through mail service pharmacy for 90-day supply.

$250 is sort of a drop in the bucket.  Because of these horrible bills, and not enough income, we are in danger of doing maxing out the cards again.  This situation has caused me horrible stress recently, waiting for the catastrophe that all of this situation might entail--not to mention the prospect of staying home to take care of my husband and not being able to make money. (I teach classes and substitute teach whenever I can.)

Publix and Wal-Mart to the Rescue. My husband's doctor gave us a big clue last week. She changed Actoplus Met( ($561.32 for three months) to Metformin and we can get it for free at Publix Supermarket--just have it get it every month! Then she changed expensive Lotrel (now $314 for three months) to two other medicines that I got today at Wal-Mart for $20 for three months. Likewise Crestor ($315.13) was changed to another $10 for three months medicine at Wal-Mart. Now we are left with Plavix, Nameda and Exelon pills, all very expensive--over $3000 for the next six months. However, Carvedilol Oil, which helps dementia as I reported in an earlier post, is only $36.78 for three months with our AARP Plan. I have heard that generic drugs may be coming for some of these medicines within the next year.

Earlier I went to freemedicine.com and they said we qualified. I paid them $10 per prescription that we both take and got forms in the mail. However when the forms came we don't qualify and they have our checks they have cashed! You can believe I am writing them! Let's see if they can get free Plavix, Nameda, Exelon pills and Carvedilol Oil or else return our money! Gentle reader, will report back to you on this outfit. I also called Canada at 1-800-226-3784 and maybe they can help. I hear that http://www.pparx.org/ is excellent for low income under $25,000 a year.

The next step is to get a proper diagnosis for my husband. What kind of dementia does it have? Vascular Dementia is a possibility, but from my reading the majority of cases are just Alzheimer's. I am filling out forms for USF Alzheimer's Center in Tampa. My husband will be diagnosed there and then they will see if he fits into a research study. I asked them if they would pay all his medicine, and the answer is no. USF Alzheimer's Center will only pay for additional medicine/or placebo medicine and gas mileage if he is admitted to a study and he will still need to take the above medicine. But at least if he gets in a study he can still take the medicine that benefits him.

My husband is in denial. When I went to my second monthly caregiver's group yesterday, he was about to have a fit. He was mad when I told him the truth. But you know he quickly forgets where I went and gets involved in his TV movies. Friday I go to another caregiver workshop (the second of three). I can't be in denial. I have to be proactive.

Added Friday, 7/16. Went to the second caregiver workshop and will write more about it with another post. Just want to say that now through-the-donut-hole Plavix came today--100% cost of $455, up from last summer's cost above.

News 7/22. Namenda is going generic in 2015. Wish it were sooner! But Aricept is going generic later this year and maybe his Exelon can be switched to generic Aricept.

News 7/29. Instead of sending the Exelon pills, AARP/Prescription Solutions send a generic Rivastigmine to save us money. $502.63 through-the-donut-hole  for three months. Folks, does this look like saving money? That credit card keeps going up.

News. Namenda for three months came mid August.  $491.71