- 901
Wowser....here we go. Granny ain't going to be happy....!!!
PDP's going Sky-high in 2024? National Base Beneficiary Premium $64.28
- Thread starter Duaine
- Start date
I have read a number of articles about how PDP will change in 2024 and it isn't pretty.
Higher premiums and tier shifts resulting in higher copay's.
PDP's have been a lousy deal for those who are not taking maintenance med's or only take low cost generics. About 80% of my client base would fit in that group. They buy the lower premium PDP to avoid the LEP. The current lowest premium plans here are $7 and $11. If those premiums double or triple I imagine a number of folks will simply drop the PDP for 2024.
What Congress has done with the "IRA" is send the PDP market into a death spiral. Healthy folks may well abandon the PDP leaving only sick folks in the plan. It may take 2 or 3 years for someone to wake up and smell the coffee on this. By then it will be too late to turn it around.
Mandates be damned, a number of folks will shun the PDP and rely on discount cards and PAP's for high priced brand names. Many will buy from Canada where drugs are not only cheaper but one can find generic equivalents that are not available in the US.
Eliquis retails for $600 for a 30 day supply in the US. I have clients who buy the $70 SilverScript Plus plan in order to get the med for $47 and no deductible.
I show them an option to get the $7 SilverScript Saver plan and buy the brand from Canada for $90/month or generic (apixaban) for $62.
Some go the Canada route while others belly up to the $70 plan . . . their choice.
Point is there are options to paying $70+ for a drug plan that offers a relatively lower copay for a drug with a ridiculous retail price vs the "world" market.
Higher premiums and tier shifts resulting in higher copay's.
PDP's have been a lousy deal for those who are not taking maintenance med's or only take low cost generics. About 80% of my client base would fit in that group. They buy the lower premium PDP to avoid the LEP. The current lowest premium plans here are $7 and $11. If those premiums double or triple I imagine a number of folks will simply drop the PDP for 2024.
What Congress has done with the "IRA" is send the PDP market into a death spiral. Healthy folks may well abandon the PDP leaving only sick folks in the plan. It may take 2 or 3 years for someone to wake up and smell the coffee on this. By then it will be too late to turn it around.
Mandates be damned, a number of folks will shun the PDP and rely on discount cards and PAP's for high priced brand names. Many will buy from Canada where drugs are not only cheaper but one can find generic equivalents that are not available in the US.
Eliquis retails for $600 for a 30 day supply in the US. I have clients who buy the $70 SilverScript Plus plan in order to get the med for $47 and no deductible.
I show them an option to get the $7 SilverScript Saver plan and buy the brand from Canada for $90/month or generic (apixaban) for $62.
Some go the Canada route while others belly up to the $70 plan . . . their choice.
Point is there are options to paying $70+ for a drug plan that offers a relatively lower copay for a drug with a ridiculous retail price vs the "world" market.
Also, the 6% premium increase cap applies to EXISTING PDP plans but presumably will not apply to NEW plans for 2024.
EDIT 9/1/2023- (the above statement is debated by folks who follow this stuff more than I do. Some are saying CURRENT PDP plans are not impacted by the 6% 2023 cap which is why some plans are projecting double digit increases. We will have a clearer picture in October.)
A current $7 PDP can either raise premiums by $0.42 or drop the plan from the landscape and replace it with a new plan that is $25.
Or, if the carrier wants to maintain market share they introduce a new plan that is $10 but even more useless than the current $7 plan.
EDIT 9/1/2023- (the above statement is debated by folks who follow this stuff more than I do. Some are saying CURRENT PDP plans are not impacted by the 6% 2023 cap which is why some plans are projecting double digit increases. We will have a clearer picture in October.)
A current $7 PDP can either raise premiums by $0.42 or drop the plan from the landscape and replace it with a new plan that is $25.
Or, if the carrier wants to maintain market share they introduce a new plan that is $10 but even more useless than the current $7 plan.
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- 2,055
somarco said:
Eliquis retails for $600 for a 30 day supply in the US. I have clients who buy the $70 SilverScript Plus plan in order to get the med for $47 and no deductible.
I show them an option to get the $7 SilverScript Saver plan and buy the brand from Canada for $90/month or generic (apixaban) for $62.
Which Canadian pharmacy do you recommend?
Eliquis retails for $600 for a 30 day supply in the US. I have clients who buy the $70 SilverScript Plus plan in order to get the med for $47 and no deductible.
I show them an option to get the $7 SilverScript Saver plan and buy the brand from Canada for $90/month or generic (apixaban) for $62.
Which Canadian pharmacy do you recommend?
- 29,488
My wife and I have the $78.50 SS and we're both in the Donut Hole. That $47 is now $175 for me and $150 for her.
john ashford
New Member
- 5
A site to check pharmacies:
PharmacyChecker.com
This is one Canadian pharmacy:
DiscountCanadaDrugs.com
PharmacyChecker.com
This is one Canadian pharmacy:
DiscountCanadaDrugs.com
My wife and I have the $78.50 SS and we're both in the Donut Hole. That $47 is now $175 for me and $150 for her.
Each situation is different and I used Eliquis as an example because a number of clients use the drug.
I also suggest buying from Canada.
- 29,488
I just checked Trelegy on Mapleleaf and it's $120 more than I'm paying in the Hole. They don't havemy wife's expensive med.
[EXTERNAL LINK] - Search results for: 'trelegy'
90 Day supply of Trelegy is $338.95 (you have to scroll toward the bottom). While it's a Canadian pharmacy, it ships from Australia so it takes a little while.
