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Caregivers Resources

Help With Keeping Rx Costs Down

Prescription drug costs are front and center in the health-care debate. Caregivers know very well why this is. They see prices for their loved one's medications skyrocketing, which poses financial challenges and forces difficult choices. 

In fact, overall prices for medication are rising faster than the pace of inflation, with brand-name and specialty drugs costs going up more than twice the rate of inflation. Sometimes, family members end up helping to foot the bill for medications out of their own pocket.

To help you and your family cope with rising drug costs, I'd like to let you know about some useful resources.

Getting Help

Does this sound familiar? Your great aunt has seven different prescriptions, all neatly lined up on the kitchen counter. As her caregiver, you are pleased. She appears so organized.

Yet you also note that one drug bottle is from the pharmacy down the block, another one is from across town, three are from a local supermarket, and two are from a mail-order pharmacy.

You ask, "Auntie, why so many drugs from so many different pharmacies?"

"Oh honey," she replies. "I just want to get the best deal for my money, you know, so I shop around. If the corner pharmacy tells me my blood-pressure pills cost $50, I go to the pharmacy across town. They can sometimes fill it cheaper."

Your aunt is like me, a comparison shopper. Many of our parents trained us to be savvy consumers, or we just learned it ourselves. Prices can vary from store to store, but when it comes to prescription drugs, there are other, healthier ways to save money.

Saving Money for Medicare Part D Beneficiaries

Today, Medicare beneficiaries have prescription-drug coverage. That's a good thing; however, the coverage is not complete. This year, more than 3 million Medicare Part D beneficiaries risk falling into a drug-coverage gap called the "doughnut hole."

Here's How:

In 2009, Medicare will cover the cost of prescription drugs up to $2,700.

After that, there is no coverage whatsoever. We call this gap the "doughnut hole."

You can "come out of the hole" once your loved one's out-of-pocket expenses reach $4,350.

At that point, the person receives coverage again, for 95 percent of his or her costs. This is called "catastrophic coverage."

So, while in the doughnut hole, Medicare Part D enrollees pay 100 percent of their medication costs, all the while still paying their monthly premiums. For some people, the added costs are unexpected, and, for many, the gap becomes a financial trap.

It is estimated that more than 3 million people will fall into the coverage gap, and when they do, their prescription costs double. In these cases, there are often disastrous results. You may know a family member who has skipped pills or postponed or cut back on medical care because of its expense. Alternatively, many older adults cut back on food, utilities, and other essentials to be able to afford their daily meds.

But there is some help. Here a few resources worth knowing about if you want to help your loved one save money on prescription drugs.

Talk to a Real Person!

I can't say enough wonderful things about State Health Insurance Assistance Programs (SHIPs). They provide personal counseling and assistance to millions of Medicare beneficiaries and their caregivers. Helping people navigate the Medicare program and the increasingly complex world of health care is SHIPs specialty.

They also provide accurate, understandable, and objective information, counseling, and assistance to families on a wide range of health-insurance issues, including Medicare, Medicaid, long-term care, and prescription drugs.

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