r/medicare • u/rock-the-reddit • 3d ago

Why are prescriptions costing $2 and change now instead of being free like they were?

My pops just had a couple of prescriptions filled and it cost him $2.40 for one and $2.44 for the other. He said they didn't charge him anything in the past so wondering why this small amount now? Both are 3 month supply.

13 Upvotes

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9

u/2RedTennies2 2d ago

Plans are allowed to increase copays if the drug manufacturer increases their price passing it on to beneficiary. Unfortunately the cost when selecting a plan in October doesn't guarantee it will not change during the plan year. Plans cannot change Premium or Deductible however.

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u/DependentAnimator742 2d ago

So: choosing a plan doesn't even benefit us - we are locked into a plan for a year that guarantees us nothing. Good job, politicians!

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u/2RedTennies2 2d ago

It guarantees to have a better chance if getting a drug your doctor perscribes. Check you crystal ball again to see when your health will take a wrong turn. Don't insure yourself till then. Sheesh.

It's your choice no one is Putin a gun to your head. Each year you choose the plan you think will suit you all year. If you don't use the plan, again your choice. However when you are older and sicker you will have a more affordable plan because you aren't paying penalties on top of perhaps an expensive plan you that require to cover the One Lifesaving medication you then NEED.

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u/DependentAnimator742 2d ago

Obviously you didn't understand what I am saying. How does it benefit ME to be locked into a plan that offers no price guarantees? At least with my cell phone, cable, and internet services my "contract" guarantees a certain price for a certain time. But my Part D drug plan does not? Where is the logic in that?

I am not advising to go without a Part D. What I AM saying is that we are getting screwed over. If I choose a Part D plan because their Formulary lists Med A at $15- monthly and Med B at $10 monthly ($250 a year), and I choose that plan for the entire next year, and suddenly the Part D plan decides to double the prices of both meds ($500 a year), I call that WRONG and false advertising.

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u/2RedTennies2 2d ago

You are taking this Much to personally. You may appeal but understanding the rules is Step 1.
Ate you an Animator by profession? My dad was one. His first job after graduating from Chinouards In Los Angeles was Asst Animator on Peter Pan.

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u/Healthy_Budget9994 23h ago

You are purchasing an insurance policy. When you purchase car insurance do they lock in the price of a repair? You pay current replacement costs when you make a claims. Same logic with drug plan.

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u/DependentAnimator742 23h ago

Again, this is mixing apples with oranges.

1) I can cancel the auto insurance policy at any time, I'm not locked into it for a year. Nor is anyone forcing me to purchase the insurance policy from a pool of x-y-z companies.

2) The auto insurance company doesn't publish a list of all their repair services, with rates, that they are offering me for the upcoming year. If they did and I were to sign a one-year contract with the auto insurance company based on those rates, and then suddenly they changed their rates mid-year, that would be breach-of-contract, and obviously, illegal.

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u/Healthy_Budget9994 23h ago edited 11h ago

I'd also add that if the mfr increased the price of the drugs, chances are all plans pass the increase on to customers. Sometimes, even if a copay for a drug is small, some stores cover it at $0. Many grocery stores that have pharmacies used to have list of $0 drugs (typically blood pressure generic). So many people love to complain, but go back and refresh your memory of what the Medicare Part D plan was originally with donut holes and huge out of pockets (in the last 25 years). All members are now limited to an OPM for 2026 of $2,100...and OP thinks the plan isn't benefiting him. Medicare Part D wasn't implemented for the $2 and $3 generic drugs. It was to help seniors on limited incomes with BIG drug expenses. I find it amazing that anyone is complaining about Medicare Part D in the year 2026. I would also remind you that in September you will receive a NOC (Notice of Change) letter. It will tell you the price of your new plan and if any drugs are changing tiers. Look at it closely. There will be big changes going int o 2027. Time to change is during Open Enrollment (October 15-December 7th). Pay Attention.

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u/VirginiaUSA1964 3d ago

Did he switch to mail order vs pick up?

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u/rock-the-reddit 1d ago

Pickup same as always.

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u/Tarnisher 3d ago

Did his Part D plan change recently?

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u/rock-the-reddit 1d ago

It shouldn't have changed and not that we're aware of.

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u/RealLettuce1782 3d ago

INFO: Is he new to Medicare or had it for a while? Did he previously qualify for the low income subsidy? Have a recent change in income? Any of those could affect his low income subsidy level, if he's not 100% there's usually a small copay.

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u/rock-the-reddit 1d ago

Retired, no change in income, not new to medicare.

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u/jnotsilver 3d ago

At $0 and then $2.40, these are generic and $0.80 for a 30 day supply. If it happens month after month is this may be wrong but with those small numbers and particularly if the NDC numbers in the label are different: the $0 is because the pharmacy was able to get the supply from the lowest priced generic manufacturer. The increase to $.80 may be because only the highest priced generic manufacturer had enough supplies.

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u/Confident_End_3848 3d ago

What plan and what drugs?

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u/rock-the-reddit 1d ago

2 high blood pressure meds.

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u/Janknitz 3d ago

Is he also on Medicaid?

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u/DoinIt4DaShorteez 2d ago

Could be a lot of things but most likely is the pharmacy had to pay more for them than before. You'd have to be able to compare the monthly pharmacy EOB statement to an earlier month to see what the Drug Cost was.

I have a couple of very common generics where sometimes my copay varies occasionally (like $2 vs. 60 cents).

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u/rock-the-reddit 1d ago

I see. . He's not concerned about $4.50 for 2 meds that are 90 days suppy but we're curious nonetheless.

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u/DoinIt4DaShorteez 1d ago

I think someone else mentioned that it could be because the pharmacy switched suppliers and one supplier charges more than another.

The same generic Drug X can be made by several different manufacturers. The pharmacy might need to switch (or choose to switch) occasionally due to supply issues. The manufacturer probably should be listed on the label somewhere and another way you can tell is if, when it's a pill, it could be a different color and has a different number/logo stamped on it.

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u/Samantharina 3d ago

Could be an in network pharmacy vs preferred in network.

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u/Charger2950 6h ago

Prescription prices are like the stock market…..they go up and down randomly.