Prescription Costs Are Creating A Vicious Cycle

General, News July 12, 2017 0
Expensive Prescriptions Are Creating A Vicious Cycle | Senior Market Advisors

Prescription Costs Are Creating A Vicious Cycle

Whether insured or not, necessary prescription drugs can force a lower-middle-class patient into poverty. That’s why hundreds of thousands of people are choosing to skip doses. Some are skipping treatment altogether because they simply can’t afford it. Almost 5% of people with prescriptions valuing $50 or more abandon those prescriptions at their pharmacies.

When people skip out on the drugs they need to survive, they get sicker and end up spending more time in the hospital. Either way, they’re stuck. They can pay thousands each month for the drugs they need, or they can pay thousands each month for hospital treatments. Welcome to the vicious cycle of unaffordable health care and coverage.

Choose High Premiums

Encourage clients to select plans with higher premiums and lower copays. Clients are more likely to forgo a drug if they have to pay more in the store than if they are paying a monthly fee. Stand-alone prescription drug plans (Part D’s) typically have higher copayments and lower premiums. It’s great for clients who don’t have expensive prescriptions. However, clients who are taking multiple drugs each month may be better off with a Medicare Advantage plan. It’ll help them to decrease their copayments and cover greater hospitalization charges.

Stand-alone prescription drug plans (Part D’s) typically have higher copayments and lower premiums. They’re great for clients who don’t have expensive prescriptions. Clients who take multiple drugs each month may be better off with a Medicare Advantage plan. It will decrease their copayments and cover greater hospitalization charges.

Medicare Advantage clients may have higher premiums, but they’ll make up for it with low or no copayments. The only other downfall to selecting Medicare Advantage over Part D is the smaller network. Clients may have to change doctors or pharmacies if they enroll in Medicare Advantage.


Think Like A Beneficiary

Clients often choose the lower premium plan because they’d rather pay as needed for drugs, but they will likely pay more in the long run. Carefully explaining the benefits of a higher premium to your clients and encouraging them to choose Medicare Advantage over a stand-alone Part D plan may help prevent abandoned prescriptions.

Remind your clients that they are legally required (under the ACA) to have not only Original Medicare but also a prescription drug plan. If they don’t enroll now, their costs will be higher later. Inform them of late enrollment fees, and encourage them to buy while you’re there to answer questions.

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Anastasia Iliou
Anastasia Iliou
Content Marketing Manager at Senior Market Advisors
Anastasia graduated from Belmont University with a Bachelor's degree in Songwriting. When she's not writing, she's on a mission to visit all 50 states in the U.S (and to date has reached 28). Anastasia loves writing music, hiking, and her pet hedgehog, Luna. She loves animals (but not so much bugs) and spends her free time volunteering for The Elephant Sanctuary in Tennesee.