Medication pricing ISSUES
Just wondering if anyone shared the same isuue ... ... I moved December 2023 and therefore had to change my insurance. I was on Enbrel for years; very happily. After retirement and our move, I tried to get back onto Enbrel. My cost went from $ 5.00/month to $ 2,556.32/mo. YES, really!
So now I'm hoping the elimination of this insurance medi loophole as of 2025 will be defeated, forever.
I hope that loophole is closed in 2025, too,
! I don't what type of insurance you are on (Medicare?), but I do hope you are able to negotiate and get that price drastically lowered.
I know other community members have been in situations similar to yours and I hope they see your post and chime in here!
Best, Erin, Team Member.
Hi
. Your frustration is certainly understandable. I had the same thought as Erin in wondering if you had switched to Medicare upon retiring. The reason I wondered is because Medicare doesn't allow the copayment assistance from the manufacturers that brings it down to the $5.00. They have ruled that it comes under an anti kickback law and is prohibited under a government program, like Medicare. It has been a big problem for people on biologics and many other expensive drugs.
You are correct that there are changes for Medicare prescription drugs for 2025. Out of pocket expenses will be capped at $2,000 and a person will be able to spread the cost over the year. This site offers more information: https://www.medicare.gov/about-us/prescription-drug-law. Best, Richard (Team Member)
