As the political season is about to heat up, I hope you won’t mind if I vent about one of my pet peeves – medicine co-pays.
Like many seniors, I am Type 2-diabetic. My primary care physician fights constantly to keep my blood sugar level on track. Fortunately, I have, (or thought I had) excellent health insurance.
Suffice to say, when the news program announced late in 2023 that co-pays for diabetic medication would be no more than $35 per 30 days I was beyond relieved.
Now I know politicians don’t lie, (cough, cough) but aren’t “lies by omission” still a lie? This season we have heard political ads from a certain senator boast on televised that she pushed for a law whereby diabetic co-pay would not exceed $35.
Later the words “insulin diabetic medication” was added, yet nothing was mentioned about tier groups and how that would affect this law.
A perfect example is my own diabetic medication, which sadly are all tier 3. One has a co-pay per 30 days of $145.00, another $265.00 until I reach the level of “critical care.”
My cousin’s husband, on the other hand, who is almost 90 is living on his Social Security. His diabetic medicine runs more than $1,000.00 per month.
Talking with him on this subject reminded me of all the times I would get my mother’s prescriptions. I’d hand over her credit card and wonder how people who had to make a choice of food or medication get by.
I called my insurance company prior to writing this column and asked why my co-pay was so insanely high. The agent explained that I was “in the infamous donut hole, but not to worry, after I paid another $5,000 out of pocket in co-pay, I would be on “critical care” and there would then be no-copay.
Obviously, before I reach the $5,000 co-pay out of pocket it would most likely be in
mid-December and I would have to start all over again.
I fully understand the costs of higher tier level pharmaceuticals. After all, developing these medicines cost millions. The reality, however, that lower income people on a very tight income must choose which necessity to pay – rent, food, or medication, is inhumane.
