We have been using Silver Scripts (part of CVS Health/Caremark) for years… I have always been rather lazy and not checking out Rx prices from various Part D programs until 2019… when I ran the program https://www.medicare.gov/plan-compare/#/?lang=en to find out what would be the least expensive annual out of pocket costs for us.
We use a local independent and had noticed over the last couple of years… our out of pocket costs for Rxs seem to be going up – dramatically !! Come to find out that Silver Scripts the only TWO PREFERRED PHARMACIES in the county of abt 85,000 population was the CVS Rx dept in Target and a new CVS store – these stores is one of the most congested roads in the entire county and about 1/2 mile apart and at least a 8 mile drive for us to go “into town” as opposed to the local indy that is abt ONE MILE from our house and will deliver if needed.
I took our new Part D cards to the pharmacy on Saturday with a refill that Barb needed and told them to fill it after the first of the year… since this year we have a $450 deductible with the new Part D prgm- but all Part D programs were going to have a deductible or higher premiums to collect the same copay over 12 months.
The prescription that I was to pickup today was suppose to be $55 but when I got there… .it was $92… Come to find out the staffer that I had talked to had filled in on Monday when I dropped it off and billed it to Silver Scripts.
The Pharmacist reversed the Silver Script and billed it to our new Part D program and the price came out as $56.. Keep in mind the Rx filled/billed to Silver Scripts …the $92 was a COPAY and the one filled/billed to our new Part D was FULL PRICE because we are in our DEDUCTIBLE PERIOD… and it is suppose to be $3 once the deductible is met.
So I went to print out all the Rxs filled with Silver Scripts for 2019 and while they don’t automatically show you this.. if you hit the down arrow on each claim it will show what they paid… and found out that they paid little to NOTHING on most of the Rxs that we had filled last year… One very notable Rx was I was charged $147.00 and THEY PAID $6.00
I just checked www.goodrx.com and the quoted prices was a range of $35 -$64 locally. So Silver Scrips (CVS) has been charging me – and everyone else that doesn’t have them filled at a CVS pharnacy ) – from 50% to nearly THREE TIMES the available CASH PRICE at local pharmacies. I was also paying Silver Scripts a MONTHLY PREMIUMS and normally the Part D/PBM gets a rebate/kickback/discount from the Pharma and I don’t know if they are getting any $$$ from the Feds/Medicare on a monthly basis.
Many scream & holler that Medicare should be negotiating prices with the pharmas… looks like they should start putting a mussel on some of their Part D prgms. Silver Scripts is one of the top three Part D providers.
Filed under: General Problems
Your not alone. Express scripts flat cut out most all independent pharmacies as Preferred 2020!
Their choices are all chains or mail order.
I prefer an independent pharmacy because the pharmacist actually gets to know you!
So now if I was to patron an independent I’d have to pay Cash! Of course using one of the discount cards from the video you posted about a week ago helps Thank you. BUT
This STILL pisses me off! Good Insurance has always given choice and co- pays for the insured were lower, not anymore!
We all know chains give patients A Hard Time on certain medications or flat out REFUSE to fill them. GRrRr!
Besides all This? I found the Independent pharmacy was being ripped off when they did have them as preferred.
This is running small buisinesses out of BUISNESS. What Screwed UP healthcare system we have today.
PBM’s should be CUT OUT Completely! Theyre greedy bastards!