Being robbed at the pharmacy counter ?

Prior to 2020 our Part D prgm was Silver Scripts … and the PBM was Caremark…  and all are part of CVS Health..

Before 2020, the Part D prgms did not have a annual deductible, but in 2020 with our new Part D prgm Humana has a $435 annual deductible, and most/all Part D prgms have a annual deductible.

I looked back to see what we were charged out of pocket cost for the same prescriptions.  Barb has already reached met her $435 deductible so I am trying to compare apples to apples..  The difference in monthly premiums is Humana is about $2.00/month more.

For 5 prescriptions filled after deductible met total out of pocket costs goes as follows:

Silver Scripts                                                         Humana

   $934.54                                                              $99.81

This is an example of how PBM’s are gouging (stealing) money from pts.  All prescriptions were filled at the same independent pharmacy.

Here is a recent article about a whistle blower claims that Caremark (part of CVS Health) is defrauding Medicare Part D on prescription prices

Aetna whistleblower accuses CVS Health’s Caremark of fraud in Medicare Part D drug prices

Our experience would suggest that there could be some validity to this whistle blower’s allegations. For the first quarter of 2020 CVS Health reported a increase in total revenue by 8% and net profit up 43%.  For a mature company (CVS was founded in 1963), it is very unusual – and certainly no where near the norm – for such companies to be able to produce a five fold increase in net profit over the increase of gross revenue.  When open enrollment period opens on Oct 15, 2020, those people currently enrolled in a Silver Scripts prgm might want to use the Medicare website ( https://www.medicare.gov/plan-compare/#/?lang=en ) to compare what their out of pocket costs could be with other part D providers

4 Responses

  1. Until this year, I had great luck with silverscripts, across two states. Now all the sudden I cant afford but 1 of my 5 expensive meds a month. I literally pay for one a month and pray I can stretch it out until I have filled the other 4 and can afford to do so again.

    I really need to find a new plan, my stomach and other issues aren’t enjoying getting a daily needed med only every 4-5 days!

  2. I change my Part D plan pretty much every year for this reason–some companies will try to gouge you if they see an opening to do so. It’s not difficult, just a little time consuming if you take multiple medications.

  3. I have little good feelings toward corporations to begin with, but CVS seems to be well in front in the Sleazy Slimy Greedy Liars competition…which is saying an awful lot. I’ve actually had a couple scrips filled there this year, one b/c it was the only place open, one b/c otherwise I’d have had to drive twice as far & they were actually cheapest b/c I could use GoodRx for an uncovered med. I felt so sleazy & slimy for supporting them that I’m now paying more & driving a lot more just to avoid them. I must say that the pharmacist herself was wonderful, & I feel sorry for her having such hideous working conditions, & tremendous respect & admiration for her that she could be patient, understanding, & helpful despite working for essentially slave-drivers.

    I’m sure they’ll get tons of PR mileage about how much they care about people that they returned the “small business” stimulus payment, which they never should’ve gotten in the first place.

  4. I was a CVS customer for over 10yrs when the problem started with opioids. First they kept telling me my meds were on back order, than it was they still haven’t come in, after two weeks of this they told me that
    They were unable to fill my script andgave it back to me. I took it to
    Walgreen’s, they filled it right away and are still filling it with no problems.

    I knew the names of each person in the pharmacy, I made baby blankets for them when they were having baby’s, I could not believe
    That these people LIED to me because of their lying Company.

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