First of the year insurance issues

Will that $120 drug come down in price once you satisfy your deductible?

I find it helpful to download the prescription drug Formulary for my insurance plan each year. It is usually a searchable form in either Word or PDF format. Then, when I get a surprise like that, I look up its generic form and ask the doctor to prescribe it. For example, a Symbicort inhaler would cost me $125/month; the generic, budosenide/formoterol, form is $10.

For Medicare Beneficiaries:

Effective Jan. 1, 2025, Medicare Part D will begin limiting out-of-pocket prescription drug costs to $2,000. This ceiling will be adjusted for inflation each year. The law was passed in 2022.

In 2024, the remaining 5% co-pay was abolished.

I could tell you STORIES!!! OMG. Medicare is denying everything for me at the end of the year. They do it in drips and drabs which is a death knoll. But they haven't met their match - an informed, EXPERIENCED and NOT patient - ME.
First let me add some info to some misconceptions: There WAS a drug shortage of Percocet in spring/summer of 2023. The DEA decided there was enough on the market and they STOPPED distribution. Isn't that crazy? but there was a substitute and that was getting the OXY codone (those teeny pink pills) and using tylenol alongside. That is what I did. It was horrible for me because I had TWO major spine surgeries in a month. I was freaked out but the substitute was made.
TIP: if you have Medicare WELLCARE part D those untrained, ill epuipped, ignorant, not - english as a first language speakers are just horrid. It makes me sad because they are SO NICE - but ask them to transfer you stateside so you don't spend all day on the freaking phone like I do. (I usually am doing work while I am waiting). Nothing gets accomplished. I've had medicine denied and they give you ONLY one reason at a time. So its death by a thousand cuts, literally! Its crazy. It bogs the doctors down as they have to repeat the same request over and over and over for a different reason. Then they don't respond in 24 hours and they shut the case!
TIP: start your med request month in advance of need.
TIP: they have NARROWED the formulary! So they don't allow you what you took before.
TIP: the meds IN THE FORMULARY are not targeted for what you may need!!! I had that 3 times happen! I have to tell those idiots - I can't take, I've already taken, or the medication (for example) is for RA and I have OA!
This is political now. It is the only reason that I can't get my meds. They don't have to do away with Medicare and Medicaid they can just sabetoge it all the way! I am telling you - who you vote for matters and you'd better contact your elected officials and file complaints.
TIP: file greivances. They can do it over the phone.
TIP: Be leary of Medicare Advantage problems. The intermediary billing companies suck. Everything gets denied. We've had another convo about that here in this group - you can google it.
TIP: If you really want to hassle it you can get your meds (they will call the pharmacy for you) but you pay, work on your appeal and they will reimburse if you win.
TIP:If you aren't too ill, and take my suggestion to not back down. Its hard when you are too sick and I understand. Find a good assembly/congress persons office and they can assist sometimes.
TIP: If you have other insurance USE THEM. With all 4 or my "ROUTINE" Requests denied between Nov./Dec (oh my gosh, my poor doctor and the paperwork!) I switched from using Medicare part D to my champVA Meds by Mail where everything was immediately approved - as my doctor ordered it - with ZERO money needed from me.
TIP: this is important: They are switching medicines on us that are NOT appropriate, or have inferior ingredients, or are not targeted for what ails you. Be sure to do your research or have someone do it for you. All 4 times they tried to get me to take something wholly inappropriate for my medical needs.
Get ready folks. Honestly, the political desire to balance the national budget is coming to a pharmacy near you.
TIP: LEARN about your insurance formulary in advance of your needs. They change! No notice given! Its not the Walgreens or the CVS or the Costco its the insurance company and the governmental regulations.
TIP: If we don't fight (I mean stand up for ourselves and our needs) it will continue to deteriorate. If our doctors are tied up writing requests, prior auths, justifications and appeals they can't doctor us.

yes, but they figured out a way to get around that by throwing your meds out of the formulary. So I highly doubt if they don't count the medication you now have to buy that it counts towards the deductible. The first step was to make prescription drugs OTC and say you can buy them yourself and so it doesn't count. And if you want something out of their formulary I believe it also doesn't count unless you file an appeal and get it accepted. See my comment below.

During December, because of the retirement Part D deductable of $500+ for the new year, (only for seniors on medigap/supplement), I get a 3 month supply of everything I can before the deductable kicks in. If I had to pay full price for all of my meds in January I wouldn't be able to have any. Its how I spread out the deductable a few months. No holiday gifts for family/friends of many seniors with $750+ deductables to start the new year. Sad.

we don't have to fall for the consumerism of the holiday season- many gifts will end up
in the landfill, regifted or at Goodwill withing a year - you found a smart way to spread your medicine expenses-

@loriesco: I hope the new legislation concerning prescription cost will benefit some people- your last tip in your comment is crucial, don't become complacent-

I hope so too! My hopes are dwindling as my options are dwindling. It started a couple years ago when the VA informed me that they had been ignoring my lactose and gluten-free profile and sending me medication’s that had them anyway because those were the only ones they contracted with. You know that old saying “you get what you pay for?” I’m so afraid a lot of people won’t know that their medication’s may not be what they think they are and they won’t know that the other things they are now being asked to take aren’t as good as the things they were taking before.

Between good Rx, Mark Cuban and Canada I saved about $3000 last year.