“… Aduhelm, an Alzheimer’s drug approved by the US Food and Drug Administration in June over the objections of its advisers. Some experts estimate it will cost $56,000 a year. Medicare is deciding whether to pay for it now on a case-by-case basis.
Because Aduhelm is administered in physicians’ offices, it should be covered under Medicare Part B, not Part D plans, which pay for medications bought at pharmacies. Traditional Medicare enrollees have to pick up 20% of the cost of most Part B medications, which would translate into about $11,500 in out-of-pocket costs for those prescribed Aduhelm.…”
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Damn! That’s a lot out of pocket for one drug. Is there sone sort of yearly max?
Part B Supplemental?
And yet cancer drugs are not covered under Part D. I believe I’m right on that one.
ONE DRUG impacts the entire system for a few people so ONE company can get paid by the giverment what nobody else can afford to pay them.
I smell a rat and a stinking rotting fish head.
There is a lifetime cap, don’t know about annual.
Half a million, or a million. Somewhere around there. Medical industry would like to maximize medical spending.
“Damn! That’s a lot out of pocket for one drug. Is there sone sort of yearly max?”
It doesn’t work, so no matter. Just another corrupt FDA favor to Big Pharma.
Medicare Advantage plans (also called Part C) have a yearly out-of-pocket maximum for Part B services. Most of these limits are lower than $3,000/year. If this drug is covered under Part B then the retiree would not suffer a huge financial loss. Chemotherapy, for example, is covered under Part B.
All bets are off, however, if the drug comes under Part D. There’s no yearly limit per se to your cost. There are four different coverage stages you have to go through before Medicare will pay most of the costs of these expensive prescription drugs. In most of the plans you have to pay at least $6,500 in a given year before costs go way down.
The brand-name drugs we see advertised constantly on TV in those glitzy commercials are all VERY expensive, thousands of dollars each month in many cases. Best to avoid them if you can.