Life's full of surprises in the donut hole

    I'm in it and am being surprised.

    Surprise 1.I'm trapped.When I reached the bottom limit of the coverage gap as it is officially known I figured that as  one way of offsetting the escalation in copays I'd save the Medicare Plan D premium by  simply withdrawing  from the plan for the rest of the year.

    Wrong,When you're in you're in . For the full year.

    Surprise 2.Not all copays are created equal. When I prepared to pay  one of my newly escalated copays today the druggist said

    o "you'll  be able to have these on Oct 10".

    o Me " Need em now "

    o D ". But you're in the coverage gap"

    o M "Gap,snap- the insurance company isn't paying anyway so what has it to do with when I buy these meds ?"

    o D " Oh you can buy them now but if you want the (enormous) cost to count against the coverage gap you have to wait until Oct 10"

    Keynes famously observed that in the long run we'll all be dead. That's likely not the prospect for Flavius if have to interrupt my daily treat of consuming 8 of these presumably gold plated tablets.......But.........

    oM  Just give me the damn pills

    So they did and I remain down in the depths of the donut hole without even the small pleasure of knowing that today's contribution to the well being and retirement package of one pharmacue...oh bleep.... drug company's ceo was at least bringing me within eye sight of that far flaky shore.

    There's a political point somewhere in this but I gotta go take a pill........  

    Post script

    Obamacare ,aka the ACA, is supposed to gradually close the donut hole so that by 2020 it will be almost gone. I've  also read since yesterday that- starting last year- the ACA requires drug companies to provide a 50% discount for non generic drugs purchased during the coverage gap. News to me and probably to my druggist since it couldn't have been implemented when  I was charged $300+ yesterday.  

    Post postcript

    The system works. I was wrong on both counts.I'd forgotten I'd had a refill of the script in mid Sept so I wasn't entitled to another on Oct 1 and accordingly it wasn't charged against the coverage gap.The insurance company contact said nicely, "you ought to go check your medicine cabinet. And I did and the meds were there.

    As to the drug company's 50% discount that doesn't apply against generics and this was a generic.

    The problem was not in stars, but in Flavius.

     

     

     

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