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Thursday, April 25, 2013

Medicare patients and Coupons

Don't you know we, as a society and as pharmacists, hate old people? Yep. That's what they tell me. Repeatedly. We're always out to screw the elderly.
Rare was the nasty curmudgeon who met every sincerity with nasty remarks. Today, it is rarer to find an older customer who isn't mean or complaining and directing his ire at us. It essentially boils down to them not being able to receive the discounts available to the rest of the population. But is it really that big of a savings that we should be treated as poorly as we are, simply because a manufacturer coupon cannot be combined with a Medicare plan? Oh. And stores that offer rewards programs for gas or groceries or sets of fine China cannot offer them on government-funded plans. Yep. Screw the elderly. Well, the welfare people too. We obviously discriminate against them as well. It's not enough that Medicare D plans give decent copays. It's not enough that welfare has copays of nothing (some States have copays, but they're usually $3 or less and it's not for all drugs everywhere).
Average Old Guy: Why can't I use this coupon?
CP: It says on the card "cannot be combined with Government-funded plans".
AOG: The government isn't funding me anything.
CP: In fact they are sir. You have a $6.60 copay for a 3-month supply of your medication.
AOG: Right. And I should be able to use this coupon to make it free. Or at least $4.
CP: No sir. The only way we could use that is to charge you the cash price.
AOG: Fine so do that.
CP: But sir, it would cost you $257.78 to pay me cash for it.
AOG: Then use the coupon so it'll be $4.
CP: The coupon maxes out at a $50 discount. You'll still be responsible for $207.78.
AOG: Then why did my doctor give this to me?
CP: Because the lovely drug rep who visited his office told him to do it. And he listened. Your doctor is not smart enough to read the coupon. Your doctor does not work in my pharmacy. In fact, he really doesn't do any work in his office. Watch him. He pops into your room, chats you up a bit, types some notes, then walks out. He may dictate some more notes, but he passes off the work to a nurse or assistant. She, if he didn't already do it, will send your prescription electronically. When you check out, another girl collects your copay, if you have one, and she bills your insurance for the office. Your doctor is really only there for the easy part-to find out what's wrong with you and to tell someone else what to prescribe electronically. He doesn't even need to sign anything anymore.
AOG: Can I at least get my store rewards for this?
CP: Only if you pay the cash price sir.
AOG: Why?
CP: Again, the government says you are already receiving perks. Also, we are not allowed to use these special perks to incentivize you to do business with us. They call it leveling the playing field.
AOG: I'm going to level someone. This is discrimination against old people.
CP: Absolutely sir. You take your lawsuit to Capitol Hill. I couldn't agree more. The government is giving you prescription drug insurance which you may not otherwise have and that is not enough.

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