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A Drug Mule for the Medicare Set
By JENNIFER CONLINSEPT. 19, 2014
My mother has many attributes, but athleticism has never been one of them. She always hesitates before stepping onto an escalator and rarely walks beyond our circular driveway. So when her physician ordered her onto a treadmill last winter, it hardly seemed surprising that her heartbeat jumped dramatically, even when the pace was not brisk. She is 80, after all.
To temper her tempo, she was soon prescribed a very expensive heart medication. “I have to take it or I might have a stroke,” she told me (a problem for me, as her future caregiver, as well as for her). Luckily, Medicare and her supplemental insurance picked up most of the cost, so a 90-day prescription’s worth of pills came to just $135 — a good rate to pay, I thought, for a good heart rate. But in July, her discount suddenly ended.
“Your mother is in the doughnut hole,” my 83-year-old father said to me grimly. I had no idea what he was talking about but knew from his expression it was not a good place to be. I instantly pictured my mom encased in a giant inner tube of fried flour, uselessly trying to eat her way out like a doomed character in Willy Wonka’s Chocolate Factory.
I quickly learned that the “doughnut hole” has nothing to do with baked goods and is, instead, the term used to describe the gap my mother had now reached in her Medicare Part D prescription drug program. She had hit her initial coverage limit of close to $3,000 a year (calculated by adding together the full fee of all her drugs), and now would have to pay a higher out-of-pocket cost for her prescription drugs until she reached the catastrophic coverage threshold, thousands of dollars later.
Given that she also takes other medications, her drug costs were suddenly going to go through the roof — and as I share that roof with my parents, husband, brother and children, it was also going to skyrocket our mutually managed budget. Her heart medication alone would now cost more than $800 for a three-month supply. Now it was my heart that was starting to palpitate. But it turned out that my parents had a plan.
Call it “The Dallas Buyers Club of Seniors,” but a number of their octogenarian friends are now ordering their prescription drugs through pharmacies in Canada. Living in Michigan, as we do, the border is an easy maple-syrup-outing away.
Having spent a portion of my youth wondering where I could score pot for myself and my friends, I now found myself spending late-night hours on the Internet looking for Canadian medications for my mother. I quickly learned that her biggest-ticket item, the one for her ticker, would cost just $335 for a 90-day supply if I bought it a mere 47 miles from our hometown.
Suddenly, Canada seemed like one giant Costco to me.
As luck would have it, I was about to go to Ontario to visit some close friends. The timing could not have been more lucky. I just had to learn the rules of the geriatric game before my time.
“I’m wondering if you can help me out,” I asked in a polite voice a few days later as I slipped a guy at a Toronto pharmacy a folded piece of paper containing copies of my mother’s prescriptions.
Continue reading the main storyContinue reading the main story
The pharmacist looked me over closely. “We get a lot of Americans like you doing just this,” he said, making me feel like the medication mule I had now become.
“Is it legal?” I asked him quietly, mumbling into the collar of my jean jacket.
”No,” he said, explaining that the Food and Drug Administration cannot allow foreign drugs to be resold or distributed in the United States. I wondered if I should make a run for the door before he called in the feds. But then he explained how it “really works.”
“Customs looks the other way when it comes to personal use,” he said.
continued here http://www.nytimes.com/2014/09/21/fashion/a-drug-mule-for-the-medicare-set.html?_r=0
By JENNIFER CONLINSEPT. 19, 2014
My mother has many attributes, but athleticism has never been one of them. She always hesitates before stepping onto an escalator and rarely walks beyond our circular driveway. So when her physician ordered her onto a treadmill last winter, it hardly seemed surprising that her heartbeat jumped dramatically, even when the pace was not brisk. She is 80, after all.
To temper her tempo, she was soon prescribed a very expensive heart medication. “I have to take it or I might have a stroke,” she told me (a problem for me, as her future caregiver, as well as for her). Luckily, Medicare and her supplemental insurance picked up most of the cost, so a 90-day prescription’s worth of pills came to just $135 — a good rate to pay, I thought, for a good heart rate. But in July, her discount suddenly ended.
“Your mother is in the doughnut hole,” my 83-year-old father said to me grimly. I had no idea what he was talking about but knew from his expression it was not a good place to be. I instantly pictured my mom encased in a giant inner tube of fried flour, uselessly trying to eat her way out like a doomed character in Willy Wonka’s Chocolate Factory.
I quickly learned that the “doughnut hole” has nothing to do with baked goods and is, instead, the term used to describe the gap my mother had now reached in her Medicare Part D prescription drug program. She had hit her initial coverage limit of close to $3,000 a year (calculated by adding together the full fee of all her drugs), and now would have to pay a higher out-of-pocket cost for her prescription drugs until she reached the catastrophic coverage threshold, thousands of dollars later.
Given that she also takes other medications, her drug costs were suddenly going to go through the roof — and as I share that roof with my parents, husband, brother and children, it was also going to skyrocket our mutually managed budget. Her heart medication alone would now cost more than $800 for a three-month supply. Now it was my heart that was starting to palpitate. But it turned out that my parents had a plan.
Call it “The Dallas Buyers Club of Seniors,” but a number of their octogenarian friends are now ordering their prescription drugs through pharmacies in Canada. Living in Michigan, as we do, the border is an easy maple-syrup-outing away.
Having spent a portion of my youth wondering where I could score pot for myself and my friends, I now found myself spending late-night hours on the Internet looking for Canadian medications for my mother. I quickly learned that her biggest-ticket item, the one for her ticker, would cost just $335 for a 90-day supply if I bought it a mere 47 miles from our hometown.
Suddenly, Canada seemed like one giant Costco to me.
As luck would have it, I was about to go to Ontario to visit some close friends. The timing could not have been more lucky. I just had to learn the rules of the geriatric game before my time.
“I’m wondering if you can help me out,” I asked in a polite voice a few days later as I slipped a guy at a Toronto pharmacy a folded piece of paper containing copies of my mother’s prescriptions.
Continue reading the main storyContinue reading the main story
The pharmacist looked me over closely. “We get a lot of Americans like you doing just this,” he said, making me feel like the medication mule I had now become.
“Is it legal?” I asked him quietly, mumbling into the collar of my jean jacket.
”No,” he said, explaining that the Food and Drug Administration cannot allow foreign drugs to be resold or distributed in the United States. I wondered if I should make a run for the door before he called in the feds. But then he explained how it “really works.”
“Customs looks the other way when it comes to personal use,” he said.
continued here http://www.nytimes.com/2014/09/21/fashion/a-drug-mule-for-the-medicare-set.html?_r=0
