Argent - I have BCBSMN BlueRX which is a 5 star drug plan and I think the copay is also 25% for the high priced cancer drugs. When I was studying plans, my wife will have the opportunity to go on a BCBS Advantage plan this year through the school district that has better drug coverage (fixed co-pays but Tier 5 drugs were at 25%) than my supplement plan although the medical insurance has all the co-pays, networks, etc typical of good Advantage plans. I asked the rep about
this and he said the group plans tend to have the better drug plans that individuals cannot get. I checked the various Medicare drug plans and they were all about
the same when it came to drug coverages for individuals so I don’t think there is a solution to the problem. You can spend 2X per month and get the deductibles and the "donut hole" covered but it seems the 25-33% co-insurance is pretty typical once you get beyond the common drugs.
I have been concerned about
the same thing and did not see any way around it. The problem from the GoodRX link I posted is that one should be able to obtain the drug for under $2000 cash, therefore, the 25% copay should be $500 but that is not the way the insurance market works currently. The catastrophic coverage kicks in after $5100 out of pocket cost so the amounts drop considerably.
Post Edited (Mumbo) : 8/31/2019 8:36:13 AM (GMT-6)