Concerns Rise as the Elderly Struggle to Pay for Medications in the U.S.

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It's not just your imagination: Prescription drug costs are rising. Thirty percent of Americans who currently take prescription medicine reported that their out-of-pocket cost for a drug they regularly take has increased over a year’s time.

In the meantime, one in four seniors relies on modest Social Security payments for at least 90 percent of their income, and 40 percent of elderly patients report they can't afford their medications.

Why Do the Elderly Pay so Much for Prescriptions?

Medicare is the U.S. federal government health insurance program that covers people over the age of 65 (and other eligible recipients) for health care services. Data from 2016 show that nearly 9.2 million Medicare beneficiaries were between the ages of 65 and 67, and over one-third were ages 75 and older.

One reason that elderly people are paying so much for prescriptions has to do with the fine print of Medicare Part D (Medicare’s prescription drug coverage that covers most outpatient medications).

Unlike commercial insurance plans that can place a limit on the amount of money patients spend on medications, traditionally Medicare has no such limit--even though several tiers exist where the beneficiary pays from 100 percent to 5 percent of the drug cost.

Still, according to a 2019 KFF analysis, out-of-pocket costs for some drugs are high with “expected median out-of-pocket costs for Part D enrollees not receiving low-income subsidies would range from $2,622 for Zepatier (for hepatitis C) to $16,551 for Idhifa (for leukemia) in 2019.”

Add to that the fact that more than half of seniors take four or more prescription drugs, and 35 percent who take four or more prescriptions report it’s difficult to afford medications.

Additionally, Social Security benefits are typically not enough to cover monthly living expenses. For example, in Sept. 2019, retired workers received an average payment of $1,474.77 per month.

What's more, the Social Security Administration estimates that 21 percent of married couples and 45 percent of single people rely on Social Security payments for 90 percent or more of their income.

This is made potentially worse by the fact that the Social Security Administration estimates that program reserves will become exhausted by 2037 if no changes are made to the current program.  

What Is Happening as a Result of Unaffordable Prescription Drugs?

As mentioned earlier, a significant number of elderly patients said they don't always comply with their doctor's instructions for taking medications due to the cost.

A KFF Health Tracking Poll (linked to earlier, and graphic below) supports this with more data, showing three in 10 Americans haven’t taken their medications as prescribed due to the costs.

This includes skipping medications, taking over-the-counter meds instead or cutting pills in half (which some experts say can be a viable option if one purchases the high dose versions of the medication).

Unfortunately, elderly people who skip medications can face serious health consequences.

For instance, those who take medications for "invisible" conditions such as high blood pressure may not immediately see any negative effects even as their blood pressure slowly rises.

What Can Be Done to Help the U.S. Elderly Pay for Medication?

To start, it's important to remember that Medicare Part D is changing. Legislation for prescription drug reform, if passed, would reduce beneficiary cost-sharing in Part D by $25 billion.

So, we can hope that patients' out-of-pocket costs will decrease in the coming years. In the meantime, the elderly and their caretakers can actively save money by learning how to cut medication costs safely.

Harvard Health Publishing recommends taking these steps, among others:

      Ask to be prescribed drugs that are "preferred" (these often cost less than their non-preferred counterparts).

      Ask to be prescribed generic drugs whenever possible.

      Buy high dose pills at no additional cost, and split them with a pill cutter.

      Check to see whether some pharmacies charge less for specific medications than others.

When shopping around at various pharmacies, many are turning to online pharmacies as a viable option. With a reliable online pharmacy, people can access safe, effective prescription medications shipped straight to their door.

These online pharmacies help patients save money by connecting them with licensed pharmacies in Canada, for example, and abroad. Through those pharmacies, customers can purchase brand-name or generic drugs that cost significantly less than if they were purchased in the U.S. Find more about what you should think about when shopping for prescription drugs from other countries here.

The way it works is that countries like Canada, for instance, have healthcare systems and comprehensive price control systems that drive down the cost of drugs sold within borders. So, when it comes to cheap medication for the elderly, online pharmacies can be valuable tools.

There are many other ways that the elderly population in the U.S. can save on their medications. Check out our recent article on how to help the elderly pay for medications for more tips.

Although the American elderly population's struggle to pay for medication is alarming, it's not without hope. With changing Medicare laws and savvy prescription drug shopping, seniors can start saving on their medications in both the short- and long-term.


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