Thursday, March 15, 2007

Olesky's first experience with Aetna drug plan

Report from John Olesky:

Well, I had my first experience with the Aetna prescription coverage that the Canadian forced BJ retirees into as of Feb. 1.

$12 was my monthly co-pay under United Health Care for my six prescriptions.

$144 was my annual co-pay under United Health Care.

$180 would be my monthly co-pay under Aetna if I got exactly the same prescriptions that I did under United Health Care.

$2,160 would be my annual co-pay under Aetna if I got exactly the same prescriptions that I did under United Health care.

$2,016 would be the annual increase for me under Aetna if I got exactly the same prescriptions that I did under United Health care.

Hytrin (terazosin), Accupril (quinapril) and Plendil (felopipine) have generic equivalents, so that brings the cost of those three to $15 a month.

Uroxatral has no generic equivalent but is on Aetna's approved list so I'm stuck with $20 a month for that.

Aciphex and Celebrex are not even on Aetna's approved drugs list, so that means $40 apiece for those two. There are drugs in the same class as Aciphex (such as Nexium, Prevacid and Protonix), but Celebrex is the only drug in its category.

So that brings my Aetna co-pay to $145 a month for what cost me $12 a month under United Health Care, even after switching at least half of my prescriptions to something else. That's $1,840 a year co-pay under Aetna. And the way that Aetna figures how the $2,400 limit applies, by the actual cost of the drugs and not by my co-pays, I'll be paying 100% on my own before you can say "heart attack." That means I'll pay 100% till I've spent an additional $1,400 of my own money, for a potential out-of-pocket cost of $3,240. That sounds like a lot more than my UHC $124 a year.

I can reduce my cost by one-third by getting 90-day supplies for each prescription via mail through Aetna, which charges for 60 days if you get 90 days by mail. That would bring my yearly co-pay down to $1,200. But the $2,400 limit would kick in just as fast, the way that Aetna figures it.

It looks like the current BJ employees aren't the only ones who got screwed by the handoff from KRI to McClatchy to the Canadian. The retirees are on a serious hit list.

-- John Olesky


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