Can you lower your expenses on Mark Cuban’s Cost Plus Drugs web site? And how does it work with Medicare?

Bill Hearn’s remedy to deal with his gentle persistent obstructive pulmonary illness, or COPD, would price him $275 monthly from CVS Pharmacy by means of his Medicare Part D prescription drug plan. But the 69-year-old retiree dwelling in Knoxville, Tennessee, will get a generic model delivered from a brand new on-line pharmacy, as an alternative. It prices a whole lot of {dollars} much less.

“I’d read some about Costplusdrugs.com on Twitter, so I decided to check it out,” Hearn stated in an e-mail. “Their website is very easy to use to check availability and prices, and I was surprised to find a $75 per month price for the same medication (as a generic). The price was lowered to $60.50 last year.”

Cost Plus Drugs can supply vital financial savings on sure prescribed drugs, however there are some downsides, too — significantly for folks with Medicare. Here’s what Medicare beneficiaries ought to find out about this on-line pharmacy.

What is Cost Plus Drugs?

The Mark Cuban Cost Plus Drug Co., or Cost Plus Drugs, is a web-based pharmacy for generic medicines. The firm, which launched in January 2022, takes its title from investor Mark Cuban, a billionaire entrepreneur and philanthropist.

Cost Plus Drugs says it sells “more than 700 of the most commonly prescribed generic medications.” It doesn’t promote any brand-name medication or specialty medication.

Cost Plus Drugs is notable for providing low-cost medicines with clear pricing. “Every product we sell is priced exactly the same way: our cost plus 15%, plus the pharmacy fee, if any,” the corporate’s web site says about its pricing mannequin.

Investor and Dallas Mavericks proprietor Mark Cuban.


Christian Petersen/Getty Images

Cost Plus Drugs gives this instance for a 30-count provide of 400 milligrams of Imatinib, a most cancers drug:

  • Manufacturing price: $31.20.
  • 15% markup: $4.80 (rounded per capsule).
  • Pharmacy labor (the “pharmacy fee”): $3.
  • Shipping: $5.

Including the delivery, that might be $44 a month.

This value gives financial savings of greater than $9,600 versus different corporations’ retail costs, the corporate says. That comparability might be primarily based on brand-name Gleevec, which may price $10,000 or extra monthly at retail. Generic Imatinib is less expensive, however it could actually nonetheless be properly over $100 monthly from main retail pharmacies with a Medicare prescription drug plan.

Also see: Federal roadblocks are holding Medicare from protecting hashish: Here’s the place issues stand.

Does Cost Plus Drugs work with Medicare?

“We are cheaper than Medicare copays, so we are a great place for Medicare recipients to buy medications,” Mark Cuban wrote in a Twitter direct message.

If you need to purchase these lower-cost medicines from Cost Plus Drugs, your Medicare plan received’t be concerned. Cost Plus Drugs doesn’t invoice Medicare, whether or not you’ve gotten a stand-alone Medicare Part D plan or a Medicare Advantage plan with prescription drug protection. You’d must pay for medicines from Cost Plus Drugs out of your personal pocket, however it might be properly price doing.

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How Cost Plus Drugs impacts your Medicare Part D protection

You don’t get any credit score towards your Part D deductible whenever you fill a prescription by means of Cost Plus Drugs. You solely meet the Part D deductible by paying for medication your plan is protecting, and Cost Plus Drugs doesn’t invoice Medicare Part D plans.

You can nonetheless meet your Medicare Part D deductible by paying for different medication your plan covers. For instance, Cost Plus Drugs doesn’t promote brand-name medication, so you would fill brand-name prescriptions by means of your Part D plan and meet the deductible that method.

If you fill most or your entire prescriptions by means of Cost Plus Drugs, although, you’re probably lacking out on a whole lot of credit score towards your deductible. You nonetheless must pay your premiums, however till you hit the deductible, your Medicare Part D plan doesn’t pay in your medication.

The Medicare Part D penalty

If you’re taking largely or fully generic medication, it could be tempting to make use of Cost Plus Drugs and go with out Medicare Part D protection. However, you would face the Medicare Part D late enrollment penalty. You’ll must have both Medicare Part D or one other sort of creditable protection (reminiscent of an employer plan) that’s not less than pretty much as good as Medicare Part D to keep away from being penalized.

Even in case you might lower your expenses through the use of Cost Plus Drugs and skipping Medicare Part D, you’d face the Part D penalty in case you ever enroll (or signal again up) for Medicare Part D.

Learn extra: What it is advisable find out about Medicare: a breakdown of its elements

Could Cost Plus Drugs companion with Medicare?

Cost Plus Drugs isn’t fully against working with insurance coverage corporations. As of February 2023, Cost Plus Drugs solely works with one insurance coverage plan — Capital Blue Cross — however the firm’s web site says “we will be adding more insurance plans in the coming months.”

Cuban described the corporate in a Twitter direct message as “willing and able to integrate” with authorities applications like Medicare, and added “but we have not had those discussions yet.”

If Medicare or Medicare Advantage corporations made agreements with Cost Plus Drugs, it might critically shake up drug pricing. “If we could sell to Medicare, we could save taxpayers tens of billions of dollars,” Cuban wrote.

A 2022 examine printed within the Annals of Internal Medicine estimates that Medicare might have saved about $3.3 billion in 2020 if it had purchased a subset of medicine accessible from Cost Plus Drugs on the firm’s charges. (For context, the whole Medicare Part D funds for fiscal 12 months 2020 was about $89 billion, in accordance with the Congressional Budget Office.)

Plus: Next 12 months’s Social Security price of dwelling adjustment might plunge by greater than half

Is Cost Plus Drugs a good suggestion for Medicare beneficiaries?

Medicare beneficiaries had a mean of 54 prescriptions per 12 months as of 2018, in accordance with knowledge evaluation by the Congressional Budget Office. In the information, one prescription equals a 30-day provide, in order that’s about 4.5 prescription fills a month. Saving cash on even a portion of these may very well be a giant deal for Medicare beneficiaries.

Cost Plus Drugs may very well be a superb choice for potential financial savings on generic medication, even for individuals who already produce other Medicare prescription drug protection.

However, there are additionally some Medicare-specific downsides to Cost Plus Drugs. Note these extra concerns:

  • Prescriptions crammed by means of Cost Plus Drugs don’t rely towards the Medicare Part D deductible.
  • Cost Plus Drugs doesn’t promote brand-name medication (which are typically the most costly).
  • You’d owe steep and everlasting penalties for going with out Medicare Part D protection, so it’s not a good suggestion to drop your Part D plan, even when you may get cheaper remedy from Cost Plus Drugs.

In quick, in case you take a drug with a generic model, it’s price checking the worth on Cost Plus Drugs to see whether or not you would probably lower your expenses. But Cost Plus Drugs isn’t a alternative for Medicare Part D, so take care to not run afoul of penalties that would add as much as greater than you save on prescriptions.

This article was written with the help of a journalism fellowship from The Gerontological Society of America, The Journalists Network on Generations and The Silver Century Foundation.

More From NerdWallet

Alex Rosenberg writes for NerdWallet. Email: arosenberg@nerdwallet.com. Twitter: @AlexPRosenberg.

Source web site: www.marketwatch.com

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