You can save up to $2,000 by managing your United Healthcare drug plan coverage gap. This article provides recommendations for managing your drug plan. There is up to 90% savings connected with buying drugs off plan through Canadian pharmacies. The strategy is to buy expensive items off plan to keep within the United Healthcare drug plan allowance of $2,700. Assess your situation by identifying big ticket items. Then see which of the examples below best fit your situation. We were buying at Wal-Mart on the United Healthcare plan but Wal-Mart has a $4.00 per month plan for generic items weather you buy on the United Healthcare drug plan or directly from Wal-Mart off plan. The most economical strategy is to buy Wal-Mart generic and big ticket items from Canada, abandoning the United Healthcare plan entirely.
In our case there were four items that were prohibitively expensive through the United Healthcare plan. These expensive items were exhausting our allowance prematurely. The most expensive drug plan items were around $5.00 per pill vs. $0.50 per pill off plan. When we went over the allowance we had spent $2,200 of the $2,700 on these four items. Here are the details of the savings in our case.
Example of savings delivered by Canadian pharmacies:
——————————-Wal-Mart———Canada Rx—————Canada Rx %
——————————- Per Pill ———- Per Pill——————- Savings
Plavix 75————————$4.90———— $0.43——————– 91%
Tricor 160 ———————-$3.90———— $0.78 ——————- 80%
Namenda 10 MG —————- $3.00 ———– $0.63 ——————- 79%
Premarin 0.625 —————– $2.19 ———– $0.39 ——————- 82%
Pot Chloride 10 MEQ ———— $0.47 ———– $0.25 ——————- 47%
This article is divided into four parts.
# A case for abandoning the United plan which maybe best for some.
# A case for supplementing the United plan with inexpensive online Canadian meds.
# A case showing the expense of not supplementing the United drug plan.
# Details about the United plan. Actual billing information for 2009.
1. A strategy for abandoning United Healthcare and using Canadian meds plus Wal-Mart $4.00 generic.
The subscriber expenses for the United plan are $2,151. If you’re total bill for meds is less then this it’s more cost effective to abandon the plan. To determine if this is so in your case review your United Healthcare billing and determine your big ticket items. Then see what these items cost from Canada. Our cost for getting everything from Wal-Mart ($4.00 generic) except the four big ticket items was $500. Our big ticket items from Canada cost $1,350.
Canadian only – abandoning United Healthcare:
Canadian ———- $1,350 ——– No United or part D.
United ————-$- 500 ———Wal-Mart $4.00 generic and other low priced meds.
Gap copay ——– $ — 0 ——— Coverage gap pay 100% after $2,700.
Total year ——– $1,850 ——— Save $2,000 over worst case.
2. A strategy for a mix of United / Wal-Mart and Canadian:
The subscriber expenses for the United Healthcare plan are $2,151. We were getting a mix of generic $4.00 items from Wal-Mart and some expensive items from the United Healthcare plan. By September we were $300 over the allowance of $2,700. Buying the four big ticket items from Canada for the rest of the year cost $350. If we did not go over the allowance we could have reduced our total spend by $200 and stayed within the allowance.
Supplement United with Canadian: (actual spend 2009)
Canadian ———– $ 350 —— Off plan Canadian.
United ————– $2,151 —– Total subscriber expense – see details below.
Gap copay ———- $ 300 —— Coverage gap pay 100% after $2,700.
Total year ———- $2,801 —– Save $1,000 over worst case.
3. A case for not using United only:
This case is a based on our exceeding the allowance in September and paying 100% copay for the rest of the year. In our case we would have paid an additional $1,500 copay and never reached the stop loss threshold of $4,350.
United only – no Canadian: (pay 100% copay United coverage gap – to $4,350)
Canadian ———— $ — 0 ——– Off plan Canadian.
United ————— $2,151 ——- Total subscriber expense – see details below.
Gap copay ———– $1,800 ——- Coverage gap pay 100% after $2,700.
Total year ———– $3,951 ——– No savings – worst case scenario.
4. Details of the United Healthcare plan as well as actual billing for 2009.
The United Healthcare insurance provides a drug plan which requires social security part D. This plan is aggressively marketed by United Healthcare. Large segments of the senior population have signed up for this drug plan.
United Healthcare drug plan structure:
Annual deductible ———— $295
Initial coverage ————– Up to $2,700 in total drug costs.
Coverage gap ————— After $2,700 in total drug costs; up to $4,300 in copay.
Catastrophic coverage ——- After $4,300 in out of pocket (copay) no limit.
It’s important to recognize the following:
1. The primary benefit is $2,700 worth of drugs.
2. The $2,700 is combined copay and plan pay.
3. The coverage gap is $4,350 of copay only. – 100% your money.
The following represents the total of subscriber payments. There are four elements of expense to the subscriber. These are actual figures are from a family member’s plan.
Premiums ———————— Month ——– Year
Medicare Part D —————– $40 ———- $ 480
United Rx Plan ——————- $23 ———- $ 276
United Deductible ——————————- $ 295
Co-payment ———————————— $1,100
Total year ————————————– $2,151
The actual benefit to the subscriber is as follows:
Allowance ———————— $2,700 Combined subscriber copay and plan pay.
Co-pay ————————- – $1,100 Subscriber copay.
Actual benefit ——————– $1,600 Plan pay.
Plan benefit ———————- $1,600
Plan expense ——————- – $2,151
Actual plan benefit ————– ($ -551) – loss
The primary benefit of $2,700 allowance includes co-pay and plan pay. Deducting the co-pay of $1,100 from the $2,700 allowance produces an actual benefit of $1,600 and a net loss of $551.