What is the cost of Tamiflu?

It’s flu season and Tamiflu is the go-to medication to help cut short the aches and pains of this illness.  But what is the cost of Tamiflu?

I have a friend who is visiting from Maine and on day 3 of her visit she came down with  flu symptoms.  We took her to an urgent care office and they confirmed she had the flu, so they gave her a prescription for Tamiflu/Oseltamivir.

My friend has Medicare and a Medicare supplement plus a stand-alone Part D plan for drugs.  She pays $28 per month for her drug plan.

What is the cost of Tamiflu if you have Medicare and a Part D drug plan? 

Tamiflu is not covered by most drug plans.  The generic, Oseltamivir is covered but….  most stand-alone drug plans treat it as a brand drug.  That means the $435 deductible that is part of almost all Part D plans comes into play. 

With my friend’s AARP Walgreens drug plan, she would have paid $50 for Oseltamivir. That is the full retail price for the drug.

With my Humana Walmart drug plan I would pay $78.54 because that is the full price and the $435 deductible applies to this generic drug.

What is the cost of Tamiflu with Medicare Advantage plans?

Tamflu, the brand drug, is not covered by Medicare Advantage plans, but…. the generic is treated as a generic – by most Advantage plans – and the cost is $5 – $10.  Advantage plans say the retail price of Oseltamivir is less than $10, so I wonder: 

How can the “retail cost” of this generic drug be so different with “stand-alone” drug plans ($78) versus Medicare Advantage plans ($8)?

I am going to send an email to all my clients who have a Medicare supplement and a Part D drug plan and tell them not to use their drug plan if they need Tamiflu.

The cost of Tamiflu (Oseltamivir) with a Good Rx coupon is:

  • $27.29 at a Frys pharmacy
  • $40.58 at a Walmart pharmacy
  • $39.99 at CVS

It is evident that people who get a Medicare supplement in order to have better coverage for their medical costs are being penalized by the Medicare Part D program. 

I figure somebody wants people to move to Medicare Advantage and away from “Original Medicare”.

Medicare Advantage plans generally do not have a deductible in their drug plans.  Almost every stand-alone Part D plan has a $435 deductible that applies to brand drugs.

I think I will also send an email to my Medicare Advantage clients to tell them to always check https://www.goodrx.com/

Even Medicare Advantage plans treat some generics as brand drugs, so it’s a good idea to shop around.  I met a lady during the Annual Enrollment Period last fall who pays $130 for a drug I had never heard of.  I checked https://www.goodrx.com/ and told her she could get it without using her Medicare Advantage drug plan for $40. 

I’ve written this many times, but I will repeat myself.  I hate Part D!

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