A health insurance system unfair to seniors and everyone else.

Of course, there is the “standard” Medicare Part D, which was once available in every location to every Medicare beneficiary. It comes with a base Medicare premium of $38.99 in 2026, that’s $467.88 a year before any benefit is paid.

It also comes with a $615 annual deductible, before any benefits are paid. So, if you want coverage that includes most every Rx, you are out of pocket $1,000 before any benefits are paid.

After the deductible, the “standard” Medicare part D comes with 80%/20% coinsurance up to an annual out of pocket limit of $2,100.

Other features include “negotiated” discounts on the ten most expensive Rx frequently used by seniors:

1. Eliquis: Prevention and treatment of blood clots
2. Jardiance: Diabetes; Heart failure
3. Xarelto: Prevention and treatment of blood clots; Reduction of risk for
   patients with coronary or peripheral artery disease
4. Januvia: Diabetes
5. Farxiga: Diabetes; Heart failure; Chronic kidney disease
6. Entresto: Heart failure
7. Enbrel: Rheumatoid arthritis; Psoriasis; Psoriatic arthritis
8. Imbruvica: Blood cancers
9. Stelara: Psoriasis; Psoriatic arthritis; Crohn’s disease; Ulcerative colitis
10. Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen;
    NovoLog PenFill: Diabetes

Bottom line is that any choice that includes all Rx, would be cadillac coverage with a price tag that makes the insurance companies richer, because most retirees only need maintenance Rx.

For example, I have a modest plan that does cover almost all Rx, and costs me and my spouse, $124/month, where she has almost no Rx usage, and while I am on 5 medications, all of them are generic, and I am paying copays of less than $300 a year. it is part of my employer-sponsored retiree medical coverage. I wish that they would offer more basic coverage with lower premiums.

For comparison, there is a Humana option here in Ohio which covers most every Rx. They charged $115 a month. How do I know this? A retiree I assist is currently enrolled there. He uses four generic Rx everyday. He pays modest copays of less than $300 a year. He has been in that option almost every year since 2006. For 2026, we found a plan with no copays for his regular visits to his primary care provider and no copays for his four generic Rx, with no monthly premium. Had he been in that or a comparable option since 2006, he would have avoided well in excess of $18,000 in premium over the past 20 years!

You are free to select higher cost options with broader coverage.

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