![]() ![]() Last year, my marketplace plan covered five primary care visits at no charge before I paid down my $2,200 deductible. There's also a hitch for any patient using the coupons, Ross points out: The discounts often have annual maximums that leave patients on the hook for the entire copayment after a certain number of months. If patients choose to use the coupons to buy a higher-cost drug over a generic or other cheaper alternative, the cost to Medicare and other federal health programs is likely to be more than what they would otherwise pay. Under the federal anti-kickback law, it's illegal for drug manufacturers to offer any type of payment that might persuade a patient to purchase something that federal health care programs like Medicare and Medicaid might pay for. The explanation may offer you little comfort. Why can't I use a $5 drug copay coupon from the manufacturer? If I had commercial insurance, I could. My doctor wants me to take Repatha for my high cholesterol, but my Medicare drug plan copayment for it is $618 a month. We have answers to these health care questions that may have been worrying or frustrating you, too: ![]() One reader suspects a double standard - how come people with private health insurance are allowed to use a manufacturer's discount coupon for medicine, but Medicare patients can't? Another consumer wonders what ever happened to cost-free primary care appointments. But health care analysts say the coupons may also discourage patients from considering appropriate lower-cost alternatives, including generic drugs. Patients with private insurance like the drug coupons because they can help make specialty medicines more affordable.
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