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New $35 cap on inhalers

Now the the three biggest inhaler manufacturers are capping their price at $35. AstraZeneca and Boehinger on June I and Glazoklinesmith on Jan 1 25. I noticed that the cap of $35 for each inhaler applies only to those in commercial insurance or no insurance at all. I guess I’m stuck with using GoodRx since my Part D Medicare coverage is so poor for these. The new provision from the drug companies ignores those on Medicare. Very disappointing

  1. Hi. How are you doing today? I am aware of the cap of $35 on asthma inhalers. But was unfamiliar about the cap not being accepted by Medicare. Is this something that you learned from your doctor? Just curious. Is there anything further that you can provide. Wishing you all the best. John. community moderator.

    1. I called GKS who makes Symbicort and talked to Brett. He said they were only capping for those who are uninsured or underinsured. The other two manufacturers show on their disclaimers that only commercial and uninsured are eligible.

    2. Thank you for this information. It's great (I am impressed) that you took the initiative to contact GSK directly for clarification – going straight to the source is always a good idea. It's regrettable that the $35 cap for inhalers only benefits those who are uninsured or underinsured, leaving people like you on Medicare unable to take advantage of this opportunity. If there's anything else you need assistance with or if you have any other questions, please don't hesitate to reach out. We're here to help and support you in any way we can. Wishing you all the best. John, Community Moderator.

  2. what about non Hmo Medicare with a Part D plan are we excluded as underinsured?

    1. that's a good question - I hope John offers up an answer. I would imagine (but unsure) that anyone who has Medicare is disqualified from the $35 cap on inhalers. Why are those who are on Medicare discriminated against so much in the healthcare field by the government? It's quite distressing. It's been like this for ... what years now? Raising awareness, advocating for change, and working towards healthcare system reforms are desperately needed. Regards, Rebecca (team member)

  3. I wonder if there is a way to use the $37 cap if we just pay cash and don't run it through our Medicare Part D? I did that with a nebulizer solution instead of waiting to see if Medicare would even cover it. I'm sure tired of paying $120 a month for my Breo after meeting the deductible (which is like $500). This is an expensive disease.

    1. I have two meds including my Fluticasone/Salmeterol inhaler that I get through GoodRx. My insurance would pay half for the brand name inhaler after a $570 deductible, so I would pay around $1,700 per year. I get the inhalers CVS for $43 with Good RX. I don’t know long they will honor that. Pharmaceuticals are inappropriately priced.

    2. It’s great that you’ve found some relief through GoodRx, getting your inhalers at a significantly reduced price. It's frustrating to see how costly medications can be, especially when they are essential for your health. I hope the program you use through the drug store continues. It's a big help. Thoughtfully, Rebecca (team member)

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