I am Kathleen Morgan, a retired healthcare professional from Aurora, Colorado, living with high low-density lipoprotein (LDL) cholesterol since 2022. Previously, I had been treated for asthma due to Gastroesophageal reflux disease (GERD) and paid for Symbicort as well. Both of these drugs were classified as Tier 3 drugs. Tier 3 to me means expensive and out of my pocket. 

I am on Medicare and currently prescribed one Tier 3 drug, Repatha. With the start of the new year, thanks to the new out-of-pocket cap, I have some savings to look forward to. 

I advocate for lower costs because affordable drugs should be a right, not a privilege. As everyone should know, the older we get the more likely we are to need life-saving medications that shouldn’t be draining our retirement savings for the benefit of pharmacies and Big Pharma.  As I get older, things happen. 

I personally skipped the past three months of Repatha because Optum wanted $600 for my co-pay. I also had to pay a percentage of my regular prescriptions towards the end of 2024. Optum is a pharmacy benefit management company (a division of United Healthcare) who acts as a middle man and ‘manages’ my prescriptions. I do not need them to manage anything of mine, nor their so-called assistance. 

Thanks to the $2,000 cap on drugs, I can now handle paying for my medications – it is a huge break for me and my family. I really feel sorry for consumers who do not have advocates or understand the management of prescription drugs in this country. We are all being taken to the cleaners. Life as well as retirement should be enjoyable and a period of time where I can enjoy savings for myself. Having to constantly worry about prescriptions and how much I have to pay for this ‘benefit’ is really unacceptable for all senior citizens.