Cost Plus Drugs is great...until it isn't

Once again, my apologies for being late with the blog. I do have a good excuse this time; my sister's family was visiting from Sunday through Tuesday, and I spent more or less the whole time with them at my parents' house in Hopewell. So I didn't get a chance to finish up this post until Wednesday. Now, on to a few words about health care costs.

When Brian retired last February, I did a lot of number crunching to find the best prices on the health coverage his job would no longer provide. The state's Get Covered NJ website helped me compare basic health plans quite easily, and a little online searching helped me find a separate plan for vision care. (Side note: the dental discount plan I chose turned out to be a complete bust. The dentist we'd been going to for years wasn't in the plan's network, and the local dentist we decided to try instead charges way, WAY more than the estimates Aetna provided for "average costs" under the plan. Unfortunately, we didn't learn this until we showed up for our appointments, so we ended up paying $100 in cancellation fees and going back to our old dentist. Add in the $145 we paid for the discount card itself—counting the extra $20 I decided to pay for prescription drug discounts that turned out to be worthless—and that's $245 wasted instead of saved.) 

Then, since our new plan had a high deductible, I also used its website to help me check out-of-pocket prices for all our prescription drugs. For most of them, I found that it would be significantly cheaper to buy from Cost Plus Drugs, a Mark Cuban venture that offers generic drugs at rock-bottom prices. The way it works is right there in the name: They charge you the wholesale cost of the drugs from the manufacturer, plus a 15% markup to pay for their overhead, plus a $5 dispensing fee for the pharmacy that makes up the prescriptions, plus shipping, which is a flat $5.25 for most orders. 

All that can add up to a substantially lower price than you'd pay at a retail pharmacy. For example, one of my rosacea medications, a 15% azelaic acid gel, would cost $81 a tube if I bought it from the nearest in-network pharmacy. If I bought it through my health plan's mail-order pharmacy, that would drop the price to just $26.14 per tube plus shipping—but that pharmacy is Amazon, which I don't want to use unless it's the only option. If I used a free discount card from GoodRx, I could get the medicine from a local chain pharmacy (which isn't in our plan's network) for around $36 a tube. But at Cost Plus, the total price including shipping is just $24.27.

This sounds great, and it is, but there are a few downsides. One is that Cost Plus only offers a limited selection of medicines. However, all of ours are on this list, so that wasn't a problem for us. The second is that they aren't in the networks of most health insurers, including ours, so we have to pay the full costs out of pocket. But I didn't consider that a deal breaker because, in the first place, our plan's high deductible meant we'd be paying for most of our meds out of pocket anyway. And even if we happened to hit our deductible in a given year, the plan would only cover 60 percent of medication costs after that. At our local, in-network pharmacy, just our 40 percent copay on the azelaic acid would come to $32.40, which is still higher than the total price from Cost Plus.

The third problem is the difficulty of transferring prescriptions to Cost Plus. Most pharmacies will happily transfer a prescription from another pharmacy for you. So, if I'd been using Amazon or another in-network pharmacy, I could have simply transferred over the prescriptions I had at OptumRx, our old plan's mail-order pharmacy, and used the refills I had remaining. But Cost Plus doesn't do this. You have to ask your doctor to send them a new prescription for each medication you use—and if the meds were prescribed by different doctors, you have to do this multiple times. It took several attempts to get in touch with my new doctor, as well as my dermatologist, and get them to send in my prescriptions to Cost Plus, but I managed it in the end for most of my meds. And once Cost Plus had the prescriptions, it was perfectly straightforward to use. They sent me a notice to say the prescriptions were ready to fill, I went on the site and placed the order in a few minutes, and the meds arrived in about a week.

The fourth problem came up with the last remaining medication I hadn't transferred over yet. This was partly my fault; I thought I had an extra tube of the azelaic acid on hand, which would have been enough to get me through to my next appointment with the dermatologist, so I was planning to ask for a new prescription then. But that extra tube in the drawer was actually a different medication, something we were no longer using. So, with just a few weeks' worth left, I reached out to the dermatologist last month and said, "Hey, I don't have enough of my meds, can you send a new prescription to Cost Plus?" and they obligingly did so. Within a day, I received a message from Cost Plus saying they had the new prescription...but unfortunately, the medication was out of stock. They promised to notify me as soon as it was back in stock, but they gave no indication when that would be.

For a couple of weeks, I waited, keeping a wary eye on my supply, to see if the medicine became available. I considered calling the doctor again to ask to have yet another prescription sent to a different pharmacy (since you can't transfer prescriptions away from Cost Plus either), but the high cost deterred me. Finally, I tried getting in touch with Cost Plus customer service to ask if they had any idea when the meds would be back in stock, and here I ran into the fifth problem: You can't. There's a FAQ on the website and a chatbot who doesn't know anything that isn't in the FAQ, and there's a feedback form on the site you can use to email them a question and hope someone answers. (I tried it over the weekend and got a response on Monday, but all it said was, "We don't have an ETA at this time. You will get an email when it's back in stock," which is exactly what they'd told me already.)

I finally settled on a solution I'd used once before when I ran out of this medicine while on vacation: I bought an over-the-counter preparation of azelaic acid instead. It's only 10 percent azelaic acid instead of 15 percent, but it should be good enough to get me through to my appointment next week. If Cost Plus doesn't have the prescription strength back in stock by then, I can ask the dermatologist to send a new prescription to another pharmacy (ideally one where I can use my GoodRx coupon). But the whole situation made me kind of nervous. If they could simply run out of this medication, could it happen with others as well? Could I log on one day to refill my prescription for, say, my thyroid medication, only to see that it's out of stock and there's no indication when it will be available again? 

I went searching online to see if anyone else had experienced this problem, and I found not one but two Reddit threads where people complained that their medications—much more essential ones than mine—had been out of stock for weeks or even months, with no indication when they'd be back. I also found a bunch of negative reviews on both Reddit and Trustpilot accusing Cost Plus of still graver errors. Some people said their doctors had sent their prescriptions to Cost Plus multiple times and they still weren't showing up on the site. Others said they'd been charged for medications they never received or had orders canceled with no notification. Worst of all, some said they'd ordered medications that were supposed to be temperature-controlled, and Cost Plus had shipped them in a regular envelope in the blazing summer heat, making them unusable. And all of these people said that they were unable to get a satisfactory response from customer service, if they got any response at all.

All this makes me feel torn about relying on Cost Plus in future. On one hand, it's much, much cheaper than the alternatives for some of our meds. But that's assuming we can actually get them there, and that seems far from guaranteed. Right now, my inclination is to keep using Cost Plus when possible, but make sure to have a backup available. I plan to refill all my meds as early as possible, and if they aren't available within two weeks of the time I need them, call the doctor and ask to have the prescription sent somewhere else. I'm not worried about the cold-chain problems, since Brian and I don't take any medications that require temperature control, but if we ever do, I'll make sure to get those somewhere else.

In the course of writing this post, I also learned about a couple of other alternatives. There are two other online pharmacies operating on a cost-plus model that can ship to my area: Blueberry Pharmacy and Midtown Express Pharmacy. (Reddit mentioned the first one, and I found the other through a search on CostPlusPharmacies.com.) Unforunately, Blueberry doesn't offer most of the medications we use in the appropriate dosages, and Midtown Express doesn't let you check prices online. So for now, it looks like my Cost-Plus-plus plan is the soundest one.

Being retired is a lot of work

Brian and I have just completed our first full month of retirement. Brian left his job in mid-February, and my last remaining client cut me off at the end of February, so we both spent the entire month of March living a life of leisure. Well, in theory, at least. In practice, we seem to be even busier than when we were both working full-time. 

Since neither of us has to work during the day anymore, we have no restrictions on scheduling meetings and appointments on weekdays, nor do we feel as much need to zealously protect our limited free time on the weekends. Consequently, we've been piling more and more things on our plates. We're in not one but two RPG groups, and we've taken on leadership roles for our Monday night board-game group as well. Brian has been going to the blood bank more often to donate platelets (I'm not allowed to do likewise because of some meds I'm taking). I've been taking part in more events with my Citizens' Climate Lobby chapter. And in between, we've been going back and forth to various doctors to treat all the health problems that popped up right on cue as soon as we became old, retired people. With all that going on, our calendar for the past month has had scarcely a day on it that's completely open. And looking at what's coming up (including the rescheduled Repair Cafe on the 19th, a half-dozen dance events, and a family wedding in June), we shouldn't expect it to ease up much for the next few months at least.

If our post-retirement schedule has been a bit of an adjustment, our post-retirement budget is an even bigger one—particularly where health care is concerned. Thanks to state subsidies, the monthly premium we're paying for all our new health plans is actually less than we paid for Brian's workplace plan: about $350 as compared to $619. But that smaller sum feels more noticeable because the payments come out of our checking account every month, rather than slipping invisibly out of Brian's paycheck before it ever hit our account. 

More noticeably still, our new plans come with significantly higher out-of-pocket costs. Every visit to a specialist, which would have cost only $30 on our old plan, rings up at $75 on our new one, and the bill for an MRI one of those specialists ordered came to about $519 (well below the full price, but still far from trivial). Add in the new out-of-pocket cost for prescription meds, and we've spent over to $850 on health care just in the past month. And there's going to be plenty more where that came from, including a second MRI that we haven't been billed for yet.

Another item on our post-retirement expense sheet: taxes. This one wasn't exactly new, as I'd always paid quarterly estimated taxes on my freelance income (up until last year, when I had so little work that I didn't owe enough to be worth counting). But I didn't have to pay tax on that income until it actually hit my checking account, whereas I'm now paying estimated tax on the dividends, interest, and capital gains from our investments. (All that was taxable income before, too, but between Brian's withholding and my estimated tax payments, we always paid enough in tax throughout the year to take care of it.) This, again, feels a lot more obtrusive, because I'm paying taxes on these earnings before I've even laid hands on them.

But what's even harder is figuring out how much I owe. When I got paid for a freelance job, I knew exactly how much I'd earned, so all I had to do was add the payments I'd received for the quarter and multiply the total by 25 percent, which was more than sufficient to cover the taxes. To find out how much we'd earned on our investments this quarter, I had to ask my finance guy—and instead of sending me back a number, he sent several different documents, each showing "trade activity" or "gain/loss" for a different account. He explained that to figure out our earnings, I'd have to open up each of the "trade activity" documents and manually add up all the figures listed for interest and dividends, then add (or, in some cases, subtract) the "total realized gains" from the "gain/loss" documents to come up with a total. You would think that with all the fancy software Morgan Stanley has, they'd have some way to calculate this for us automatically, but apparently not. I ended up creating a new spreadsheet page to do the math for me.

It's not the money that bothers me so much about any of this; it's the paperwork. When Brian was working, dealing with income and expenses was simple. Health premiums and taxes came out of his paycheck automatically, and our take-home pay got deposited automatically into our bank account. When we needed to see a doctor, we paid the copay, and the insurance took care of everything else without bothering us. I knew, in theory, that after retirement we'd have to do more of this work ourselves. But it does seem like it's all more complicated than it really needs to be.

Signing up is hard to do

Thirteen years ago, when we paid off our mortgage, I was surprised to find at how hard it was to make that final payment—not financially or emotionally, but technically. We had the money, and we were ready and eager to hand it over, but getting the bank to accept that final payment was way more complicated than I expected. It took a whole series of transactions online, by phone, and in person at our local branch to get the job done.

Right now, we're having similar problems with another big life transition: Brian's retirement. Specifically, the process of switching over to a new health care plan.

The problems started in January, when Brian chose February 11 as his official retirement date. I got straight to work trying to sign us up for new coverage on Get Covered NJ, only to run into a snag: because it was January, the state was still in the middle of "open enrollment." If I signed up for a new plan during that period, it would automatically start on February 1, while Brian was still employed—and double-dipping on coverage is a big legal no-no. So I had to wait until February 1 to sign up for a new plan that would start on March 1.

Once I'd done that, I still had to take care of all the other details associated with changing coverage, like choosing a new primary care doctor and transferring our prescriptions. To do that, I needed to set up an online account with the insurer. And here I ran into my second snag: Because our new insurance plan was with the same provider as our old plan, I already had an account on their website. I could find no obvious way to add my new plan to that account, so I struggled through the maze of customer support and eventually learned that I'd have to wait until the new plan took effect on March 1 (today) to create an account for it.

So, this morning, right after breakfast, I settled down for what I figured would be a busy day of paperwork (or, since it was all going to be online, pixelwork). I punched in all my details—name, date of birth, member ID—and tried to create an account. And ran straight into snag three: I couldn't create an account using my email address because I already had one linked to my old account. I could still log into that old account, but it only had information about the old plan that had just expired. And because it was Sunday, I couldn't call or chat with customer service to fix the problem. Until the customer service lines open tomorrow morning, I'm stuck in limbo.

Annoying as that situation is, it seems positively straightforward compared to the problem I'm having with the website for our new dental savings plan. I registered on that insurer's site as soon as I bought the policy—or at least, I thought I had. But when I tried logging in today, using my email address and the password I'd selected, it told me either my username or my password was wrong. Okay, no big deal: I just clicked on "find my username" and entered my member ID, name, and date of birth to get my official username. Then I entered that username and the password I'd selected...and once again, the site told me that one of the two was wrong. So I took a different tack and asked to sign in without a password, using my username and date of birth to receive a login code. And I got the same error again. It told me that either the username it had just given me or the date of birth I gave it to get that username was wrong. I must have gone through the same cycle four or five times—check the username, enter the username and password, enter the username without the password—before I gave up. So that's yet another customer service call I need to make tomorrow.

Naturally, all this left me feeling a bit disgruntled. But as I was about to make some snarky remark to Brian about how much technology has "simplified our lives," I thought, well, wait a minute: would this actually have been any simpler before the Internet? And as it happened, I already knew the answer, because the last time I'd signed up for private health insurance was in 1995, before any of this stuff could be done online. To get my policy back then, I had to make an appointment to meet in person with an insurance agent, drive to his office, look at a list of plan options he presented to me, flip through a bunch of paper books to compare them, fill out the enrollment forms for my chosen plan by hand, and pay my first monthly premium by check. The whole process was a much bigger hassle than this year's online enrollment, even with all the glitches. It just didn't feel like a big hassle back then because there was no simpler alternative. 

This little glimpse back down memory lane has helped me put my #firstworldproblems in perspective. Yes, it's annoying that these websites are so hard to use. But it's also kind of amazing that they exist at all. Looking at the situation through 1995-era Amy's eyes, having to wait until Monday to call customer service—from my own home, most likely in my pajamas—doesn't seem like such a big deal.

[EDIT, 3/2/26: After a frustrating half hour on the phone with the insurer, I'm no longer convinced doing things the old-fashioned way was harder. After working my way through the maze of the automated phone line and spending about 15 minutes on hold, I was informed that it was not possible to set up a new online account with my current email and my only option was to create a new email for this purpose. I gently (okay, maybe not so gently) pointed out that it can't be too uncommon for people to change plans, and it seems unlikely that the system simply doesn't allow for this possibility. The agent then put me on hold again while she presented this argument to the "e-services department," which eventually conceded that it would be possible to unlink my email from the existing online account so I could use it to create a new account. (Doing this would cut off my access to the old plan info, but that wasn't a problem because Brian still had an account linked to his email, so we could use that to deal with any lingering problems.) However, it apparently takes three to five business days to perform this apparently simple operation, so I'm now stuck in a holding pattern until Friday. The call then redirected me to a customer satisfaction survey, which I used to register my customer dissatisfaction. I even pressed the button to add an extra comment, gently (again, not that gently) suggesting that it would have been helpful to warn me about this "feature" when I first signed up for the new plan, so I could have dealt with it ahead of time.

On the plus side, one quick call to the dental plan provider was enough to unlock my account, so that shows competent customer service still exists somewhere in the modern world.]

[EDIT, 3/5/26: Well, there's good news and bad news. The good news: It didn't actually take 3 to 5 business days to uncouple my email from my old account. I got a call back within one day to say it was done, and I took the precaution of keeping the customer service agent on the line until I'd confirmed I was able to sign up for a new account. The bad news: Even with that account set up, I wasn't able to select a new Primary Care Provider online. I went through all the steps to do it and got a message saying, "Your PCP request could not be processed." So I got in touch with customer service again and they made the PCP selection for me—or at least, they said they had. It's now been two days and no PCP is showing up on my account. 

What's odd is that Brian made his PCP selection shortly after I did, using the phone system rather than chat, and his selection has already been processed. I just called Member Services again to sort this out, and as best I could make out from the agent's somewhat incoherent explanation, Brian's request somehow superseded mine. So this agent made the PCP selection for me again, and once again told me it would take 3 to 5 business days to go through.

So I'm now back in limbo, unable to transfer my medical records, see my new doctor, or get new prescriptions for any of my meds until this is resolved. In my ongoing battle with bureaucratic B.S., it's easy to see who's winning.]

How we became financially independent

This week, Brian finally did something he's been wanting to do for years: He quit his job. He is now officially retired, financially independent, a gentleman of leisure. Thirteen years after we officially set our sights on early retirement as a goal, we have now crossed that goal line.

How did we do it? Basically, by following the same plan that I outlined in that 2013 post and later expanded on in a 2016 article for Money Crashers: 

1. Cut your expenses as much as possible to maximize the amount you can sock away each month. (This step is what you've been reading about here for the past 13 years.)
2. Invest those savings in a mixed portfolio of low-fee funds. We've had some help with this step from a reliable finance guy who's sniffed out investments that earn us solid returns while minimizing what finance guys like to call "downside risk." (What exactly would be an upside risk?)
3. Stick with the plan until you've earned enough to retire. Technically, we reached this point a few years ago, but Brian needed a little time to get comfortable with the idea. Last year, he decided he was ready to take the plunge, and his official last day was Wednesday.

Before we could cross that finish line, though, there were a few t's to cross and i's to dot. The most obvious one: health insurance. Luckily for us, we live in New Jersey, which has a well-organized state health marketplace (Get Covered NJ) that makes it quite easy to shop for plans and compare costs. Even more luckily, New Jersey is one of the ten states that have stepped in to pick up the cost of the Obamacare subsidies Congress canceled last year. With our new, lower income (which is based on our taxable investment earnings, not the amount we withdraw each year to pay our bills), we qualified for a discount of over 80%, cutting our monthly premiums to just $318 for the two of us. Mind you, this is for a plan with a pretty hefty deductible ($2,100 per person per year), so we'll have to get used to paying out of pocket for a lot of costs that used to have only a nominal copay, such as prescription meds. But with all the practice we've had stretching our dollars over the past 22 years, I'm sure we can manage to keep those costs under control.

The health plan I bought doesn't cover dental or eye care (except for children, which we don't have). With a little searching, I was able to find a separate vision plan that wasn't too expensive (around $21 a month for both of us) and included our current eye doctor in its network. Based on our typical eye-care needs, which are a bit on the high side, it looks like this plan will save us around $300 a year. But dental coverage, at first blush, looked like a completely different story. There were dental plans available on Get Covered NJ, but most of them, once again, offered coverage for children only. The few plans I found that included adult care were not only expensive but had very low out-of-pocket maximums. (The worst of the lot capped payouts at a mere $1,000 per year, which was barely more than the annual cost of the premiums. It was practically guaranteed to cost us more out of pocket than it would ever pay back.) With such limited coverage, these plans would do little to nothing to protect us from ruinous costs, which is what insurance is supposed to be for.

But after looking a little further, I found an alternative that looked much more cost-effective: a dental discount plan. This isn't technically the same as insurance, which pays your bills (or a portion of them) for you. Instead, for a nominal yearly fee (around $125), you get charged a reduced rate for all care from dentists in the plan's network. If the plan's estimated costs for services like cleanings, exams, and fillings were accurate, it looked like it would save us about 65 percent on our average yearly dental costs. The only catch was that it would require us to choose a new dentist, since the trusted dentist we've been seeing for years isn't part of this or any other dental network. But after a little research, I was able to find a dental office with very good reviews from customers that's not only in the network, but also within walking distance of our house. Given how much we stood to save, it seemed like we should at least give the new dentist a try. If we didn't like her, we could always go back to our old dentist, and it would cost us nothing (since the savings just on that one visit would be enough to offset the signup cost).

In addition to the health insurance, there was one other workplace benefit we had to replace: Brian's computer. The laptop he's been using for the past several years belongs to Rutgers, and we knew he'd have to surrender it when he left. The last time we bought a computer, we chose a mini PC, which combined a low price with ease of upgrading. But Brian prefers the portability of a laptop, which he can easily haul into the kitchen for a video chat with his folks, set on the coffee table to stream a show on the TV, or take with him on a trip. So I did a search on Craigslist and found a lightly used Lenovo ThinkPad, which gets high ratings for repairability, for just $200. It's pretty basic, but more than adequate for his modest needs (email, Web surfing, streaming video and audio).

Although Brian is now officially retired, there still are a few more retirement-related tasks we need to clear up. For one, I've scheduled a couple of doctor appointments to take advantage of our current health insurance before it switches over at the end of the month. (One of these is with a dermatologist to see if I can find a cheaper alternative to the cream I'm currently using for my rosacea, which I've just learned would cost me about $100 a month to buy out of pocket.) Then, once the new plan kicks in, we'll need to officially select our new doctor and dentist and arrange to have our health records transferred to these new providers. And there's a bit of paperwork I need to complete to roll over Brian's 403(b) to a new IRA under the care of our trusty finance guy. 

But within a few weeks, we'll be officially set up to live a life of leisure. I'm already more or less retired myself, as all my long-term clients have dropped me one by one over the past few years and I've had no luck finding new ones. I've spent quite a bit of time over the past year or two scouring freelancer job listings and applying for suitable-looking jobs with essentially no results, and since we don't really need the money, I've decided to stop bothering with it. I'm happy to accept a new assignment if it simply falls into my lap, but I'm not wasting any more of my time looking for work. I'll leave it to the younger freelancers who need it more than I do.

Having reached this major financial goal, we don't feel any need to set a new one. All we have to do at this point is make sure our nest egg can carry us through the next 40 years or so. (We'll still have smaller, shorter-term goals, like gradually electrifying our home and, eventually, our car. But we've got ample cash in the kitty to dip in for those expenses as needed without cutting into our income.) So basically, we just need to stick with the same plan we used to get here: keep our expenses low, keep our investments sound, and keep on trucking. Which means that the posts you'll be reading on this blog in the future will probably be along much the same lines as the ones you've read here in the past. We'll still be doing all the same things to save money and care for the environment as we've always done; we'll just have a lot more time now to do them.