Dealing With Quantity Limits in Part D Drug Plans

[Ian S]

So I'm about to sign up for the super cheap SilverScript SmartRx (PDP) Part D prescription drug plan. Via the Medicare comparison tool, it shows all my prescriptions (generic) are covered and result in no cost to me. Unfortunately, when I check the formulary, one of my prescriptions has a quantity limit of 30/mo when my prescription is for 60/mo. Are there ways around the limit and for a tier 1 generic that is pretty cheap, what is the pharmacy likely to do when presented with the prescription and the quantity limits of the plan? I have a couple of alternatives: use Goodrx for the prescription instead of the insurance or go with an alternate drug which would not have the same quantity limits. The other drug probably will work just as well but requires a new prescription. Any other thoughts/ideas?

 

[kaneohe]

would another plan in the same price range have fewer limitations? could you double the dose and keep qty the same. Is GoodRx.com a good choice for the lower level drugs.........I seemed to find them more expensive at the low end.

 

[Ian S]

would another plan in the same price range have fewer limitations? could you double the dose and keep qty the same. Is GoodRx.com a good choice for the lower level drugs.........I seemed to find them more expensive at the low end.

Thanks for the suggestions. Unfortunately, the drug is in capsule form and I have to take two a day. It's already the highest dosage (40 mg.) GoodRx is pretty cheap especially if I can get a 90 day supply. This plan is by far the cheapest - the next one up is $10 a month more which is more than I would pay for the drug under GoodRx and then the more expensive plan charges for another of my drugs!

 

[Sunset]

How expensive is this drug ?

First time you show the prescription, if the pharmacy has an issue then:

Use a mix of prescriptions.
Tell doc you need a (30/mo with 12 repeats) prescription and a second prescription for ((30/mo for 90 days with 4 repeats , which you will use goodrx upon even at a diff pharmacy if you like).