Medicare Part D, 2019 planning

[omni550]

As I am not on any ongoing Rx's, I opted for the least-expensive Medicare Part D Drug Plan I could find for 2018 (Envision RX Plus $12.60/mo.) I just received notice that Envision's premiums are going up to $14.50/mo. in 2019, with a deductible of $365.

I'm wondering if it might make sense to change to another Part D provider, as I plan to get my 2 Shingrx shots in 2019, plus I am going on a 2-week cruise in April and will need an Rx for Transderm Scop for seasickness.

Envision's formulary does not cover the new Shingrx vaccine, which costs about $150-$160 each (for the required 2 shots). and Transderm Scop, which runs about $60-80/2 week supply, coverage is listed as Tier 4, non-preferred with a 43% co-pay.

I'm now looking for a Part D provider who DOES include Shingrx and Transderm Scop in their formulary and whose costs all-in would be less than staying with EnvisionRx.

Preliminary research has turned up SilverScript Choice with a $0 deductible and a $29.10/mo premium (2018 pricing).

In SilverScript's formulary I see that Shingrx is Tier 3, Preferred, at $41/vial (shot) and Transderm Scop is Tier 4, Non-preferred, at 41% co-pay.

This^^ looks promising and would save me money over staying with Envision for my planned 2019 Rx usage.

I'll be keeping an eye out for their 2019 pricing update.

I'm sharing my thinking and plan in case someone else here might be in a similar situation.

BTW, Medicare participants are free to switch Part D providers annually, during Open Enrollment (Oct 15-Dec 7)

omni

[NoMoreJob]

I considered trying to save a few bucks by doing something similar but the only thing I knew I'd need is Shingrix and I like my current pharmacy which is tied to my (cheap) drug plan. My doctor also encouraged me to get the Shingrix shot sooner rather than later. So I just bit the bullet and paid for it because I was nowhere near to covering my deductible for the year. The good news is that I'm probably right at that number now so if anything else comes up before year end there's a chance it's covered.

Just a heads up to others. My doctor also said that his clinic had the Shingrix vaccine and could administer it immediately. I asked him how much and he said $160. However, later when I decided to go ahead and get it and called in I found that there was an additional $30 'administration fee.' That was also the case at our local grocery store pharmacy. My regular pharmacy (WalMart) charged no such fee, just the price of the vaccine itself. I'm glad I checked around.

[MBSC]

The Medicare Health Plan Finder now defaults to a preview of 2019 Part D and MA plans.

In my area, the lowest premium PDP will be Wellcare Value Script at $14.00 with $415 deductible.

Quote:

Attention: The 2019 plans are now available to review and compare. You can join a plan starting October 15, 2018 through December 7, 2018. https://www.medicare.gov/find-a-plan...ions/home.aspx

[Bir48die]

I just have to say as my wife approaches 65 she has become the most popular person in the world. Her mail has increases five fold between Medicare and supplemental programs.

[Telly]

Quote:

Originally Posted by MBSC The Medicare Health Plan Finder now defaults to a preview of 2019 Part D and MA plans. In my area, the lowest premium PDP will be Wellcare Value Script at $14.00 with $415 deductible.

Thanks for alerting us to the update.

In my area, 3 more plans have been added, including the Wellcare Value Script at only $10.40 here, also with $415 deductible. No idea what they don't cover or drugs vs. tiers. They undercut the previous lowest premium, Aetna Medicare RX Select (which I have, starting next month). The Aetna premium drops from 2018's $16.70 and $405 deductible to 2019's $16.10 and a lower $380 deductible. I'll have to look through the 2019 Formulary before the end of Open Enrollment. Other than ShingRix, I don't have anything to really look for.

[ivinsfan]

I'm debating if I should start a new thread about increases in Part D...I went on Medicare TODAY...I selected the cheapest Part D available in my area as a placeholder as I currently do not take any prescription drugs and my cost was 20.40 a month. Arriving in todays mail.... as of Jan 1 it will cost me 25.60 which is over a 20% increase. And the deductible went up 15 a year... In my state I can't get anything cheaper....I'll look at new offering for 19 but not too optimistic.

[Ian S]

My current plan (Aetna Medicare Rx Select) has had a slight reduction in premium for 2019 and is still the lowest premium available in Phoenix ($12.20/mo). For my atorvastatin, there is no out of pocket cost. My pantoprazole was costing $3/mo in 2018 but appears to $0 for 2019. The Shingrex is $143. No other plan comes close to it in either premium or total costs so I'll probably be sticking with it.

[ivinsfan]

I'm realizing that even though Part B cost are fixed nationally supplement and part D costs vary wildly and I'm in high cost state...bummer

[calico1597]

I had a web chat with SilverScript, the choice plan for my zip code has a $26.80/month. No copay for mail order generic drugs with 90 day refills, and SHINGRIX is covered, cost is $79.39 per dose. Their preferred stick store is CVS. My current plan, Humana, just quoted me $140 per dose for SHINGRIX

[kaneohe]

My Humana Walmart plan, previously one of the lowest cost plans, is now 4th....primarily from a $10/mo. increase in premiums. Anyone have experience w/ Wellcare, Cigna or Envision which are now lower cost for me?

[ivinsfan]

Sounds like Humana is raising prices for next year...

[Steve s]

I am presently with Humana but in Iowa I see they are 4th on list. If I change to another company for 2019 do I have to contact Humana to drop me in 2019 or will that be automatic when I sign up with another company? thanks

[Another Reader]

Unlike Medigap plans, which all provide the same benefits and have similar quality ratings, it's open season with Plan D. Benefits and ratings can differ dramatically, and it is hard to discern who is best. The ratings are fair at best for all the plans, at least on the One Exchange site. Three out of five stars is not a positive recommendation to me.

To me, the most important aspect of a Part D plan is how they deal with the expensive drugs. If you take no drugs or have one or two common generic prescriptions, probably the cheapest plan will do. But what happens when you suddenly need that new, $5,000 a dose prescription? How much does the insurance company drag its feet approving that? How flexible are they with skipping step therapy if your doctor certifies you need the more expensive drug? Who has favorable formularies and who pushes commonly used medications into higher tiers?

To a large extent. it comes down to how much pressure on and control of your doctor does the insurance company have. I would like to hear from the doctors, pharmacists, and drug company employees in this forum, especially those that can be completely candid about their experiences. Insurers as well. Who are the best and worst purveyors of Part D plans? What companies are hard to deal with or are slow to approve expensive drugs? Does it make sense to buy a more expensive plan if you don't need it today, especially if someone else is footing the bill? Are these large insurance agencies such as Boomer Benefits and Senior Savings Network really looking out for the customer or are they pushing plans that benefit them?

Anyway, I think we would all benefit from hearing from those in the trenches. Thanks in advance to anyone in the industry willing to step up and share their knowledge and experience.

[SumDay]

We've been very pleased with Silver Scripts. We're paying far less for DH's prescriptions than we did when he was on my very generous employer-provided plan.

2018 premium is $24, next year it will be $29. We went with the Choice (standard plan) and see that Shingrix will be $35 for us, with the plan paying $106. YMMV

[wmc1000]

Quote:

Originally Posted by Steve s I am presently with Humana but in Iowa I see they are 4th on list. If I change to another company for 2019 do I have to contact Humana to drop me in 2019 or will that be automatic when I sign up with another company? thanks

Changing Part D plans automatically unenrolls you from your current plan as of Jan1, 2019

[grasshopper]

Quote:

Originally Posted by Ian S My current plan (Aetna Medicare Rx Select) has had a slight reduction in premium for 2019 and is still the lowest premium available in Phoenix ($12.20/mo). For my atorvastatin, there is no out of pocket cost. My pantoprazole was costing $3/mo in 2018 but appears to $0 for 2019. The Shingrex is $143. No other plan comes close to it in either premium or total costs so I'll probably be sticking with it.

Another resident of the dry heat state. My Humana/Walmart went up 30% so of course it is time to switch. Aetna Medicare Rx Select (PDP) has my only script at tier one mail order at $0. So I will pull the trigger on Aetna. Has Aetna been OK with you.

[Ian S]

Quote:

Originally Posted by grasshopper Another resident of the dry heat state. My Humana/Walmart went up 30% so of course it is time to switch. Aetna Medicare Rx Select (PDP) has my only script at tier one mail order at $0. So I will pull the trigger on Aetna. Has Aetna been OK with you.

Haven't had any problems with Aetna but my needs are rather simple. When I was on the Humana-Walmart plan, I never went to Walmart, always Frys Food but then they made it cheaper if I got ongoing prescriptions by mail so I opted for that. Now I'm back to monthly prescriptions at Frys because I don't like it when a mail order prescription sits in my mailbox for hours in 110F heat and full sun. Can't be good for the medicines! And $0 cost monthly is just as cheap as $0 mailorder!

[grasshopper]

Quote:

Originally Posted by Ian S Haven't had any problems with Aetna but my needs are rather simple. When I was on the , I never went to Walmart, always Frys Food but then they made it cheaper if I got ongoing prescriptions by mail so I opted for that. Now I'm back to monthly prescriptions at Frys because I don't like it when a mail order prescription sits in my mailbox for hours in 110F heat and full sun. Can't be good for the medicines! And $0 cost monthly is just as cheap as $0 mailorder!

Thanks for the info, yea I have my meds shipped to a post office in New Mexico, in a air conditioned building. Aetna looks a lot like the Humana-Walmart plan which is at $26 + change.

[wmc1000]

Quote:

Originally Posted by grasshopper Another resident of the dry heat state. My Humana/Walmart went up 30% so of course it is time to switch. Aetna Medicare Rx Select (PDP) has my only script at tier one mail order at $0. So I will pull the trigger on Aetna. Has Aetna been OK with you.

DW and I switched to Aetna last year. No issues at all. Like others have mentioned the rates dropped slightly fir next year, in our case from 17.70 to 17.10 each and most generic RX's are $0 cost.