Medicare Part D 2021 price increases

[ShokWaveRider]

Has anyone actually seen the formulary for Aetna Silverscript SmartRX? I would not find it.

[harllee]

Quote:

Originally Posted by Sue J DH and I started Medicare this year so we haven't gone through the Part D yearly open enrollment yet. For 2020 we both have Wellcare for $14.20 each. My Rxs are all tier 1, cost $0 and I get them from the mail order CVS Caremark or our local grocery store preferred pharmacy. DH has two Tier 2 Rxs that cost $5/mo through the local preferred pharmacy. Wellcare has been great since we started but I am very interested in this Aetna SilverScript SmartRx for $7.50/mo! When we started Medicare I used a comparison tool on the Medicare site to compare plans and costs. When is this usually updated? I checked and it's still using 2020 plans. The SilverScript SmartRx formulary being limited to 98 drugs makes me want to verify that our current Rxs are included. We take very common stuff so I'm hoping this plan may work for us.

The dates to change Part D run from 10/15 to 12/7. The Medicare comparison site should hopefully be available by 10/15.

[badatmath]

Whole process sounds annoying but it is quite a ways off for me so who knows what they will play by then.

[harllee]

Quote:

Originally Posted by badatmath Whole process sounds annoying but it is quite a ways off for me so who knows what they will play by then.

It is somewhat annoying but the Medicare website is good. The real annoying part is that people on Medicare still have to pay a lot for their prescriptions-- Part D is not full coverage by any means. But it is better than it was 20 years ago when most people over age 65 had no prescription coverage. My mother age 90 has told me how awful it was for her.

[badatmath]

Quote:

Originally Posted by harllee My mother age 90 has told me how awful it was for her.

Probably why my grandma never went to a doctor until they took her to one in an ambulance when she fell down a flght of stairs and broke her hip.

[audreyh1]

Quote:

Originally Posted by harllee The dates to change Part D run from 10/15 to 12/7. The Medicare comparison site should hopefully be available by 10/15.

Right, no point in calling Boomer Benefits before then.

[MBSC]

As in previous years, the updated Medicare Plan Finder on Medicare.gov will be available October 1.

In the meantime, Q1Medicare.com has very limited information on 2021 Part D Plans. Number of plans available, plan name and premium. NOT yet available are cost sharing and formulary. It also has a "2020/2021 Part D Comparison" section where you can see the premium changes.

Quote:

Starting on October 1, you can take an early peek at Medicare health plans and drug plans by using the Medicare Plan Finder. If you have a Medicare Number, you can log in or create an account to put together or access a list of your drugs... Source: https://www.medicare.gov/blog/medica...set-a-reminder

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Quote:

Originally Posted by Corporateburnout How about my plan that went up from $14.20 to $34.40 with no medication changes. EnvisionRx was acquired by Elixir and that's the only change that I've noticed.

I have no firsthand knowledge of the following, only secondhand information. Envision is mapping some Plus Plan members (except NY, DC, MD, SC, and DE) to a higher priced Elixir plan. You have to manually change to the lower priced Elixir Plus plan ($16 range for 2021).

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Quote:

Originally Posted by Buckeye I see the plan for $7.50. Is it saying it covers only 98 different drugs?

See below. I increased the font size for you. The 98 is only referencing the 100 most common drugs so the total formulary is larger, but basic plans do have smaller formularies. CMS has regulations on minimum overall formulary size as Audreyh1 pointed out. This plan is only for those on no prescriptions or a couple of Tier 1 drugs.

Each year, the question is asked about picking one plan and then going on a new non-formulary prescription mid-year. For inexpensive drugs, use a discount program like GoodRx. For expensive drugs, the prescribing doctor can submit a Formulary Exception Request to potentially have the drug added to the formulary for your account until the next AEP. Sample Exception Request Form: https://docushare-web.apps.cf.humana...p?file=1828827

Quote:

Formulary Coverage (6): 98 (6) Top 100 drugs most commonly prescribed to Medicare beneficiaries.

[harllee]

MBSC--thanks for all this information, very helpful. I have always waited until after 10/15 to do my Part D shopping on the Medicare site because I figure there could be some last minute changes.

[Corporateburnout]

Quote:

Originally Posted by MBSC I have no firsthand knowledge of the following, only secondhand information. Envision is mapping some Plus Plan members (except NY, DC, MD, SC, and DE) to a higher priced Elixir plan. You have to manually change to the lower priced Elixir Plus plan ($16 range for 2021).

Thanks for the info. I will most likely switch to another company during open enrollment and not bother with Elixir.

[lem1955]

I have Plan D with MutualofOmahaRx. I pay $21.40/month with a $435 deductible. After reading these posts I thought, I could probably find a cheaper plan. But then I looked into it further. I have one prescription for which I would pay $39.10/90 day supply except my plan charges $0 as long as I buy from CVS or ExpressScripts. It would do the same for a long list of generic drugs. I haven't received any renewal notices yet. For now, I'm sticking with this plan. Now I see Elixer has the same deal for the drug I use. I'll wait until all the prices are updated and then check again.

[sn2792]

We have Anthem Blue RX. It is going up $1.00 from 18.90 to 19.90 and deductible is going up from $300 to $340. I don’t take any prescriptions and DH takes one that costs $6.00 a month.

[RobLJ]

Should the Barrett nomination go through and ACA be eventually voided (as expected but perhaps not the reality, to be sure and it almost surely will be different than what is expected), it will be interesting to see the effects on the FIRE group.


There are so many unknowables, so all of you doing the 2 or 3% withdrawals are undoubtedly smarter than me. Kudoes to you all.

[RobLJ]

I'm covered by state plan, so it may have something of an effect on me, but pretty minimal.
If you're counting on ACA, good luck, although if you're not sick it's probably a no brainer. If you or your significant other are sick, you might want to consider an alternate scenario (20-60%--I have no clue how to game this in terms of increased or decreased costs. No clue.)
If you're like me, covered with a State Employee plan, it doesn't really have much of an effect.

I have no clue how to game this--it's beyond me.

[RobLJ]

My twin had a progressive neurological disease, so I'm paranoid about you all. I was behind the door and dodged the bullet, so apparently no matter how much I drink, I'm pretty safe, as my doctor tells me. His expenses were massively expensive--and covered by insurance back in the day (20 years ago).

Good luck to all of you and perhaps nothing will change for you, either in ACA or medically. I hope so. I wish all of you well!

[omni550]

Quote:

Originally Posted by Corporateburnout How about my plan that went up from $14.20 to $34.40 with no medication changes EnvisionRx was acquired by Elixir and that's the only change that I've noticed.

I just got my EnvisionRx/Elixir change notice. My Premium is going from $14.20 to $29.30 and the deductible from $435 to $445.

Luckily, I am not on any Rxs. And I will be shopping for a better-priced plan.

Glancing at the just-opened (effective 30 minutes ago) Medicare Pan Finder site shows Aetna's SilverScript SmartRx at $6.90/mo for my state with deductible of $445. I think we have a winnah!

(And I will have just saved $268.80 for my 10 minutes of work.)

omni

[DoHowv]

Quote:

Originally Posted by Corporateburnout How about my plan that went up from $14.20 to $34.40 with no medication changes EnvisionRx was acquired by Elixir and that's the only change that I've noticed.

I have the same increase from Envision/Elixir. Not very happy about it. I will look to change provider.

[Koolau]

I hope this doesn't sound too cavalier but I don't worry too much about my HC costs at this point. They seem to have stabilized since going on MC. I've got my supplements all locked in as well. Yes, they've gone up a bit, but NOW that I've gotten from age 58 (FIRE) to early 70s (several years on MC now) my ONLY big worry (losing health insurance and being forced to go "find" new health insurance) is GONE. One of the few advantages of getting old seems to be health care costs. Go figure!! Of course, YMMV.

[harllee]

Quote:

Originally Posted by Koolau I hope this doesn't sound too cavalier but I don't worry too much about my HC costs at this point. They seem to have stabilized since going on MC. I've got my supplements all locked in as well. Yes, they've gone up a bit, but NOW that I've gotten from age 58 (FIRE) to early 70s (several years on MC now) my ONLY big worry (losing health insurance and being forced to go "find" new health insurance) is GONE. One of the few advantages of getting old seems to be health care costs. Go figure!! Of course, YMMV.

Koolau, even if you are not concerned about costs if you have Medicare Plan D you should check it on the Medicare website just to be sure that your plan is still the best one for you --that it still covers all your drugs, etc. Every Part D plan changes every year.

[SonofCohoes]

I am so not looking forward to wading through this stuff.

[Telly]

Quote:

Originally Posted by SonofCohoes I am so not looking forward to wading through this stuff.

I think it's a triumvirate... Medicare, Social Security, and the Tax Code.

We like what we (eventually) get with two of them, but not the third