part d drug price increases

[ashok_sharma]

Even though as I am still working and have Kaiser HMO, I buy my prescription medicines from Walmart without using insurance. Walmart prices are cheaper than Kaiser permanente and some of the generic drug suppliers are even the same..then I think why to get the D coverage ? Anyone has any such experience and can share here? Am I being too naive about this?

 

[azxracer]

I looked the other day; my Wellcare plan goes up from $15.20/mo to $59/mo. ALL the drugs I take (save 1) are generic and have been $0. Next year all will range from $8 to $25 per refill (90 day mail order). And the 1 non-generic is no longer on the drug plan so it will be full price. Basically my Part D insurance & drug costs go from about $600 this year to at least $3000 (with no drug change) next year on this plan. Will start comparing plans next week but I'm not optimistic.

 

[harllee]

Even though as I am still working and have Kaiser HMO, I buy my prescription medicines from Walmart without using insurance. Walmart prices are cheaper than Kaiser permanente and some of the generic drug suppliers are even the same..then I think why to get the D coverage ? Anyone has any such experience and can share here? Am I being too naive about this?

This is true for generics but if you need an expensive drug for which there is no generic (like my DH does) then your Part D can save big bucks.

 

[Sue J]

I signed DH for Aetna Silverscript for $7.20/month in California. It had 2 preferred pharmacies (Safeway & CVS) and a preferred mail order that ships 3 month supplies at no extra charge. DH takes 2 tier one prescriptions, so his copay was $0.00. He switched to the mail order, and it has been trouble-free. They ship promptly and overlap shipment of his next refill by one week so there is no fretting. Next year, his copay for tier one prescriptions will be $1.00 per prescription. So far, he’s satisfied.

We have the same plan.

As for the change from a Tier 1 zero copay to a $1 copay, the $1 is for a 30 day supply. If you get a 90 day supply it will be $3. Still a bargain!

When I checked on our Rxs some of them come in at a little less than the $3/90 day copay because the pharmacy can sell them for less than the $3.

 

[rodi]

Even though as I am still working and have Kaiser HMO, I buy my prescription medicines from Walmart without using insurance. Walmart prices are cheaper than Kaiser permanente and some of the generic drug suppliers are even the same..then I think why to get the D coverage ? Anyone has any such experience and can share here? Am I being too naive about this?

From what I've read (on the medicare.gov site) if you delay taking medicare part D then when you *do* sign up for it, it will be at penalty rates. The longer you delay, the bigger the penalty pricing.

So - I have DH sign up for the cheapest part D plan to avoid penalties.

https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/part-d-late-enrollment-penalty

 

[Dash man]

I’m staying on the Aetna Silverscript plus plan. Nothing much has changed. But I tried changing my prescriptions to mail order and their website is really buggy. I tried both Safari and Brave, but the same issues kept popping up. I eventually got some changed over. I’ll do the rest another day.

 

[RetMD21]

From what I've read (on the medicare.gov site) if you delay taking medicare part D then when you *do* sign up for it, it will be at penalty rates. The longer you delay, the bigger the penalty pricing.

So - I have DH sign up for the cheapest part D plan to avoid penalties.

https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/part-d-late-enrollment-penalty

Interesting link, the penalty for delaying is $40/month after 10 years based on current part D rates. Dr David Belk, author of the great American Healthcare Scam suggests that for some it would be worth it, because it is a scam. I'm looking for a low cost plan because I don't know if I'll be lucky or not

 

[audreyh1]

Just checked with Medicare.gov for my cheapest plan (I don't take any prescriptions so I usually go with the least expensive plan). The cheapest plan for me is Silverscript Smart RX (only $7 per month, next cheapest is a about $20 per month). Does anyone know anything about Silverscript? I loooked at Silverscript's reviews and they are awful for customer service ( I guess that is why they are so much cheaper).

DH used that plan this year, no problems, and is keeping them next year.

He had two one-off prescriptions. Prices were OK - beat GoodRX. Didn’have to call customer service.

 

[Teacher Terry]

Harlee, I get reimbursed 195/month for using via benefits from my old employer. My plans all add up to around 330/month so that’s a huge financial help. It’s a benefit that you forfeit forever if you screw up. It turns out that the letter from my RX plan was wrong and I can’t keep it. I chose a different one and also a new supplement.

 

[frank]

I was on medicare.gov this morning and it will not let you see plan details. the screen just goes blank and you have to start overs. anyone else having this problem?

 

[PaunchyPirate]

I was on medicare.gov this morning and it will not let you see plan details. the screen just goes blank and you have to start overs. anyone else having this problem?

I'm having no problems looking at plan details on the site right now. 9:08 Eastern time. Maybe clear your browser cache or try a different browser.

 

[prudent_one]

^^ worked for me this morning.

 

[wmc1000]

Site working fine, looks like our best bet is to switch from existing to wellcare plans.

I was on wellcare in 2020 went to aetna in 2021 and will go back to wellcare in 2022. Both of these use CVS Caremark as their mail order provider so at least that has remained consistent for me. DW was on wellcare, went to elixir which uses riteaid for mail order and will now go back to wellcare.

We have had zero problems using mail order since we started our part D coverages.

 

[athena53]

Interesting link, the penalty for delaying is $40/month after 10 years based on current part D rates. Dr David Belk, author of the great American Healthcare Scam suggests that for some it would be worth it, because it is a scam. I'm looking for a low cost plan because I don't know if I'll be lucky or not

That penalty is NOT a scam. Insurance premiums would be far higher for everyone if people went without coverage and just signed up when they needed it. You can't buy windstorm insurance on coastal property when a hurricane warning has been posted. Most private dental plans cover only routine cleanings the first 6-12 months to avoid people waiting till they need a root canal and then getting insurance.

I'll agree that our medical system has many problems but the penalty for signing up late for Plan D when you haven't had creditable coverage since reaching age 65 is fair.

And, back OT, I signed up on Medicare.gov last night for a cheaper plan- no issues at all.

 

[Magus]

why is it cheaper to buy some of the more expensive drugs from canada? way cheaper. you would think this country could get at least the same drug pricing as our northern neighbor.

Because we are dumb enough to grant a long term monopoly while simultaneously not regulate the pricing. You don't get the benefits of capitalism OR socialism with how our healthcare is setup. Every other country in the world regulates pricing to at least some degree on healthcare, including prescriptions.

 

[audreyh1]

That penalty is NOT a scam. Insurance premiums would be far higher for everyone if people went without coverage and just signed up when they needed it. You can't buy windstorm insurance on coastal property when a hurricane warning has been posted. Most private dental plans cover only routine cleanings the first 6-12 months to avoid people waiting till they need a root canal and then getting insurance.

I'll agree that our medical system has many problems but the penalty for signing up late for Plan D when you haven't had creditable coverage since reaching age 65 is fair.

And, back OT, I signed up on Medicare.gov last night for a cheaper plan- no issues at all.

I think some people claim the entire part D drug coverage is a scam. Or even Medigap coverage for that matter. I don’t think they’ve seen chemotherapy copays.

 

[Sue J]

I picked up an Rx refill yesterday. If I would have used my very inexpensive (when used for tier 1) Part D plan this drug is tier 3, $120.75 for 90 days.

Instead, I used a GoodRx coupon for a price of $20.50 at the grocery store pharmacy.

The first time I got this Rx the pharmacy charged me only $10.44 when I expected to pay $20.50. When I got the refill yesterday it was only $5.11!

I asked the pharmacy tech what kind of magic they use to get prices like this and he said he didn't understand it either, but that they do try to get the best price for the customer.

 

[harllee]

Need advice regarding which Part D drug plan to pick. I am fortunate--healthy age 70, take no prescription drugs. I normally sign up for the cheapest Part D plan every year. But I have just turned 70 and I figure it is just a matter of time before I have some health issues and have to take some prescriptions so I am being more careful this year. According to Medicare.gov the cheapest plan available to me is Silverscript Smart Rx at $7 per month. Normally I would just sign up for that plan without any thought. Now at age 70 I am more concerned so I researched Silverscript--it gets awful reviews for customer service and it has a very limited drug formula ( the Silverscript drug formulary only has about 1000 drugs and most of them are tier 3-5). The next cheapest plan available for me is Humana Walmart (the plan I am on now) at $22 per month. Humana Walmart gets good customer service reviews and covers 3,600 drugs that includes a lot of tier 1 drugs.

What advice do you have for me? Go cheap with Silverscript or go for Humana Walmart that costs more but is a better plan?

 

[audreyh1]

You simply can’t figure out ahead of time which drugs you might need, and formularies change annually anyway.

If you’ve avoided routine prescriptions up until age 70, you must be free of common chronic diseases associated with aging, so I wouldn’t assume you would suddenly need new drugs.

And if something does happen you can switch plans within a year or less.

 

[Teacher Terry]

I would take the 22/month plan to be on the safe side.

 

[REWahoo]

You simply can’t figure out ahead of time which drugs you might need, and formularies change annually anyway.

If you’ve avoided routine prescriptions up until age 70, you must be free of common chronic diseases associated with aging, so I wouldn’t assume you would suddenly need new drugs.

And if something does happen you can switch plans within a year or less.

^ This.

A waste of money to take a plan at 3X the cost if you take no prescription drugs.

 

[RetMD21]

I think some people claim the entire part D drug coverage is a scam. Or even Medigap coverage for that matter. I don’t think they’ve seen chemotherapy copays.

I haven't actually read Belk's book but I have seen a couple of videos. He thinks the whole part D and supplement system is a scam, but it seems like we're stuck with it unless something changes.

 

[harllee]

^ This.

A waste of money to take a plan at 3X the cost if you take no prescription drugs.

That is what I have always thought. But at age 70 it is getting more likely that I will develop something that requires prescriptions in the next few years.

For those who say that Part D is a scam--I have to disagree. My DH has an autoimmune disease and must take a very expensive drug. This drug is fairly expensive even with Part D (costs him around $7000 per year) but without Part D it would cost DH $30,000 plus per year. I remember before there was a Part D my mother (who is now 90) sometimes could not afford her medications and I would have to help her pay for them. That changed once Part D came into being.

 

[meleana]

My Aetna plan only went up .50 per month and my copay went from $0 to $3.00 for a 90 day supply. When I applied in June when I turned 65, Walmart was not on the preferred pharmacy list so I use CVS. Now fir 2022 that has changed as both are preferred pharmacies.

My husband’s WellCare policy will not be offered in 2022 and the premium for another one would be $4 per month cheaper at something like $11.40 per month, and his copay would stay at $0, but he would have to switch pharmacies from Walmart to CVS.

He decided to enroll in the same Aetna plan I have instead for 2022 with a $7.60 premium per month, his copay will be $3.00 per 90 day supply and he could keep Walmart as his pharmacy..

So he saves a BIG $38.80 per year! lol!

He uses GoodRX for two other drugs he takes. He has to get those at Hannafords for the best deal.

The whole system is absolutely crazy!

 

[sn2792]

We have Anthem Part D and it is going from $19.90, to $80 a month. I don’t take any prescription drugs and DH takes a statin. We will definitely be changing part D plans. It looks like Aetna Silverscripts will be the best for us.