part d drug price increases

[audreyh1]

Quote:

Originally Posted by athena53 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]

Quote:

Originally Posted by 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.

^ This.

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

[RetMD21]

Quote:

Originally Posted by audreyh1 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]

Quote:

Originally Posted by REWahoo ^ 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.

[Koolau]

Almost as much as having cost increases for meds, I'm frustrated with having to play the "game" of fitting my particular (and changing) meds needs as insurance company formularies change. The older I get, the less I like playing that game. YMMV

[harllee]

Quote:

Originally Posted by Koolau Almost as much as having cost increases for meds, I'm frustrated with having to play the "game" of fitting my particular (and changing) meds needs as insurance company formularies change. The older I get, the less I like playing that game. YMMV

But Koolau, at least we have some prescription drug coverage now. I remember at one time my DH had an insurance policy that had a cap of $1000 per year for drugs (it was the only policy DH could get since he had a preexisting condition). And my 90 year old mother talks about how awful it was when Medicare had no prescription coverage at all. I definitely agree that the US system is not good--but it use to be so much worse.

[Koolau]

Quote:

Originally Posted by harllee But Koolau, at least we have some prescription drug coverage now. I remember at one time my DH had an insurance policy that had a cap of $1000 per year for drugs (it was the only policy DH could get since he had a preexisting condition). And my 90 year old mother talks about how awful it was when Medicare had no prescription coverage at all. I definitely agree that the US system is not good--but it use to be so much worse.

Can't argue with that. But it just seems "wrong" to make "old people" try to figure out all this stuff. At some point, I'll no longer be able to do so. With enough resources, it's only wasting money. For some folks it may be the old "drugs or food" problem. YMMV