300% Increase in Part D Plan for 2025

[Dash man]

Got my brother's letter from AARP/United Health. Going up from $34 to $69 a month. Need to do some shopping.

I got my AARP/UHC ANoC and was shocked that my plan went down in price by $3 and copays went down a couple of dollars. I’m on the no deductible plan and have been paying $107/month and it’s dropping to $103. I’m on a lot of meds, so the no deductible plan was a no brainer. I was prepared for a price hike and planned to shop around. Now I will likely stay with them, assuming no major changes to the formulary when I check it.

 

[marko]

Just got our Wellcare notice. Went from $0.50 cents to $12.40. Still a bargain IMO.

 

[MBSC]

2025 plans are on Medicare.gov

 

[camfused]

^^^ Interesting. For me, Silverscript is $40/month + $1072/year for my tier 1 drugs. Wellcare is $0/month + $0/year for the same drugs at the same pharmacy. You gotta wonder, what is the catch? In fact, DW is a little reluctant to switch from Silverscript until we understand why there is such a difference.

 

[target2019]

^^^ Interesting. For me, Silverscript is $40/month + $1072/year for my tier 1 drugs. Wellcare is $0/month + $0/year for the same drugs at the same pharmacy. You gotta wonder, what is the catch? In fact, DW is a little reluctant to switch from Silverscript until we understand why there is such a difference.

I and many others are wondering about this.

 

[Marc]

Been online this morning comparing drug plans. All of plans come to just below $2,000 total cost (including deductible) PLUS premiums. I still can't figure out why I would go back to Aetna SilverScript instead of WellCare? If there is a catch I am not finding it. I did research going to a Tier 5 drug next year but it was priced at over $80,000 per year versus "prior authorization" in 2024; I guess this cap is driving insurers to limit their formularies; I think I won't make any big moves this year and just pay my $2,000 and be happy; of course my total for same drugs in 2024 was a lot less than $2,000.

 

[MBSC]

^^^ Interesting. For me, Silverscript is $40/month + $1072/year for my tier 1 drugs. Wellcare is $0/month + $0/year for the same drugs at the same pharmacy. You gotta wonder, what is the catch? In fact, DW is a little reluctant to switch from Silverscript until we understand why there is such a difference.

Change the year to 2024 and see what the Wellcare cost is for Nov/Dec.

 

[MichaelB]

2025 plans are on Medicare.gov

Thanks!

 

[Donno]

I just looked at the available plans in my area, and not a single one covers one of the medicines I have been on for the last 7 years. It's affordable though with a pay out of pocket cost of $99k to $102k per year depending on pharmacy. The number of plans available to choose from has also dropped from 37 to 13.

 

[RetiredHappy]

I just looked at the available plans in my area, and not a single one covers one of the medicines I have been on for the last 7 years. It's affordable though with a pay out of pocket cost of $99k to $102k per year depending on pharmacy. The number of plans available to choose from has also dropped from 37 to 13.

Wait...what? $99K to $102K pay out of pocket in medications a year is affordable?

 

[camfused]

Change the year to 2024 and see what the Wellcare cost is for Nov/Dec.

I am missing something. Why would I want to do this? I am already covered with Silverscript until the end of this year.

 

[MBSC]

I am missing something. Why would I want to do this? I am already covered with Silverscript until the end of this year.

Your profile says you live in NC. I wanted you to see that 2024 Wellcare Value Script was $0 premium/$0 copay on Tier 1 drugs and the $545 deductible only applied to Tiers 3-5. Similar to 2025 so there is no reason to be skeptical. Consistency is a good thing.

 

[Donno]

Wait...what? $99K to $102K pay out of pocket in medications a year is affordable?

I just assumed people would see this as sarcasm.

 

[Koolau]

I just assumed people would see this as sarcasm.

Heh, heh, we can get pretty "literal" from time to time.

 

[Marc]

I just looked at the available plans in my area, and not a single one covers one of the medicines I have been on for the last 7 years. It's affordable though with a pay out of pocket cost of $99k to $102k per year depending on pharmacy. The number of plans available to choose from has also dropped from 37 to 13.

I had similar findings. I have been on Jardiance (which is one of the drugs supposed to be controlled starting in 2026) and I have been paying $11 per month on WellCare; now WellCare wants close to the $2,000 max for just Jardiance. I think the anecdotal stories we are finding will be hitting the press soon.

Marc

 

[Koolau]

I had similar findings. I have been on Jardiance (which is one of the drugs supposed to be controlled starting in 2026) and I have been paying $11 per month on WellCare; now WellCare wants close to the $2,000 max for just Jardiance. I think the anecdotal stories we are finding will be hitting the press soon.

Marc

My Part D dropped Jardiance but covers Farxiga which my doctor was willing to prescribe instead of Jardiance. YMMV

 

[Marc]

My wife's two insulin products, Tresiba and Novolog, are now showing up as "not covered;" anyone else had this issue? Are there generic substitutes?

 

[orchid55]

I and many others are wondering about this.

Many people had this concern last year when Wellcare debuted their $0 premium plans. Maybe some who were new users of Wellcare can chime in.

We personally have been using Wellcare for 3 years for my husband and 2 years for me. We have had no problems at all. We enjoy the low to non-existent premiums and are looking forward to $0 for drugs this year (last year was $60 for the year).

Someone recently said that their prescription strategy was to use the free or low-cost plans, and fill in, if necessary with GoodRX or Mark Cubans' company.

 

[target2019]

Many people had this concern last year when Wellcare debuted their $0 premium plans. Maybe some who were new users of Wellcare can chime in.

We personally have been using Wellcare for 3 years for my husband and 2 years for me. We have had no problems at all. We enjoy the low to non-existent premiums and are looking forward to $0 for drugs this year (last year was $60 for the year).

Someone recently said that their prescription strategy was to use the free or low-cost plans, and fill in, if necessary with GoodRX or Mark Cubans' company.

My use case sounds very different than yours. For example, I've entered catastrophic coverage (Tier 5 drug) each year I've been with a Part D plan. So, for the two years my total out-of-pocket has gone down. I understand that is due to certain provisions of "The Inflation Reduction Act of 2022".

Until I log in and check plans, though, I don't have much to say.

Just applying logic, I can understand how a plan can cost -0-, if the drugs are a few, just generic, and so on. However, that is not my situation.

 

[RetiredHappy]

Every year we have been using Medicare.gov to look for the cheapest overall out of pocket costs for Plan D for my husband and last year it suggested $0 Wellcare plan. Total OOP was $3K+ for 2024. The Wellcare plan sent a mail to us indicating that it is still $0. We just used the Medicare.gov site and it's now pointing to the AARP plan, with total OOP of about $1200 for 2025. Wellcare plan has a deductible of $500+ and total OOP is about $2K. We will definitely be switching.

 

[Koolau]

My wife's two insulin products, Tresiba and Novolog, are now showing up as "not covered;" anyone else had this issue? Are there generic substitutes?

I mentioned Jardiance, above. My guess is that the insulin products can be substituted with other drugs, but that means her doctor has to agree to the substitutions and write the new scripts for the new (different) drugs. I assume the insurance company failed in their attempt to negotiate an acceptable price on these drugs and plans to make other drugs available in their formulary which (hopefully) do the same things.

 

[wolf]

California.

Wellcare. Monthly prem. 2024 $ .40 Deductible $ 545.


Monthly prem. 2025 $ 17.40 Deductible $ 590.

Also, taking Jardiance. Will have to shop Part D as usual.

 

[audreyh1]

California.

Wellcare. Monthly prem. 2024 $ .40 Deductible $ 545.


Monthly prem. 2025 $ 17.40 Deductible $ 590.

Also, taking Jardiance. Will have to shop Part D as usual.

Just to be clear your Wellcare premium will increase $17 a month?

The Medicare.gov site provides total cost results if you put in your regular prescriptions. This is really the only way you can compare your plan options.

 

[MBSC]

California.

Wellcare. Monthly prem. 2024 $ .40 Deductible $ 545.
Monthly prem. 2025 $ 17.40 Deductible $ 590.

Just to be clear your Wellcare premium will increase $17 a month?

Correct. Someone on another forum was trying to be funny and calculated it as a 4250% increase due to the low starting amount.

In NY, it's a $35 increase from $3.70 to $38.70.

 

[RetireBy90]

Just got our notice of changes for 2025. Advantage cost paid to Kaiser this year is $22, 2025 will be $15, other costs will be the same or less. Specialist goes from $35 to $30.