300% Increase in Part D Plan for 2025

[camfused]

I am leaving wellcare due to a recent customer service issue. A prescription got lost in transit. I don’t blame them for that but they refused to replace it and initially told me I had to wait a month to get any more. Two hours on the phone and speaking with ten people and someone authorized an early refill ( still not a replacement). I am not sure if this is specifically wellcare or expressscripts generally.

One of the ten people I spoke with was at ups ( because expresscripts/ wellcare took no ownership) I could hear the eyeroll in her voice when I said expressscripts so I doubt this is unusual. No one made the slightest apology

The medication is metformin which is very inexpensive. I take it off label but if I were diabetic a month without could be dangerous

Wellcare is fine - until you have an issue

Unless you are physically unable to, I think it is best to go to a B&M store and get prescriptions. 1) they won’t get lost in the mail, 2) they are less likely to be exposed to extreme heat and cold, which can have negative effects on medications. Sure, if you live in the sticks, perhaps you don’t have the choice.

 

[frank]

my wife has the wellcare part d and I was checking on costs. medicare priced 3 drugs and said the 3rd(advair} was not covered. does that mean she has to pay full price or that the insurance company doesn't do anything with it?

 

[Sarah S]

It likely is expressscripts i had them once before pre medicare and they were my only previous mailorder pharmacy issue but express scripts is the only wellcare option. Had I known how calling was going to play out I wouldn’t have done it.

Re going to the local pharmacy. It isn’t utterly impossible but I do not drive and am physically disabled so it would be challenging

 

[ShokWaveRider]

I am leaving wellcare due to a recent customer service issue. A prescription got lost in transit. I don’t blame them for that but they refused to replace it and initially told me I had to wait a month to get any more. Two hours on the phone and speaking with ten people and someone authorized an early refill ( still not a replacement). I am not sure if this is specifically wellcare or expressscripts generally.

One of the ten people I spoke with was at ups ( because expresscripts/ wellcare took no ownership) I could hear the eyeroll in her voice when I said expressscripts so I doubt this is unusual. No one made the slightest apology

The medication is metformin which is very inexpensive. I take it off label but if I were diabetic a month without could be dangerous

Wellcare is fine - until you have an issue

In the las 6 years we nave never used Express scripts. There are so many preferred Pharmacies in our area there has been no need. Wellcare combined with GoodRX and Costco has not been an issue so far.

 

[athena53]

I just checked my WellCare plan- minimal premium increase so I'm sticking with it. I'm on only one prescription and it's still under patent so GoodRx is of little help. I get somewhat of a break at Costco compared to other providers.

 

[Ian S]

I am leaving wellcare due to a recent customer service issue. A prescription got lost in transit. I don’t blame them for that but they refused to replace it and initially told me I had to wait a month to get any more. Two hours on the phone and speaking with ten people and someone authorized an early refill ( still not a replacement). I am not sure if this is specifically wellcare or expressscripts generally.

One of the ten people I spoke with was at ups ( because expresscripts/ wellcare took no ownership) I could hear the eyeroll in her voice when I said expressscripts so I doubt this is unusual. No one made the slightest apology

The medication is metformin which is very inexpensive. I take it off label but if I were diabetic a month without could be dangerous

Wellcare is fine - until you have an issue

That's one of the reasons I prefer using a local pharmacy rather than mail order. My $0.00 premium Wellcare plan has the same pricing for both, assuming you choose a "preferred" pharmacy, and if there's an issue I can discuss it face to face with the pharmacist at CVS.

 

[RetMD21]

my wife has the wellcare part d and I was checking on costs. medicare priced 3 drugs and said the 3rd(advair} was not covered. does that mean she has to pay full price or that the insurance company doesn't do anything with it?

Yep.You can ask them to pay for a non-covered drug.There is always some sort of appeal process

 

[Chuckanut]

Only 300%. You are lucky. My Part D is going up 1000%, 10 times more. And the deductible is increase by more than double. And, Co-pays have been added or increased.

 

[audreyh1]

I switched to Wellcare for 2025. Otherwise I was facing a large increase. Fortunately my one prescription is a generic classified as tier 2, and $5 a month copay at my favorite pharmacies. Also $0 in premiums.

 

[MichaelB]

One thing I noticed when using the Medicare website Plan D finder was the estimated cost to me for my prescriptions is far higher than the actual cost I’m paying at Costco.

 

[audreyh1]

One thing I noticed when using the Medicare website Plan D finder was the estimated cost to me for my prescriptions is far higher than the actual cost I’m paying at Costco.

Well that’s interesting. I checked directly with Wellcare as well as the Medicare site. I noticed that Wellcare showed me the retail prices for the pharmacies I selected including for Costco.

 

[Koolau]

Unless you are physically unable to, I think it is best to go to a B&M store and get prescriptions. 1) they won’t get lost in the mail, 2) they are less likely to be exposed to extreme heat and cold, which can have negative effects on medications. Sure, if you live in the sticks, perhaps you don’t have the choice.

I'd actually prefer B&M to mail order, but I just can't justify the price differential. My Insurance carrier covers either, but gives the big discount for their "captive??" mail order pharmacy. It's hundreds of dollar savings per year so something I can't turn down.

Hope I don't jinx myself, but no lost orders so far. I have had to deal with some issues with them, but always got resolved in 10 or 15 minutes on the phone. YMMV (OptumRx) if interested. I have no idea if they are open to "anyone" or just to my insurance carrier.

 

[Montecfo]

My plan (Aetna) that I only selected in September, is going up 600%. So switched to Wellcare which looks good, similar cost to what I had.

My drugs are all generic and cheap. I do think there is some game playing going on when
1. Premiums on old plan are more than cost of drugs without insurance and
2. Alternatives exist for premium of 0 and low co-pays.

And with insurer responsible for more now it is expected premiums would increase.

My consultant said over 1 million people benefit from the cap on out ot pocket. This compares to 60 million+ on Medicare. So most figure to pay more and a few pay less,.maybe a lot less.

 

[Marc]

We are both going to be on WellCare $0/month premium and will both hit the $2,000 cap. Does it make any sense for us to even look at using GoodRx or other coupons to cut costs of certain prescriptions if we are still destined to be capped at $2,000?

thanks,

Marc

 

[Montecfo]

I don't think so. And this is why caps can drive costs higher. There is no incentive to manage costs when the recipient effectively has no skin in the game.

 

[RetMD21]

We are both going to be on WellCare $0/month premium and will both hit the $2,000 cap. Does it make any sense for us to even look at using GoodRx or other coupons to cut costs of certain prescriptions if we are still destined to be capped at $2,000?

thanks,

Marc

The cap doesn't apply to the drugs you buy outside your part D plan with GoodRx or similar

 

[Texas Proud]

I was looking and the website was giving me huge payments if I went on Ozempic like my Dr wants me when added to my expensive diabetes drugs... cost was like $2900...

Will have to look... might have to change plans...

 

[Dawg52]

I switched to Wellcare for 2025. Otherwise I was facing a large increase. Fortunately my one prescription is a generic classified as tier 2, and $5 a month copay at my favorite pharmacies. Also $0 in premiums.

I did the same. So zero premium vs a $40ish one. Two of my prescriptions will also be zero and one will be $25 per qtr which is roughly the same as last year. Pretty pleased with the way it worked out for me. I wish I had this luck with homeowners insurance.

 

[sengsational]

We are both going to be on WellCare $0/month premium and will both hit the $2,000 cap. Does it make any sense for us to even look at using GoodRx or other coupons to cut costs of certain prescriptions if we are still destined to be capped at $2,000?

There's a disincentive to getting prescriptions filled with anything but your plan because only items filled through your plan add to the accumulator.

A lot of weird dynamics come into play when the government forces all players to abide by a set of rules. For many, including you, there's the magnitude of the premium, whether the formulary covers your needs, and expected customer service level. Individual drug pricing is irrelevant. Maybe Wellcare's plan somehow soak the government or manufacters and that is how they give away their plan for free

 

[audreyh1]

We’ll see how the Wellcare plan works out long term. Aetna kind of started the trend with a low cost Part D plan a few years ago. Then Wellcare barged in for 2025 and total undercut them. I think these companies are mainly repositioning themselves to serve different strata of their market based on the drugs they include in their formulary.

 

[PointBreeze]

My plan is going from $0.50/month to $0.00/month. Wellcare Value Script.

 

[Texas Proud]

My plan is going from $0.50/month to $0.00/month. Wellcare Value Script.

This is a 'Yea but'....

The total spend for me is going up a LOT... higher deductible, higher costs on generics... high cost on my expensive drugs...

I would rather pay the 50 cents and have the lower costs of this year....

 

[RetMD21]

We’ll see how the Wellcare plan works out long term. Aetna kind of started the trend with a low cost Part D plan a few years ago. Then Wellcare barged in for 2025 and total undercut them. I think these companies are mainly repositioning themselves to serve different strata of their market based on the drugs they include in their formulary.

The zero dollar premium is good for those of us who have no or inexpensive prescriptions. My prescriptions both cost $0 for 2025 so I'll fill them using Wellcare.

I don't think that most people understand that general tax revenue subsidizes the part D insurers

 

[Marc]

The zero dollar premium is good for those of us who have no or inexpensive prescriptions. My prescriptions both cost $0 for 2025 so I'll fill them using Wellcare.

I don't think that most people understand that general tax revenue subsidizes the part D insurers

The zero dollar premium is also good for those of us with expensive prescriptions as the premium is not considered part of the $2,000 cap.

 

[Dash man]

We just switched our Part D prescription plans. DW isn’t on any, so she’s using WellCare, switching from SilverScript. I’m dropping UHC and going with Cigna for $12/month. UHC lowered my no deductible premium by $4, but all the copays/coinsurances are higher. GoodRx will help with two prescriptions.