Experiences With The Medicare Part D Process

[zl55lz]

For those using a Part D Rx plan, what has been your experience with the actual process -- with doctors prescribing, pharmacy issues, problems getting Rx approved through the actual company?

I am not talking about tiers, or cost issues, but rather if there is a hassle factor to using Part D plans in general.

Thanks for any comments.

 

[Teacher Terry]

I haven’t had any problems at all.

 

[Sunset]

No problems at all.

I do use the preferred pharmacy for my plan, just so drugs will be cheaper.

I really like how each year I can compare the plans at medicare.gov and pick a different plan D , if it will work out better for me.

 

[user5027]

We have had no issues with our part D insurers.

I did notice the star ratings on all the plans were pretty low. Reading through the reviews it seemed most of the complaints were with mailed medications arriving late or never being shipped and had skewed the ratings low. We've never used the mail options and have paid a little more while staying with the local "non-preferred" mom and pop pharmacy. Never a line and as soon as I walk in they grab our refills without giving our name.

My wife was recently discharged from the local ER after being diagnosed with pneumonia. We stopped at the pharmacy on the way home to pick up the prescriptions. The pharmacist asked if the ER warned of a possible drug interaction with the antibiotic. They had not and he suggested we contact her doctor. At home we messaged her regular cardiologist (different hospital network) and the nurse immediately replied to not take the antibiotic and that they contacted their pharmacy department for a substitution. A short while later her cardiologist prescribed the substitution and we went back to the pharmacy. I thanked the pharmacist.

I've read recent reports of the major chains having issues; a possible looming bankruptcy, pharmacists striking over pay and working conditions leading to mistakes.

One dark and stormy evening, we noticed a large unexpected box on our porch. Not sure how long it was there. We looked at the labels and determined it was mail order prescriptions for a home 5 doors down the road. Must have been packed in a cooler. They had the recipient's phone number on the label. We called and the lady drove up in the rain at night to pick up the box.

I'm sure many have had no problems with mail order and the big chains.

 

[folivier]

Works well for us. But DW always checks the price on higher priced Rx's with Costco and Costco is usually cheaper than our preferred pharmacy.

 

[Sue J]

I am not talking about tiers, or cost issues, but rather if there is a hassle factor to using Part D plans in general.

Thanks for any comments.

DH and I have used WellCare and Aetna SilverScript. I use mail order and he prefers our local grocery store which is a preferred pharmacy. Neither of us have had any problems with our Rxs. It all runs very smoothly.

Our Rxs are all Tier 1 except for 1 for each of us that is a Tier 2. For the Tier 2 Rxs I check the price using our Part D plan and end up using GoodRx coupons instead of the Part D.

 

[ShokWaveRider]

Our Rxs are all Tier 1 except for 1 for each of us that is a Tier 2. For the Tier 2 Rxs I check the price using our Part D plan and end up using GoodRx coupons instead of the Part D.

I do that too. I currently have Aetna and find some drugs cheaper with GoodRX.

I will be switching to Wellcare in 2024.

 

[Midpack]

We both have Part D through WellCare, and we've had no problems at all, pretty seamless process. We're amazed at how much has been covered considering the tiny premiums we pay. We also check GoodRx, but DW has often gotten better prices from SingleCare.

 

[youbet]

The real benefit of being on Part D is the catastrophic coverage should you wind up with a health issue that requires expensive drugs to manage. Yeah, it's nice to save a few bux hear and there on a few Tier 1 and 2 prescriptions. But it's knowing that if my drugs are going to cost, say, $25k/yr that I would fall into the catastrophic coverage classification that's the real benefit to me.

I think of most insurance that way........

 

[aja8888]

I've been on Part D for 15 years now.

The only issue is that once in a while you will end up being prescribed a higher Tier drug and it will cost a bunch. But when that happens, you can use GoodRx or Single Care, etc and get it much cheaper. If those fail, Canadian pharmacies are available (drugs may come from India though).

 

[Koolau]

I haven't noticed any serious issues with the process. Getting doc to send script to the right place has been problematic once in a while. I use a mail-order unless for emergency.

 

[Chuckanut]

My Part D insurance company has done two things that really annoy me.



One, in July of 2023 they made changes to their formulary. I check the formulary every November during open enrollment. But, it seems that they can change it on the fly.I would think they should be locked in for the year unless something unusual happens such as a medicine lose its FDA approval, etc. Has anybody else had this happen to them. In my case one med I was taking moved from Tier 1 to Tier 2. It's still available to me but at a higher cost.

The second thing is there is no number I can use to call them. I can request a call back, or handle things via messages. But, I can't initiate a call at a time convenient for me. Yes, First world problems, but still annoying. In November they are actively competing for my business, the other 11 months they act like they don't care what I think of them.

 

[RS53576GG]

I've had good experiences with my drug insurance providers. I changed insurance company a couple years ago when I needed some new drugs that I could get cheaper through another provider. Coverage can vary a bit on which drugs an insurance company covers and what your out of pocket expense is so if your prescriptions change it's a good idea to go to the Medicare website and see which drug policy gives you the best deal for the drugs you'll be buying with your drug insurance.

One thing I've changed in the last year or two is that I now use three sources for my prescriptions. The generic drugs that are pretty cheap I buy from DiRx which is an online pharmacy that sells generic drugs. They have better prices than my local drug store and don't require that you have a drug insurance policy. In fact your drug insurance company has no idea that you are buying anything from DiRx. This can come in handy if you also have some expensive brand name drugs that still have active patents and are priced accordingly. By pushing all my generic drugs off on DiRx I leave more funding in my drug insurance policy that can be spent on expensive brand name drugs and won't fall into the donut hole as quickly. In my case it made financial sense to buy their $119 annual savings plan because all my cheap generic drugs are covered by it. They have a second annual savings plan for $299 that covers more expensive generic drugs. Or you can just pay their regular cheap price for whatever you need.

If a person knew they'd only need cheap generic drugs for the foreseeable future you could ditch your drug policy and buy them from DiRx. There might be some risk involved if your drug needs should suddenly change but for some people dumping their drug policy might make sense.

I also get one prescription from Amazon Pharmacy because they have a cheaper price on a brand name drug than my regular drug store and I can buy it with an Amazon Visa card and save another 3%. Unlike DiRx Amazon needs your drug insurance information.

I only buy one prescription from my regular drug store and it's something that needs to be continually refrigerated before use. I use their credit card to pay for it and get a bit of kickback by doing this.

I've had good service out of DiRx, Amazon Pharmacy and Walgreens. One time DiRx ran out of one of my prescriptions and it took a while for the next shipment to arrive so I went without this particular prescription for a few days. It wasn't an important prescription so this wasn't a big deal but after that I moved my refill date 6 weeks further ahead so there's plenty of cushion in the schedule to accommodate problems like this.

It took a while for me to learn enough about drugs and drug insurance to arrive at this somewhat complicated scenario but it saves me some money and it's really not a big deal once you get things set up. I have Amazon and DiRx on auto refills so it all goes pretty smoothy.

 

[target2019]

For those using a Part D Rx plan, what has been your experience with the actual process -- with doctors prescribing, pharmacy issues, problems getting Rx approved through the actual company?

I am not talking about tiers, or cost issues, but rather if there is a hassle factor to using Part D plans in general.

Thanks for any comments.

Once you're signed up and accepted into the rackets, La Cosa Pharma has your back!

I sweated over that Part D, and leaving great group insurance. The only problem for me was moving through tiers, all the way to catastrophic now. But that's how it is.

The mail order side of things is better than before. Let's put it this way, Caremark is very eager to have me fill the prescriptions, and it is an easy click or two to let them know to chase my doctor, or whatever.

 

[Katsmeow]

I haven't really had a problem. Do check the formulary for any medications you use a lot of that are expensive. One year I needed a particular eye drop and they wouldn't cover the one the doctor prescribed. But there was an alternative that was also effective so that was OK.