Medicare Part D changes for 2023

[Buckeye]

Is this true also if you have a Part D plan, but choose to purchase drugs through GoodRx or other third party?

I think all they care about is that you are paying a Part D premium, i.e. you are in the system and contributing.

I don't think we've ever used the insurance price. Always use GoodRX for the once in awhile prescription for something for DH. Last prescription was some ointment. Insurance was $9. GoodRX was $4.00.

 

[TrvlBug]

Both DH and I signed up for the Wellcare Value Script @ $100/yr . My savings will all come from the lower premium as I never reach my deductible. DH both on premium as well as med costs.

 

[Trooper]

This may be a bit off-topic, but how does one manage their drug costs at the time of prescription?

Scenario: I am in the Dr's office being looked at for <insert ailment here>. The doc says "you should take <insert drug here>" and asks what pharmacy to send it to.

How do you know at that point in time, 1) whether the drug is covered, 2) what tier level it is, 3) what it would cost, and 4 ) are there cheaper alternatives?

Does it require memorizing your formularies, or having the formulary on your phone at the point of prescription?

Cleary the doc's office can't know how every drug is handled on every plan. There's also the possibility (probability?) that the doc is financially incented to prescribe one drug over another.

I am probably over-thinking this, but just trying to be prepared.

 

[Donno]

This may be a bit off-topic, but how does one manage their drug costs at the time of prescription?

Scenario: I am in the Dr's office being looked at for <insert ailment here>. The doc says "you should take <insert drug here>" and asks what pharmacy to send it to.

How do you know at that point in time, 1) whether the drug is covered, 2) what tier level it is, 3) what it would cost, and 4 ) are there cheaper alternatives?

Does it require memorizing your formularies, or having the formulary on your phone at the point of prescription?

Cleary the doc's office can't know how every drug is handled on every plan. There's also the possibility (probability?) that the doc is financially incented to prescribe one drug over another.

I am probably over-thinking this, but just trying to be prepared.

I always ask my doctor when I get prescribed something whether it is on my plans formulary. For generic medicines it usually doesn't matter, but name brand medicines it does, and usually doctors know when they prescribe a name brand drug which companies cover it and which don't.

 

[Sue J]

This may be a bit off-topic, but how does one manage their drug costs at the time of prescription?

Scenario: I am in the Dr's office being looked at for <insert ailment here>. The doc says "you should take <insert drug here>" and asks what pharmacy to send it to.

How do you know at that point in time, 1) whether the drug is covered, 2) what tier level it is, 3) what it would cost, and 4 ) are there cheaper alternatives?

Does it require memorizing your formularies, or having the formulary on your phone at the point of prescription?

Cleary the doc's office can't know how every drug is handled on every plan. There's also the possibility (probability?) that the doc is financially incented to prescribe one drug over another.

I am probably over-thinking this, but just trying to be prepared.

In the past I have asked for a printed prescription then I check my plan’s price vs GoodRX and a few others. Unless I’m sick and I need it ASAP. Your plan may have an app to check the price.

 

[Dash man]

This may be a bit off-topic, but how does one manage their drug costs at the time of prescription?

Scenario: I am in the Dr's office being looked at for <insert ailment here>. The doc says "you should take <insert drug here>" and asks what pharmacy to send it to.

How do you know at that point in time, 1) whether the drug is covered, 2) what tier level it is, 3) what it would cost, and 4 ) are there cheaper alternatives?

Does it require memorizing your formularies, or having the formulary on your phone at the point of prescription?

Cleary the doc's office can't know how every drug is handled on every plan. There's also the possibility (probability?) that the doc is financially incented to prescribe one drug over another.

I am probably over-thinking this, but just trying to be prepared.

I just have the doctor’s office send the prescription to my regular CVS. If there’s a price difference the pharmacy will give me the GoodRx price. If it’s expensive I’ll check other pharmacies and have the prescription transferred if I find a better price.

 

[youbet]

This may be a bit off-topic, but how does one manage their drug costs at the time of prescription?

Scenario: I am in the Dr's office being looked at for <insert ailment here>. The doc says "you should take <insert drug here>" and asks what pharmacy to send it to.

How do you know at that point in time, 1) whether the drug is covered, 2) what tier level it is, 3) what it would cost, and 4 ) are there cheaper alternatives?

Does it require memorizing your formularies, or having the formulary on your phone at the point of prescription?

Cleary the doc's office can't know how every drug is handled on every plan. There's also the possibility (probability?) that the doc is financially incented to prescribe one drug over another.

I am probably over-thinking this, but just trying to be prepared.

I struggled with this for a while but finally the light bulb came on.......

You walk out of doc's office with a paper script and go shop it (probably on line). You get a chance to do your homework and in the future, you'll know where to have doc send the script.

 

[wolf]

I had a good Part D surprise. Earlier this year my doc prescribed Jardiance for me. With insurance it costs ~$1,400 annually. I recently had blood work and my annual wellness visit and my numbers were better so I asked him if there was something other than Jardiance that he could put me on. He said since my numbers improved and Jardiance was so expensive that we should try something different. The something different costs $5 a year!

Just curious. My Md, mentioned Jardiance, as one of the "newer" class of drugs. Something in the future, to consider. Currently, on Metformin and glipizide. Could you mention what the something "different" was.

 

[Pluperfect]

I have a friend who's been on Medicare for 9 years. He used a broker and has AARP/UHC Plan F, which he is stuck with because he can't pass medical underwriting. He has an AARP/UHC Part D prescription drug plan, which he can change during Fall open enrollment.

I told him to call his broker to have him run his drugs through his price calculator thing to see if he should change plans. He called, and his broker said he didn't have time because this is his super busy time. My friend mistakenly thought he could change Part D any time during the year, so he didn't press it.

(I recently read on an insurance agent discussion forum that they have access to a "better" drug price calculator than the one available to the public; that's why I wanted his broker to do it. Whether that's true or not I don't know, and how it's "better" I know even less about, but it doesn't matter because his broker wasn't going to do it anyway.)

So I ran the numbers for him, and was astounded. His current Part D premium is $99.20/month, and is going up to $108/month in 2023. But there's a Blue Cross plan for $16/month that actually provides better coverage for the maintenance drugs he's on.

Under his current plan, the six drugs he's on will cost $732/year at Walgreens. Under the plan I found, the same six drugs will cost $192/year at Walgreens.

But that's just the drug costs--don't forget the premium. By paying a premium of $16/month instead of $108/month, the total cost (premiums + drugs) for his new plan will be $389/year, compared to $2,028/year under the plan his broker is fine with him keeping. That's $1,600/year I'm saving him.

I wish he could pass medical underwriting so we could wrestle his supplement away from this bastard, too.

Of course all of this Part D is based on the drugs he knows he takes, and has nothing to do with what he might be prescribed in the future, which is absolutely ridiculous and a terrible way to treat our precious senior citizens, but that's the system. For me, I don't take any drugs so I get the cheapest Part D I can find and hope for the best.

Also, I travel fulltime so I don't have a regular doctor and I don't have a regular pharmacy. The last time I had to get a prescription at the urgent care place, I said I wanted it printed and there was much drama about how that could be done, but I insisted. I started doing that after I got shingles and followed the nurse practitioner's advice to have the prescription filled right there at CVS, and ask for the best price.

Later, I looked at GoodRx for that drug and found out I paid like $50 more than I would have at a grocery store right near me, instead of standing around waiting at this CVS that was 30 miles away (closest doc-in-a-box that was in my pre-Medicare insurance's network).

I'm never assuming anything when it comes to how much a prescription is going to cost, and I'm going to continue to get paper ones. I don't want to have it called in somewhere and have to then call them myself and tell them to transfer it somewhere else. Waiting on hold is not one of my strong suits.

 

[Chuckanut]

I recently switched my Medicare Part D coverage from AARP Walgreens plan to Aetna Silver Script. This changes takes place on January 1, 2024.

For 2023, the Part D monthly cost was deducted from my SS check.

I recently received a notice from SS that they will “no longer deduct money for your Medicare prescription drug plan costs from your monthly benefit”.

No reason is given for the change. I understand that Medicare can takes months to process the change, so that I may have to directly pay the Part D insurance company for the first few months. Has anybody else experience this?

 

[REWahoo]

I recently switched my Medicare Part D coverage from AARP Walgreens plan to Aetna Silver Script. This changes takes place on January 1, 2024.

For 2023, the Part D monthly cost was deducted from my SS check.

I recently received a notice from SS that they will “no longer deduct money for your Medicare prescription drug plan costs from your monthly benefit”.

No reason is given for the change. Can anybody shed some light on this?

Same thing happened to me. This appears to be a change in SS policy, requiring us to initiate a new request to have deductions continue if we change part D providers.

I chose to set up an auto monthly charge to my credit card. It was easy to do via my part D insurer's website.

 

[Ian S]

I chose to set up an auto monthly charge to my credit card. It was easy to do via my part D insurer's website.

That's what I've been doing too although for next year, I don't have to: the premium for my new Part D plan is $0.00!

 

[Chuckanut]

Same thing happened to me. This appears to be a change in SS policy, requiring us to initiate a new request to have deductions continue if we change part D providers.

I chose to set up an auto monthly charge to my credit card. It was easy to do via my part D insurer's website.

So far, I can't find an easy online way to do that, but I am still not officially insured by Silver Scripts. No doubt they will send me a bill very soon.

 

[harllee]

When I signed up for my new Part D plan on Medicare.gov I was asked if I wanted the premium paid out of my SS and I checked yes. The insurance company sent me a notice that my premium was being paid out of my SS.

 

[5Miler]

I might have done a foolish thing with Medicare Part D. I'm 70 and have never had a Part D plan as I have been covered by the Veteran's Administration since I was 61. I received a letter from my new plan (Wellcare) stating I was going to be charged IRMAA by Medicare as I showed no coverage from Oct 1, 2018 until present day. Of course I spelled out my VA coverage on my online application when I signed up. I also requested my $0.50 monthly premium be taken from my SS payment but that didn't happen either apparently as I show no method of payment on the Wellcare web portal.

I did call Wellcare today and gave them the same information I provided on my application and was told my dispute was filed I should get a response in about 10 days. I suppose I can go online to fix the payment but it looks like I can't until coverage begins on Jan 1.

I only signed up for this coverage as it was cheap at $6.00 for the year and I like having a way to obtain prescriptions outside the VA system. I hope I don't end up regretting this. I reordered my Atorvastatin prescription on Nov 17 with the VA and I have been out for almost 2 weeks now with a scheduled delivery date of Jan 7. Second time this year that has happened. I was thinking about switching my prescriptions to Wellcare to end this BS as they will all still be free but nothing seems to go as smoothly as planned.