Medicare Part D Rx cost

[BoodaGazelle]

Hello all,

I just completed my signup for my Medicare Supplement with AARP/UHC. I am using Boomer Benefits, and while I will be continuing to work with them, I wanted to ask a question here.

Right now I take Losartan 50mg. I get 90 for $12.00, or $48/yr.

The Humana Walmart Part D plan (not the cheapest but 3rd)... shows these costs:

Monthly plan premium $17.20
Drug deductible $445 (excludes Tiers 1 and 2)
Initial coverage limit $4,130
Catastrophic coverage limit $6,550

Call me crazy, but how does this help me?

Is this "just the way it is"? I understand that there are many drugs I could be prescribed in the future that would be more expensive and thus might be worth it, at least if said drugs are in the "formulary".

Thanks,

Mitch

 

[REWahoo]

Booda, many of us take no drugs or inexpensive ones and get no current benefit from our Part D plans. That's my situation yet I enroll in the lowest cost Part D plan I can find each year so I can avoid a late enrollment penalty should I want a Part D Plan in the future:

Here's the details: Part D late enrollment penalty

 

[BoodaGazelle]

REWahoo: I do understand the issue that forces me to have Part D... my 83 yr old FIL tried to add Part D and the penalty would have made his monthly cost over $300!

 

[kevink]

Excellent post on this issue that I've bookmarked for when I have to deal with it (next year):

https://retireearlyhomepage.com/medicare_partD_2021.html

 

[Jerry1]

Excellent post on this issue that I've bookmarked for when I have to deal with it (next year):

https://retireearlyhomepage.com/medicare_partD_2021.html

Good read.

DW is going on Medicare this year. I just started looking at the Part D plans. This is going to be a difficult purchase since DW (or me) are not currently taking any prescriptions. I guess the only thing that makes sense is just to get the absolute cheapest plan that is considered credible coverage.

 

[fosterscik]

+1. I also liked his description of his medicare plan selection
https://retireearlyhomepage.com/medicare2020.html

 

[Sunset]

Good read.

DW is going on Medicare this year. I just started looking at the Part D plans. This is going to be a difficult purchase since DW (or me) are not currently taking any prescriptions. I guess the only thing that makes sense is just to get the absolute cheapest plan that is considered credible coverage.

I have found the medicare.gov site very excellent for finding and comparing drug plans.
I've used it for 3 older relatives to save them hundreds to thousands of dollars per year compared to the old plan they were on for years.

Being flexible as to which pharmacy to use, by entering in 4 possible ones, will allow the site to show differences between participating and preferred pharmacies. Sometimes a huge difference.

I did notice at the end of last year (medicare sign up time) that picking the future next year was accurate, but picking the current year only forecast future prices for the remaining year, which is "less" accurate, when comparing different plans.

 

[Animorph]

Each different Part D plan has different costs for drugs. I selected my plan because it was the lowest cost for premium + drugs, even when paying the deductible.

Last year my four generic drugs totaled something like $120. This year the premium went down a couple bucks and I have a $0 copay for tier 1 or 2 drugs (all of mine) if I order them from their preferred mail order provider. That is true during the deductible period as well. So $0 total for my drugs this year, plus the premium. Really a great plan, and at $28/month it's actually cheaper for me in total than the lower premium plans.

Medicare.gov has a decent calculator for figuring out your costs.

 

[BoodaGazelle]

Thanks again to all!

 

[bmcgonig]

I just signed up for part D as well. Got the silverscript from Aetna thru Boomerbenefits. Costs $7 a month. I have no prescriptions either.

Must say that Boomerbenefits were excellent throughout the whole experience. Did everything for me with a few phone calls. What I really like about them is that if we have any issues with the Medigap plans or the part D plans we contact them and don’t have to deal with the companies.

 

[REWahoo]

Must say that Boomerbenefits were excellent throughout the whole experience. Did everything for me with a few phone calls. What I really like about them is that if we have any issues with the Medigap plans or the part D plans we contact them and don’t have to deal with the companies.

+1

The same reason I went through them to sign up for a Medicare Supplement (Medigap) policy. Their claims research and resolution benefit is something I hope we never need but it is great to know it is available.

 

[Bamaman]

I was talking to the CVS pharmacist last night. He said that just about every customer has chosen the low cost/$445 deductible Part D plans, and they're all complaining about having to pay so much toward the first of the calendar year.

I went on Medicare's website and it computed my drug costs. I won't even hit my deductible this year on my $17.99 monthly plan. So the only reason I'm even in Part D is in case I get sick and require some very expensive pharmaceuticals.

In the past, insulin (for my pump) was on Part B, and Medicare was billed about $2500 a quarter which is $315 a vial. My 20% has been just over $500 per quarter. The last administration twisted arms of Big Pharma and right now insulin in vials is a maximum of $35 per month on Part D. That's like getting a raise.

 

[Chuckanut]

So the only reason I'm even in Part D is in case I get sick and require some very expensive pharmaceuticals.

+1

And that can happen suddenly and without warning. If it does, the deductible will seem like peanuts.

 

[Car-Guy]

So the only reason I'm even in Part D is in case I get sick and require some very expensive pharmaceuticals.

If they cover the needed drugs... My Part D provider (Atena) has been a real PIA to deal with... I've been pretty much "stuck" with them since going on Medicare years ago (another story) but I can switch next year... Example, I've been taking Toprol for ~20 years now and they were paying ~70% for refills until a few years ago. Then they said Toprol had been added to their restricted list and I needed to take the generic rather than the brand name. (a lot cheaper) I told them the generic brands of Toprol didn't work for me and my doctor told them that too but they still refused... Some day big pharma insurance companies are going to get their come-uppins.

 

[frank]

I just signed up for part D as well. Got the silverscript from Aetna thru Boomerbenefits. Costs $7 a month. I have no prescriptions either.

Must say that Boomerbenefits were excellent throughout the whole experience. Did everything for me with a few phone calls. What I really like about them is that if we have any issues with the Medigap plans or the part D plans we contact them and don’t have to deal with the companies.

did you have to contact boomerbenefits on the phone or internet to get the pricing? I don't see any kind of pricing close to that on medicare.gov.

 

[audreyh1]

did you have to contact boomerbenefits on the phone or internet to get the pricing? I don't see any kind of pricing close to that on medicare.gov.

It was there on Medicare.gov during the open enrollment period. DH switched to Aetna’s cheap plan via Medicare.gov.

He did his initial enrollment with boomer benefits including Part D, but for switching part D plans during open enrollment he had to do himself. They had a video on boomer benefits telling you exactly what to do.

 

[bmcgonig]

did you have to contact boomerbenefits on the phone or internet to get the pricing? I don't see any kind of pricing close to that on medicare.gov.

Yes. I called them originally and they offered to set everything up I.e., both Medigap and part D. I had no contact with anyone except for them.

 

[Gotadimple]

Hello all,

Right now I take Losartan 50mg. I get 90 for $12.00, or $48/yr.

The Humana Walmart Part D plan (not the cheapest but 3rd)... shows these costs:

Monthly plan premium $17.20
Drug deductible $445 (excludes Tiers 1 and 2)
Initial coverage limit $4,130
Catastrophic coverage limit $6,550

Call me crazy, but how does this help me?

Is this "just the way it is"? I understand that there are many drugs I could be prescribed in the future that would be more expensive and thus might be worth it, at least if said drugs are in the "formulary".

Thanks,

Mitch

Several questions here:
How does the detail about premium/deductible, initial limit/catastrophic help me? This is the explanation of benefit limits - you can use it to compare to other Part D plans. As others have said, the Medicare.gov site has a good comparison tool, as does Boomer Benefits. The Medicare & You booklet you received before signing up provides a good description of your Rx benefit.

REMEMBER: the government designs the benefits, dictates the initial coverage limit ($4130) and the catastrophic coverage limit ($6550).

The insurers set the formulary, tiers in the formulary, and co-pay amounts (if any). They can set or waive a drug deductible ($445 in your case).

Your current prescription has a copay of $12 a quarter or $48 per year. But your $48/year cost is under your current health plan and may have been subsidized by your employer. ALthough your drug is generic and can be bought without insurance for about $18 a month (just Google it for prices).

So the question for your current prescription is what tier is it in the plan I selected? (You can find this on Medicare.gov) Losartan is a generic and without checking on Medicare.gov I am guessing it is either Tier 1 or Tier 2. BUT you need to check because an insurer can choose to have you pay a small co-pay (i.e. $12) or $0 co-pay if the drug is one that is heavily used - like a statin or blood pressure medicine - where they want to encourage you to take the medicine because it avoids other higher health costs.

Your final question is "Is this just the way it is?" Yeah, Mitch, it is - Welcome to Medicare! It is an annual comparison exercise we all go through to make sure we get the most affordable coverage for ourselves. That is why Medicare.gov, and agents like Boomer Benefits are so helpful. And yes you need to enroll now to preserve a lower premium and good coverage for more expensive drugs should you need them later.

- Rita

 

[PoorOldCountryBoy]

Hello all,

I just completed my signup for my Medicare Supplement with AARP/UHC. I am using Boomer Benefits, and while I will be continuing to work with them, I wanted to ask a question here.

Right now I take Losartan 50mg. I get 90 for $12.00, or $48/yr.

The Humana Walmart Part D plan (not the cheapest but 3rd)... shows these costs:

Monthly plan premium $17.20
Drug deductible $445 (excludes Tiers 1 and 2)
Initial coverage limit $4,130
Catastrophic coverage limit $6,550

Call me crazy, but how does this help me?

Is this "just the way it is"? I understand that there are many drugs I could be prescribed in the future that would be more expensive and thus might be worth it, at least if said drugs are in the "formulary".

Thanks,

Mitch

Just for perspective and a little Schadenfreude, our BC/BS premiums just hit $1412 per month.



If they ever make Medicare available at 60, I'll sign up today!



and yes we are quite healthy.

 

[BoodaGazelle]

Just for an update. I did sign up with AARP/UHC through Boomer Benefits and it went very well. I also ended up with Humana/Walmart for Part D. In our case, we figure DW's SS will more than pay for both of our "normal" medical costs, once she turns 65 in about 18 months.

Thanks again to all for posting.

 

[audreyh1]

Just for perspective and a little Schadenfreude, our BC/BS premiums just hit $1412 per month.



If they ever make Medicare available at 60, I'll sign up today!



and yes we are quite healthy.

I hope that is combined. If so, we were above that before DH started Medicare.