Shopping Medicare Part-D with the GoodRx Wild-Card

[audreyh1]

Wow!

 

[workmyfingerstothebone]

Not seeing any Wellcare plans with 0 dollar premiums in my area,,,,,

Wellcare value script 17.40/month
Wellcare classic 16.80/month
Wellcare Rx Value Plus 117.60/month

 

[audreyh1]

Wellcare Value Script is the one that is $0 premium here.

 

[spncity]

If interested, you can work with a SHIP counselor each year for free. They will analyze your meds and your preferred pharmacies, and help you determine which plan that is best for you (taking into consideration your meds and the premiums).

It's a service paid for by the government (typically outsourced).

One reason it's good to check annually (if you take an expensive med) is that the Part D companies often change their formularies and may drop a medicine from the plan that it covers now.

Here's more about SHIP:

How to Use Medicare SHIP Services

Whether you’re new to Medicare or looking to change your current coverage, you may benefit from speaking with a SHIP counselor. SHIP counselors are unbiased, trained volunteers from the local community who can advise you on all things Medicare, free of charge.

www.healthline.com

What Is a SHIP and How Can It Help Me?

Trying to navigate the complexities of Medicare? Your local State Health Insurance Assistance Programs (SHIPs) offers free, unbiased Medicare counseling and can help you as your make decisions.

www.ncoa.org

I got the contact info from my insurance broker. But you can search for SHIP plus your county and state.

 

[EvanC]

I use Wellcare value script.For the past few years it was four dollars a month and I supplemented it with the one or two drugs that were through GoodRx.

I was loyal to CVS for 17 years until one drug cholesterol even with Good RX drug was $178 and at another Pharmacy it was $21. (tell me that makes sense.)

This year I was suspicious of zero cost for Wellcare and hoped I was making the right decision as even though GoodRx has come through. I’m always suspicious of it because it seems too good to be true.

As I age, fortunately I’m fairly healthy so Im not on that many drugs. But this portion of our medical plan terribly difficult to confidently navigate.

 

[sengsational]

I thought that this was interesting (from KFF)

Good info. It answers my wondering, up thread, about why plans formularies are so similar:

Part D plans must offer either the defined standard benefit or an alternative equal in value (“actuarially equivalent”) and can also provide enhanced benefits. Both basic and enhanced benefit plans vary in terms of their specific benefit design, coverage, and costs, including deductibles, cost-sharing amounts, utilization management tools (i.e., prior authorization, quantity limits, and step therapy), and which drugs are covered on their formularies. Plan formularies must include drug classes covering all disease states, and a minimum of two chemically distinct drugs in each class. Part D plans are required to cover all drugs in six “protected” classes: immunosuppressants, antidepressants, antipsychotics, anticonvulsants, antiretrovirals, and antineoplastics.

 

[RetMD21]

If I am interpreting this correctly when a new cancer drug is approved the plans have to cover it.

 

[BarbWire]

Slightly off topic perhaps but: the broker that I have used in Texas for Medicare Part D (Aetna, the premium for which has gone up 500%) does not have a contract with Wellcare and so is urging me to stick with Aetna, even though I have no prescriptions "just in case..."

Per their website, WellCare ValueScript $0 is offered in my zipcode, and I can enroll directly with Wellcare (so I would then tell my broker not to renew the Aetna).

Is there any reason NOT to get Wellcare PartD directly from Wellcare and instead try to find a broker in my area to reps them?

 

[Irishgirlyc58]

Slightly off topic perhaps but: the broker that I have used in Texas for Medicare Part D (Aetna, the premium for which has gone up 500%) does not have a contract with Wellcare and so is urging me to stick with Aetna, even though I have no prescriptions "just in case..."

Per their website, WellCare ValueScript $0 is offered in my zipcode, and I can enroll directly with Wellcare (so I would then tell my broker not to renew the Aetna).

Is there any reason NOT to get Wellcare PartD directly from Wellcare and instead try to find a broker in my area to reps them?

Have you gone to the Medicare.gov website and looked at what Part D plans are available in your area?
I personally don’t see the need for a broker. I prefer to research this type of thing on my own since I know what type of plan I’m comfortable with.

 

[RetMD21]

Have you gone to the Medicare.gov website and looked at what Part D plans are available in your area?
I personally don’t see the need for a broker. I prefer to research this type of thing on my own since I know what type of plan I’m comfortable with.

And I think some plans don't pay commissions l.e. should not be on your broker's list

 

[BarbWire]

Have you gone to the Medicare.gov website and looked at what Part D plans are available in your area?
I personally don’t see the need for a broker. I prefer to research this type of thing on my own since I know what type of plan I’m comfortable with.

Yep. Wellcare, Cigna, Humana, Aetna ... the usual list.

 

[BarbWire]

Have you gone to the Medicare.gov website and looked at what Part D plans are available in your area?
I personally don’t see the need for a broker. I prefer to research this type of thing on my own since I know what type of plan I’m comfortable with.

So the question is: what value does one get from a broker, other than s/he does the research...

 

[CardsFan]

So the question is: what value does one get from a broker, other than s/he does the research...

In this case, no value.

 

[audreyh1]

Slightly off topic perhaps but: the broker that I have used in Texas for Medicare Part D (Aetna, the premium for which has gone up 500%) does not have a contract with Wellcare and so is urging me to stick with Aetna, even though I have no prescriptions "just in case..."

Per their website, WellCare ValueScript $0 is offered in my zipcode, and I can enroll directly with Wellcare (so I would then tell my broker not to renew the Aetna).

Is there any reason NOT to get Wellcare PartD directly from Wellcare and instead try to find a broker in my area to reps them?

You can sign up through Medicare.gov, and Medicare will take care of both contacting Aetna to cancel for 2025 and Wellcare to start. I did exactly this last month and have already been notified by both companies.

I had already used Medicare.gov to compare 2025 for my county even adding my regular prescriptions and pharmacies. Then selected Wellcare from there to sign up. So all of this is done on the Medicare.gov site.

 

[audreyh1]

So the question is: what value does one get from a broker, other than s/he does the research...

No value. They will steer you where they get the best commissions.

 

[Irishgirlyc58]

No value. They will steer you where they get the best commissions.

This is what I think- it’s actually a negative to use a broker if you are comfortable doing your own research.
I’m currently researching part D plans and have narrowed down my comfort level to 2 plans.
I could go for the absolute cheapest one that covers my medication but after looking I decided that I didn’t like that gamble.
I like to look at the cost if I end up having to add higher tier medication.
3 years ago I wasn’t taking any and now I have 2 pills and eye drops.

 

[BarbWire]

You can sign up through Medicare.gov, and Medicare will take care of both contacting Aetna to cancel for 2025 and Wellcare to start. I did exactly this last month and have already been notified by both companies.

I had already used Medicare.gov to compare 2025 for my county even adding my regular prescriptions and pharmacies. Then selected Wellcare from there to sign up. So all of this is done on the Medicare.gov site.

Were you able to set up payments before receiving the first paper bill?

I want to have an autopay from a credit card or a draft from a bank account each month. And, because I will be out of the country Dec-Feb, I can't wait for the January bill to arrive to set up payment (which is how Cigna does it).

Ideally as soon as I enroll I'd be able to go to a member portal and set up payments for 2025.

I tried calling Wellcare but each of the three people I spoke to were clueless about how premiums are paid other than deduction from Social Security, which I don't get.

 

[CardsFan]

Were you able to set up payments before receiving the first paper bill?

I want to have an autopay from a credit card or a draft from a bank account each month. And, because I will be out of the country Dec-Feb, I can't wait for the January bill to arrive to set up payment (which is how Cigna does it).

Ideally as soon as I enroll I'd be able to go to a member portal and set up payments for 2025.

I tried calling Wellcare but each of the three people I spoke to were clueless about how premiums are paid other than deduction from Social Security, which I don't get.

maybe because the premium is $0? (according to your post above). Just sign up online. No bill. That is what I have done the last 3 years. (well, actually, to renew, I don't need to do anything)

 

[audreyh1]

Were you able to set up payments before receiving the first paper bill?

I want to have an autopay from a credit card or a draft from a bank account each month. And, because I will be out of the country Dec-Feb, I can't wait for the January bill to arrive to set up payment (which is how Cigna does it).

Ideally as soon as I enroll I'd be able to go to a member portal and set up payments for 2025.

I tried calling Wellcare but each of the three people I spoke to were clueless about how premiums are paid other than deduction from Social Security, which I don't get.

My Wellcare premium is $0, so I won’t be setting up payments for 2025.

I did already get the materials to set up an online user account, so I imagine I could pay that way if I had a nonzero premium. Will you have internet access?

It might have been two weeks to get materials from Wellcare, maybe a little longer. There was some kind of confirmation I got from Medicare.gov.

 

[audreyh1]

Medicare.gov makes it super easy to research your part D plan options and to switch plans. You really don’t need to go anywhere else. When you log in you’ll see that Medicare.gov already knows your current coverage including Medigap and Part D, and for me right now they also display my 2025 plans.

I did double check on the Wellcare site for my 2025 part D and got the same result as Medicare.gov. From what people are have posted here recently the Medicare.gov comparison results are very accurate.

 

[BarbWire]

Thanks -- I had a good chat with the Medicare folks yesterday. No one is quite sure when I will have the information to set up online billing (I leave the US on Nov 22 and return at the end of January so will miss anything in snail-mail) but as was pointed out above, the monthly premium is $0 so I won't be in arrears even if I set up the payments at the end of January.

It's my typical nomad full-time traveler overthinking of "what could go wrong ...." <Doh! dope-slap to forehead ....>

 

[audreyh1]

There is nothing to pay Wellcare besides the premium, and if the premium is $0…….

 

[sengsational]

If I am interpreting this correctly when a new cancer drug is approved the plans have to cover it.

I think that's right, except they'll probably try to wear you down with utilization management tools (i.e., prior authorization, quantity limits, and step therapy) before you get to the new/expensive one.

 

[CaptTom]

Good discussion, thanks! I'm looking at Part D now and finding that medicare.gov, like all the other sites I've looked at, wants me to enter all my current prescriptions and pharmacies. I have no ongoing prescriptions, and lots of pharmacies near me to choose from.

Without that information, apparently there's not much point in doing any comparisons.

I've used GoodRx before, and last time the pharmacy in the local supermarket was able to beat the GoodRx price with some sort of "special" pricing the pharmacy looked up only AFTER I presented my GoodRx coupon, knocking something like 90% off the price they originally wanted to charge me.

At this point my best strategy seems to be one of the "$0 premium" plans and going on-line to research prices of whatever drug I'm prescribed in the future. Of course this means the doctor has to write me a paper prescription, rather than calling it in to my "regular" pharmacy. I sort of messed them up in the office with that last time I tried, but with some coaxing they were able to do it.

 

[audreyh1]

With no prescriptions, as DH does, you are simply comparing Part D premiums on Medicare.gov. That’s still useful.

You can also check if your favorite pharmacy is in network and preferred by the Part D insurer. DH usually checks that to know where to tell the doctor to send the prescription for a one off type situation.

You can also transfer prescriptions between pharmacies.