Medicare Part D ?

[mike7mm08]

I am a long way of from using medicare. Probable won't exist when I get around to that age. Anyways my parents will be enrolled next year. Went over all the plans. Found what seems to be the best for what they need covered.

I got to thinking though do they need to use it for all their medications? A couple of their meds will have a high onetime copay and a higher than they were paying monthly copay.

I know for certain one of meds would me dirt cheap if they bought it without insurance. I was on the same med at one point and was about a third the cost without insurance.

So I am thinking one pharmacy for their affordable Medicare covered meds and go to another and say no insurance.

But with this being a government run cluster... I am wondering if they do this could it come back to bite them in the ass with some kind of penalty.

Any advice from those that have btdt is appreciated. Also if you can direct be to any online resources that I can show them as proof they could do this.

 

[RSIno1]

Do they have some other insurance from a work retirement? There are also supplement policies by outside suppliers for meds or being that close to the border the Canadian option. I signed up for medicare even though I'm still working and covered. I just got the hospital part (costs me $0) which my employer would require me to get when I retire anyway. I won't need the Dr or med parts as my retirement health plan will cover those.

 

[Rick Courtright]

Hi,

Several of my clients told me when Medicare Part D got started they looked into it, and every one of them found a separate Rx insurance coverage (outside of Medicare) to be a better deal.

My personal feeling on doctors is that if something's obviously broken or bleeding, they're the guys to see. Otherwise, I try not to let them kill me (long story for a different day), so when it came Medicare time I signed up for a simple M/C supplement which takes the monthly Medicare premium and calls it "payment in full" for their insurance. A certain amount of Part D coverage is included. Unless I somehow end up needing a lot of meds, it seems ok for my needs as they stand right now. You have to do a lot of reading and weighing one thing against another, as it seems there's no "one size fits all" solution here!

I know only a couple of people who have the actual Medicare Part D, and they're healthy enough they don't need much, if any, Rx medication, so they're not a good source of info on how it works in practice.

Rick C

 

[Pat-inCO]

Nothing says you . . . have . . . to get the meds from the place you get
the majority of yours (theirs) from. If a different place has one med for
significantly less, just buy it as an out of pocket expense.

 

[DGW1949]

I am a long way of from using medicare. Probable won't exist when I get around to that age. Anyways my parents will be enrolled next year. Went over all the plans. Found what seems to be the best for what they need covered.

I got to thinking though do they need to use it for all their medications? A couple of their meds will have a high onetime copay and a higher than they were paying monthly copay.

I know for certain one of meds would me dirt cheap if they bought it without insurance. I was on the same med at one point and was about a third the cost without insurance.

So I am thinking one pharmacy for their affordable Medicare covered meds and go to another and say no insurance.

But with this being a government run cluster... I am wondering if they do this could it come back to bite them in the ass with some kind of penalty.

Any advice from those that have btdt is appreciated. Also if you can direct be to any online resources that I can show them as proof they could do this.

The only "daily meds" I take are a multi-vitamin and a half aspirin, so all I've got are parts A and B.
On the other hand, my wife takes about six prescription-drugs a day, plus four at night, all of which are covered by her "part D" Medicare once the yearly deductible is paid. That said though, be aware Medicare-D doesn't cover all of the cost of all medications, meaning that ever now and then, she's been given a "one time" prescription for something different and had to pay for it herself.

Neither of us have any other form of insurance, and neither of us have ever been subjected to the infamous "Affordable Care Act" penalty.

As for "hiding" your Part-D coverage from any certain pharmacy, I'm not so sure that that's even possible these days. It seems to me that there's some sort of data base they all use that can accessed via name and DOB, with no SS-number needed...but I could be wrong about that.

Hope this helped.

DGW

 

[Jimbo357mag]

They should each search or better yet have someone else search for which plan is best for each of them. There are agencies that will do that. My wife has a plan with Humana/Walmart because she has mostly generic drugs. I have a plan with AARP/United Healthcare because I take several name brand drugs. The plans that have the best coverage will cost the most but some of the lower cost plans may work for them.

 

[JackpineWillie]

I use Wisconsin Senior Care. My monthly prescriptions cost about $60 and that is less than other part D coverage would cost. Senior Care has a deductible based on income. Mine is about $7000, an amount I hope to never achieve. The point is that for $30 annually Wisconsin Care acts as a place holder so that if I ever find myself needing expensive drugs I can enroll in another plan without being penalized. My Humana agent actually recommended this for my specific situation.

 

[Cholo]

This month I started on Medicare. I use www.SilverScript.com It was highly recommended, and I can now recommend it. I pay under $20 per month for it. All my regular meds are available in generic form, so that's what I get. Yesterday was my 1st time using it. My blood pressure med was the most expensive at $73.50; I paid $4.60. I had to make a rare trip to the Dr. yesterday. I was given 2 Rx's totaling $43.77; I paid $13.56.

This is MUCH better than I was getting with BC/BS at a fraction of the cost. What an individual would pay for SilverScript had to do with what meds you're taking. It's worth talking with them. I'm glad I did!

 

[luvmyRugers]

I use Humana for Part D coverage. I pay $17/month premium and get three prescriptions from their mail order pharmacy. It was $18.41 last year and actually went down!!! So far, I haven't had to pay anything for drugs which used to cost me over $50/month. My Dr. writes 3 month prescriptions and they are delivered in the mail within a few days. No more pharmacy visits for me!
Good luck.

 

[pete44ru]

I am a long way of from using medicare, my parents will be enrolled next year.

I got to thinking though do they need to use it for all their medications ?

A couple of their meds will have a high onetime copay and a higher than they were paying monthly copay.

I know for certain one of meds would me dirt cheap if they bought it without insurance. I was on the same med at one point and was about a third the cost without insurance.

So I am thinking one pharmacy for their affordable Medicare covered meds and go to another and say no insurance.

Anybody on any pharmacy coverage (I have company-provided insurance & VA coverage) can choose to buy any one (or more) Rx's from the same, or any other, pharmacy w/o penalty.

In fact, I long ago listed each of my medications, along with the dosages & frequencies, and presented the list to several different pharmacies (CVS, Walgreen's, Wal-Mart, + several small/family-owned pharmacies), asking for a price quote for a 90-day supply (3 months, what the mail-order Rx's send)

As a result, going with the least expensive options, I obtain my (17) different meds from two different local sources as well as both the VA & my insurance plan.

My Rx co-pays went from the $25-$50 range to the $6-$27 range for a 90-day supply.

FWIW: My diabetic supplies (glucose meter, lancets & test strips) are provided @ N/C (free) by the VA.


.

 

[Rick Courtright]

FWIW: My diabetic supplies (glucose meter, lancets & test strips) are provided @ N/C (free) by the VA.

Hi,

You're welcome! There are some things I don't mind paying my taxes for, and do so with gratitude. Happy New Year! :)

Rick C

 

[BROKENBEAR]

I use Humana for Part D coverage. I pay $17/month premium and get three prescriptions from their mail order pharmacy. It was $18.41 last year and actually went down!!! So far, I haven't had to pay anything for drugs which used to cost me over $50/month. My Dr. writes 3 month prescriptions and they are delivered in the mail within a few days. No more pharmacy visits for me!
Good luck.

What he said ...except I had a heart attack mid 2016 and the first round of drugs were insane using the Walmart partnership ...so bad that the hospital gave me the first 30 days meds to take home ...and a hint to shop around ...one med (a radical blood thinner) was $770/mo no insurance, $225 with Humana / Walmart ....and after getting quotes from all major players Walgreen filled for $75/mo

2 take aways ....A. Shop shop shop ..who insurance company says is their "partner" just may be the one who puts the most in their pocket (only thing I can figure anyhow)

B. when pricing various pharmacies make sure the patient who are shopping for have met their deductible because the only way the pharmacy can quote is to plug in your patient/group number and the machine will ADD the deductable every time ...so until you get it out of the way you cannot get realtime normal pricing to make comparisons

Good luck
Bear

 

[mike7mm08]

Thanks for all the advice. They went with a AARP supplement plan. Supposed to be the best deal for what they need covered. Now that I know cash is an option will have to do some figuring. Comparing savings to reaching out of pocket costs and deductibles that reduce the copays etc.. All very confusing. Parents are of the type to just say the hell with it and pay whatever. I learned along time ago anything insurance related is scam and add .gov to the mix and it gets even more interesting. Thanks again.