Plan D drugs

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Plan D drugs

Postby stevelb » Fri Mar 15, 2013 5:38 pm

Used the Medicare website and found a number of Plans that cover my meds. A significant difference between the lowest and highest cost plan. I don't want to use either Walmart or CVS. Elimating those two is there any reason not to choose the lowest cost plan? After using the Medicare tool, why would anyone take a plan that was a lot more expensive than others?
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Re: Plan D drugs

Postby Sam I Am » Fri Mar 15, 2013 6:01 pm

Message deleted.
Last edited by Sam I Am on Sun Oct 06, 2013 2:40 pm, edited 1 time in total.
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Re: Plan D drugs

Postby mur44 » Fri Mar 15, 2013 6:11 pm

You should choose Medicare PART D plan based on the following criterion:

Plan that is the lowest TOTAL annual cost that covers
all your drugs (with no usage restrictions: Step Therapy,
Prior Authorization and Quantity limit).

Also, make sure the plan has 3 (or higher) star rating.

Note that using mail order usually saves some money.


Disclosure: I am a Certified Volunteer Medicare Counselor from NJ
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Re: Plan D drugs

Postby midareff » Fri Mar 15, 2013 7:16 pm

I took AARP United for RX with the Preferred Plan. They went through an evaluation to get me the lowest plan expenses which included costs of the drugs I was taking. I worked with my doctor to chnge a few drugs to generics and use their mail order pharmacy. Three of my four medications are free 90 day supply and one is $5.00 every three months. Insurance is $41.40 a month. Drug selection matters.
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Re: Plan D drugs

Postby stilts1007 » Sat Mar 16, 2013 1:06 am

mur44 wrote:You should choose Medicare PART D plan based on the following criterion:

Plan that is the lowest TOTAL annual cost that covers
all your drugs (with no usage restrictions: Step Therapy,
Prior Authorization and Quantity limit)
.


Speaking as a pharmacist, this an important distinction that I know gets lost on a lot of patients, and I think probably by design on the part of some of the insurance companies that put out the plans.
I can't tell you how many times I have had a patient tell me "the website said it would be covered" when really, it is covered BUT for a maximum of 1 tab daily, or is covered ONLY when patient has tried 2 alternatives first, or only AFTER doctor sends in mountains of paperwork to the insurance company for review.
It's frustrating for us and for the patients. So make sure your medications are covered with no restrictions.
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Re: Plan D drugs

Postby Sheepdog » Sat Mar 16, 2013 1:27 am

mur44 wrote:You should choose Medicare PART D plan based on the following criterion:

Plan that is the lowest TOTAL annual cost that covers
all your drugs (with no usage restrictions: Step Therapy,
Prior Authorization and Quantity limit).

Also, make sure the plan has 3 (or higher) star rating.

Note that using mail order usually saves some money.



As this says, don't automatically take the lowest monthly premium, but the lowest total annual cost for the drugs you use. Too many buyers of these policies pick the lowest premium without looking at their prescriptions. They often will end up with higher costs due to co-pays, higher drug prices, etc. When you look at the insurance companies at the Medicare site, be sure to add the drugs you use, the strength of the drugs, and the dosage and then compare the total annual cost calculations for each company. Often an insurance company with a higher monthly premium has a lower total annual cost.

I review rates every year and have used several companies to get the lowest cost. For the last 2 or 3 years, the lowest cost policy for my wife and I has been First Health Part D Value Plus (from Coventry Health Care). All of our normal maintenance drugs are presently generic, and none of these require any copay with our policies. Each of us pay $33.90 a month insurance premium.
A side note: Four years ago my wife was using several high cost non-generic drugs. She was reaching the "donut hole" regularly. She changed physicians and he said he wanted to try generic medications to replace Actos and the other name drugs. They worked just as well, were low cost, and safer.
People should not say everything they think. They should think about everything they say.
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Re: Plan D drugs

Postby kitteh » Sat Mar 16, 2013 5:33 am

stilts1007 wrote:
mur44 wrote:You should choose Medicare PART D plan based on the following criterion:

Plan that is the lowest TOTAL annual cost that covers
all your drugs (with no usage restrictions: Step Therapy,
Prior Authorization and Quantity limit)
.


Speaking as a pharmacist, this an important distinction that I know gets lost on a lot of patients, and I think probably by design on the part of some of the insurance companies that put out the plans.
I can't tell you how many times I have had a patient tell me "the website said it would be covered" when really, it is covered BUT for a maximum of 1 tab daily, or is covered ONLY when patient has tried 2 alternatives first, or only AFTER doctor sends in mountains of paperwork to the insurance company for review.
It's frustrating for us and for the patients. So make sure your medications are covered with no restrictions.


I have AARP for Plan D, and they have been great. Only one brand name med needed an exception (one page) and they okayed it in a day.
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