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Medicare part D quandry

A

Anonymous-0

Well-known Member
Well, I qualify for Medicare. Already they've nipped my social security a chunk. What's worse, I have to sign up for some form of part D - which covers medications. (If I don't, they'll penalize me when I try to sign up later.) This part is run by private companies. With some variations, there are basically two plans: The cheap and the expensive. Cheap plans are approximately $25 to $35 a month About $320 deductable before they start paying for prescriptions. Expensive plans $75 a month and on up - typically no or low deductable, and a bit better on co pays...... Now here's the sticker shock. I'm getting my meds now for less than $75 for THREE MONTH SUPPLY. Now, I will grant you, my pharmacist is very careful to match cheapest costs on the items I use. But either plan is going to cost me far more than I'm paying now. Amy one else run into thus problem? I've got until the 7th of December to decide how bad I get taken! Not happy!
 
i had the same dilemma and i took the cheap way out NO PART D
because my check is so little my dr signed me up with drug co's for free meds...i still pay about 40 a month for regular scripts but the expensive ones are waiting for me at dr office when i go in for regular checkups.
this doesnt base on what you own,its based on your monthly income.
 
This is not Randy it is his wife, I do know that with the deductible on the cheaper plan you will have to hit what they call a doughnut whole, which is they will only pay so much for your scripts, then you pay full price again until the max hits again, then they will cover them again. I would personally go for the more expensive one because you know you have to pay $75 anyway, but you may need meds in the future that are more money.
I took care of someone who was getting the cheaper plan, and she had a ton of pills, but the part D wouldn't pay for some of them, and she had a doughnut whole like every three months, so she paid the cheaper cost, but every three months she ended up paying about $200 for her scripts, for three months, then the insurance would kick in again. Just make sure the scripts are paid for all the time, look for the word doughnut whole. Or you could call a hospital and ask if they have a certified person to discuss part D insurance.
 
I feel your pain. The very good plan we have now is not offered in 2012, so for part D we will be paying $15/Month each for $320 deductible. The 2011 plan has zero premiums and no deductible. We reluctantly signed up yesterday. That is not the kind of "change" I'd "hoped" for.
 
Insure for the major expenses.

The high priced meds are the ones that hurt.

Back in 2004 the wife came home from work and said they are offering medicine insurance. We didn't have any before then.

Her meds were $15 a month and I had none. The insurance was $12 a month with a $5 deductible per prescription.

I said go for it you never know what will come up.

One year later I was on a $84 a day $32,000 a year drug. And am still on it today. If it wouldn't have been for that insurance I would no longer have a farm.

Gary
 
You can buy a cheap Hummana plan for $15.00 per month. Gets your foot in the door. True, it won't help you much now. But, if you have a major health issue, you can could easily have a list of meds as long as your arm. Go to medicare.gov and research online. You can sign up right there on your computer at home.
 
Ray your not alone. I went on plan D in Oct. I took a plan with no deductable and a monthly payment of $63.00. As of the first of the year it goes to $85.00 a month.With my D plan i am paying about the same for a three month supply as I was under my retirement ins. The copay on drugs are cheaper on the more expensive plans.On the plan I took when I hit the donut hole I pay very little for generic drugs.
 
Why not switch to AARP plan and pay about $44/month with no deductable. Go to medicare.gov and research your drugs cost and options.
 
Have you looked at "Medicare Advantage" plans? My wife and I went this route. About $70 a month on top of Medicare B. This has low copays for medical expenses and includes drug coverage. I am in east central Wis. This is a PPO that covers only a 6 or 8 county area. We are very happy with the plan.

Areo
 
We look into the part D plan every year. This year it worked out so that the more expensive plan with less deductible worked out the best for my wife and I. All of our meds are generic, except one, and it goes generic in 2012. You just have to compare them every year to know what's best for you individually.
 
This coming year the dothole is when you hit $2930.00. That is based on the total cost of the drugs not what you pay each month. You stay in the coverage gap stage until your out-of-pocket costs reach $4700.00. Once you have spent a total of $4700.00 in out-of-pocket cost within the calender year,you will move from the coverage gap stage to the catastrophic coverage stage. When you get to this out-of pocket cost there is a list of what you can & can't use.
 
While I'm not a fan of telesales reps,I got desperate for a job and "now I are one." I'm licensed to sell health insurance in 28 states, and there are different plans in different areas. Some areas have Medicare Advantage plans that include prescription drug coverage [MAPD's] for a $0 monthly premium; some areas have MAPD plans with small premiums; some areas don't have MAPD plans at all. Some areas only have Medicare Supplement plans available, with stand-alone prescription drug plans...and both have premiums

The company I represent usually has two stand-alone PDP's in every state; the low-premium plan usually has slightly higher copays, and the higher-premium plan may have some drugs on their formulary that the low-premium plan won't cover at all. [There's no free lunch, folks...even here.]

I won't mention what company I work for, but I suggest you go to the www.medicare.gov website and check out your options...then go to the website of the company whose policy seems good, and read the fine print to make sure it's a plan you can live with.

BUT...my companies PDP's have NO deductibles. Go to www.medicare.gov and check out the plans avaiable in YOUR area...and remember, the Annual Election Period ends on December 7th, so you've got just about a week to get signed up!
 
Been there about four years now. My part D is around 75 per month. I have figured it time in time and IF I can buy my medicine for what they pay it would be about a wash , but as it is I know if I have to get more medication I will be solid on the cost. Had heart problems 3 years ago and now take 4 diffrent medicines a day. If right now you do not figure it benifits you I don,t think the penalty is that much for waiting.
Might check and see what that cost would be.
 
Yep they have you coming and going and unless you can do it like I do your just plain screwed. I am lucky the V.A. covers all my meds so not part D
 
The "late enrollment penalty" for Part D coverage is 1% per month of the average Part D premium, as determined by Medicare. For 2011, that figures about 32 cents a month...for the rest of your life. So if you've missed having Part D coverage since its inception in May of 2006, the maximum late enrollment penalty is about $21 or so...for now. BUT...that's $21 a MONTH, EVERY month, for the rest of your life.
 
Unless your current plan is exiting the area, you can DO NOTHING and keep your current plan. That's the only time you HAVE to change plans...well, that, or when you move out of a plan's service area.
 
AARP is pushing United Health Care! I had United
Health Care, as a Union Machinist/Mechanic, for
Burlington Northern Railroad..United Health care
WEASELED out of Everything !!!! They dictated
which Hospital/Clinic to go to..then wouldn't
pay their full part,due to "More than the usual,
or customary". Worst Insurance I've ever had!
 
That is exactly correct. Most seem to think that once your total drug bill comes to the 4700 you are in the next stage, BUT, that is not the case, it is when your out of pocket expense reaches that figure. My wife always gets into the donut hole. About sept this year. She refuses to continue the Fentanyl pain patch which costs about 250 a month and went to morphine at 38. So far so good, but the reason she was put on the patch instead of oral meds was due to her eternal gastro-intestine problems.
 
We once had UHC too. They wouldn't pay a claim because Medicare did not approve it. They wouldn't pay another claim because it was covered by Medicare. Go figure.
 
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