My Medicare Part D Plan Went Belly-Up
5 years ago
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Medicare Part D Questions
Comments (12)I'm finding that Part D plans don't change the base problem: The uncontrolled cost of prescription drugs. A low-premium Part D plan sounds good when it offers you an initial copay that is a small percentage of the retail cost of your medicatiion. But inflated retail on drugs means more people reach the 'donut hole' sooner. (That's $2930 total retail cost for 2012.) Then the individual will pay at least 50% of that inflated retail. Few will go beyond the 'hole' to the 'Catastrophic Stage', where they pay only 5%. (That kicks in only after a person has OUT OF POCKET costs of $4700.) Dadoes, I'm glad your grandmother doesn't need any expensive meds. Part D premiums plus our prescription drugs cost my DH and me over $4000/year. When I add the cost of Medicare Part B and a supplementary medical policy, the total is more than I budget for groceries. I've been taking Advair for about ten years. Their lawyers have a stranglehold on the product; I doubt I will live to see this go generic. In January of this year Walgreens quoted Advair retail at $516.79 for a 90-day supply, a big jump from the prior year. In March Walgreens quoted the same 90-day supply at $823.59 retail. This month it went to $849.19. Zap! I'm in the donut hole on this medication alone! I'm investigating Part D plans from two different companies. THEY are quoting retail of $684 for a 90-day supply of Advair in 2012. It's hard to believe they are right when Walgreens has been much higher for *this* year. IF the retail price quoted by a plan is accurate, I pay $110 copay for four 90-day supplies of Advair and I DON'T go into the 'donut hole' in 2012. (My drug's total retail won't top $2930.) However, if the retail is actually higher, I DO go into the 'donut hole', and I'd be paying 50% of retail (plus dispensing fees) before the end of 2012. In the second plan I looked at there is no flat dollar-amount co-pay; it's a percentage of the *whatever* retail from the start of the year, going to the same 50% of retail in the 'hole'. The unforseeable retail sways me towards the plan with a dollar amount copay. I can count on that exact amount for at least most of the year. If I avoid the 'hole', I'd be paying $440 for my Advair + $410 for the plan premium. Wow, 'only' $850 for one medication for one year. DH has TWO expensive meds. He goes into the 'hole' at the end of May -- or sooner if Walgreens is right on retail and the plan prediction is short. The least he will pay for these two meds and premium is over $3000....See MoreOn Medicare? Know You MUST Buy Part D?
Comments (36)Here is a good read taken from the link below. The Penalty Can Add Up! How much the late enrollment penalty will cost you depends on how long you did not have creditable prescription drug coverage. The late enrollment penalty is calculated by multiplying 1% of the "national base beneficiary premium" ($32.34 in 2011) times the number of full, uncovered months that you were eligible but didn't join a Medicare drug plan and went without other creditable prescription drug coverage. The final amount is then rounded to the nearest $.10 and added to your monthly premium. Since the "national base beneficiary premium" may increase each year, the penalty amount may also increase every year. You may have to pay this penalty for as long as you have a Medicare drug plan. Example 1: Mrs. Jones did not join a Part D plan when she was first eligible (by May 15, 2006). She joined a Medicare drug plan during the 2009 enrollment period (November 15,December 31, 2009), for an effective enrollment date of January 1, 2010. Since Mrs. Jones did not join when she was first eligible and went without other creditable drug coverage for 43 months (June 2007,December 2010), she will be charged a monthly penalty of $13.90 in 2011 ($32.34 x.01 = $.3234 x 43 = $13.90) in addition to her plan's monthly premium. If Mrs. Jones continues with her Part D drug plan for the next five years, her penalty will cost her over $800.00 Example 1: Mr. Smith did not join a Part D plan when he was first eligible (by January 15, 2010). He joined a Medicare drug plan during the 2010 enrollment period (November 15,December 31, 2010), for an effective enrollment date of January 1, 2011. Since Mr. Smith did not join when he was first eligible and went without other creditable drug coverage for 11 months (February 2010-December 2010), he will be charged a monthly penalty of $3.60 in 2011 ($32.34 x.01 = $.3234 x 11 = $3.0) in addition to his plan's monthly premium. If Mr. Smith continues with his Part D drug plan for the next five years, his penalty will cost him over $200.00 That's food for thought. Good post Molly. Here is a link that might be useful: Medicare Part D Late Enrollment Penalty...See MoreExplain Medicare Part D Deductibles
Comments (20)I am embarrassed that I didn't remember that the deductible was 'in there' as part of the annual premiums. (Maybe I'm old?) It's annoying to have to shop Part D *every year*. It's a rare year that one or both of us can stay with the same plan from year to year. Our medications change -- maybe go generic (hahaha). DH's doses change. One plan considers XYZ Med a Tier Two; another says it is Tier Three. Each plan has its 'preferred' pharmacy chain. (Most years our plans have *different* preferred pharmacies -- two trips required.) Mail order is often more, rather than less. In 2017 I discovered that one of DH's meds costs the same whether the tablet is a 2mg or a 5mg. His MD is fine with buying the 5mg and using a pill splitter to get four doses. BTW, I am giving up on finding a cheaper alternative to Advair. Symbicort is only $25 cheaper per month (retail); I don't know how I'd react to it; and I'm charged the same out-of-pocket for it as for Advair. Good thing I hadn't already spent my 'savings'....See MoreForgive My Asking Again About Medicare's Part D
Comments (8)It will depend on the policy where the deductible is paid. Rather than worrying about that I would check each companies formulary to see what they cover for each of your medicines along with any co-pays for that medicine. Reason why I posted the "where" is some consider the co-pay as going to the deductible others want the deductible paid before the co-pay starts. Knowing how much your regular medicines will cost is a good starting point then follow Elmer's suggestion on the ones that you think you may want....See More- 5 years ago
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