another medicare question - part D

[Kali]

am I stupid? I can normally figure complex government shit out but this is worse than anything I have come across. guy is pretty healthy, takes exactly 2 prescriptions now, one for thyroid and then the one that is giving me so much hell.

product SEEMS to retail for cash at about $40/month though I couldn't get a straight answer about that from our normal pharmacist. according to the medicare D options for our area it seems to cost upwards of 6 or 700 and some have it over 400 PER DAY!!! so that deductibles and copays and donut holes and catastrophic variables start playing in.

help! just get the cheapest premium and buy his prescriptions cash. wait for possible real need? or try to figure out the math on these insane "plans" that I can't understand???

[SoonerPride]

1. You can use Medicare.gov

To enter his exact prescriptions and see which PDP plan has the lowest annualized out of pocket cost for your preferred pharmacy.

[Kali]

2. um yeah

that is what I have been doing - for hours

if I am correct on the retail cost of the one in question, not using ANY insurance seems to be the lowest cost! WTF??!!!

[Raven123]

3. That is very strange

Have you tried the Medicare.gov website? I used this to help someone find a plan. At least you can double check the info from your pharmacist. Maybe their source has it wrong. The alternative unfortunately is as you describe. Pay cash for the cheaper meds. That’s what some people do.

[Kali]

12. yes have been on it all day

I think you may be right. just pay for the stuff or quit taking it, it isn't that important anyway. LOL

[rsdsharp]

4. Do you currently have insurance coverage for these

prescriptions? That can wildly skew the difference between what you are paying, the insurance company’s share, and what the price would be without coverage.

For what it’s worth, we went with an Advantage plan. We checked up front to make sure our doctors and our prescriptions were on the plan. The out of pocket for most of our prescriptions run from a couple of bucks up to ten. I have one for which we pay $47 per month. It would be over $800 otherwise.

[Kali]

10. yes BCBS through ACA, prescriptions have been included (no cost to us)

but he is going on medicare now. he's going traditional (A and B) with a supplemental - the G high deductible.

[MOMFUDSKI]

5. Find an insurance broker that deals in multiple medicare plans

such as Advantage, Supplement Plan, etc. Broker will look at the cost of that particular drug and find the best plan for you. Only way to go these days. A good agent is invaluable. I rely on mine a LOT. I even ask for doc recommendations from mine and he is always very helpful. Develop a relationship with your broker.

[Patterson]

6. This is the answer for you.

[Kali]

9. I guess that is the way to go

it just seems so unnecessarily complicated.

[PoindexterOglethorpe]

16. How does one go about finding such an insurance broker?

[Pathwalker]

7. Have you tried GoodRX or Singlecare? They offer coupons which help SOME times.

You can also check with the manufacturer, who MAY offer help if you can't afford it.

[Kali]

8. yes that is where I am seeing this for around $40

I just don't get the complicated crap that I am seeing from these plans. why does it need to be so bizarre?

[Pathwalker]

11. Because it was written by congress? That's my guess. I have found it

head bangingly frustrating at times, too. One month my blood strips are covered, the next time - they're not. Good luck!

[Kali]

13. or written by ins co.s and set by congress

[Hoyt]

14. Unfortunately, you'll never figure Part D out. My plan covers a brand name inhaler,

but does not cover the lower cost generic. Some months my other meds have no copay, other months it’s $3 or $5 each. No one can explain.

Good luck.

[Kali]

15. at least it is not just me then?

I need a drink.