Among Friends

[UpNorthGorgy]

We have a consulting service office called Mediquist.  Small town of 5000. I assume she works on Commissions. She checks your meds and the best plans for your prescriptions. She also helps people enroll in Social Security.  However During enrollment period she was swamped.

 I used a similar service  when WelCare was no longer associated with Walmart Pharmacy and went to Aeta. Sometimes pharmacy's prices differ. How co-pay prices are figured out is a mystery?  Copay for  my two three month meds range $.37 to 2.81 blood pressure and a cholesterol.  I am lucky not to have to take much. I  only have three pharmacy choices in town or mail.

[Jo1313]

DH has Humana script plan..I had Aetna..I changed to Humana...it's easier to to use 1 company..JMO as I get older...The killer for us is that PENALTY FOR LIFE!..If you didn't take a script plan when you started Medicare..

My secondary for everything else is BC/BS..Hefty premiums but I never get a bill for anything.Don't think this plan is still available...They pay everything as long as Medicare pays atleast $1! Won't change that until they throw us out!

They LIFE LONG penalty on script plans is an insane money grab.

[Rose429]

@monicakm  I had Humana for 4 years and it went up every year. It is $104.00 now. I changed to WellCare for $5.70 a month. We will see.

 My supplemental has also climbed. I have United and it is $256.00 a month. I do not have any chronic health problems but it just keeps going up. I am changing next Feb. on my birthday. 
    I find it all very frustrating. 

[Icegoddess]

---

@CelticCrafter wrote:

---

@CalminHeart wrote:

---

@monicakm wrote:

We just spent over 2 hours with Medicare to enroll in Part D.  A poke in the eye with a sharp object might have been preferred.  She told us that the above was the least expensive @ 31 and $34 premiums/month.  All of our medications would cost $0 before and after deductibles.  

I told her that both of us take a medication that the manufacturer is currently providing free of charge.  She said I would have to call those manufacturers to inquire how they would be handled. 

Does anyone here use this company for prescription coverage?  Are there other companies I should look into?

I can't believe this has to be done every year...bleh!  I know there are seniors who can't do this for themselves and might not have anyone to do it for them.  What do they do?

---

It sounds too good to be true. $31 a month and no copays is outstanding....if it's true.

Qestions.

• Did you talk to Humana or just to Medicare?  
• Or was it some kind of third party that sells medicare related products?
• What kind of product is it?  Is it a standalone RX policy or part of a Medicare Advantage policy?

I investigated corporate fraud for many years. I'd never sign up through any party except directly with the company. These third party entities make me too nervous. 

---

@CalminHeart we have Wellcare for our Part D coverage and there are no co-pays for what my husband takes.  The 2026 premium will be less than $30 a month.
I question that premium because they did not sign up for Part D coverage when they became eligible and are subject to a penalty for the rest of their lives.

---

@CelticCrafter , I wonder if that penalty comes out of the SS check, so it doesn't show up when you're shopping for Part D plans.

It's easy enough to shop the plans on your Medicare website.  It'll even have your current prescriptions filled in.  Some math may be involved. 

I'll be on my 3rd plan.  Both years, the plan I was on was discontinued and they were going to move me to a more expensive plan.  I got it down to either Humana Value or Humana Basic.  

The difference between the two is that Humana Basic doesn't cover anything until you meet the deductible, but it has a $0 Premium (in my zip code).  The Value plan will cover the Tier 1 generics for free starting at day one.  The deductible is the same for both plans ($600).  The Value Plan's Premium is $37.70.  

So, I just added up all my drugs and did the math for what it said the retail price is which added up to $525.  That's less than the deductible.  For the Value Plan, I only had to add up the yearly price for my 1 Tier 2 drug (subject to the deductible).  Then, I add that to the Premium ($37.70 x 12) and that came to $830.  

Boomer Benefits has a Medicare Q&A Facebook Page and they have been having Webinars on how to go through the process that you could sign up for (free) if you're a member of the page.  

[Still Raining]

---

@monicakm wrote:

We just spent over 2 hours with Medicare to enroll in Part D.  A poke in the eye with a sharp object might have been preferred.  She told us that the above was the least expensive @ 31 and $34 premiums/month.  All of our medications would cost $0 before and after deductibles.  

I told her that both of us take a medication that the manufacturer is currently providing free of charge.  She said I would have to call those manufacturers to inquire how they would be handled. 

Does anyone here use this company for prescription coverage?  Are there other companies I should look into?

I can't believe this has to be done every year...bleh!  I know there are seniors who can't do this for themselves and might not have anyone to do it for them.  What do they do?

---

You were given incomplete information.  If the two drugs you and DH take are currently covered by a manufacturer's plan, then they can also be dropped.  Assume they are pricey?

You need to understand how Part D will price them.  What tier.  What plan.  Could be a budget breaker.

Call the manufacturer is a sleazy cop out.

[reiki604]

Whatever plan you choose, you better do it by tomorrow because it is the last day of the enrollment period. If you miss it, you will be stuck with your old part D or none at all if you don't currently have one.

[conlt]

@Jaynah Thank you, I am a home care RN with 44 years experience working with primarily Medicare Patients. I have seen it all, I also worked many years on the business end of the business and have seen how the insurances work.

Not everyone likes what I have to say about Medicare. Basically, I am usually against Advantage Plans. Sometimes people have to get them because of the affordability. 

We had a patient referral yesterday, a man who was really sick with Esophageal Cancer, he had a feeding tube and a complicated surgical wound. 

They were having difficulty finding a home health agency to see him because of his Medicare Advantage Plan. 

I feel sorry for people like this, because I know the level of care that he needs and he does not need to be fighting with insurance right now.

Part D, is pretty benign though, basically look up your options available to you and choose the plan that covers your medications at the best price. 

I suspect the original poster went on an Advantage Plan. It sounds like it from what she says in her post. People get so mixed up. 

Sometimes the "brokers" have incentives to promote a company. I don't trust them either but don't need one for myself. 

[Jo1313]

---

@Icegoddess wrote:

---

@CelticCrafter wrote:

---

@CalminHeart wrote:

---

@monicakm wrote:

We just spent over 2 hours with Medicare to enroll in Part D.  A poke in the eye with a sharp object might have been preferred.  She told us that the above was the least expensive @ 31 and $34 premiums/month.  All of our medications would cost $0 before and after deductibles.  

I told her that both of us take a medication that the manufacturer is currently providing free of charge.  She said I would have to call those manufacturers to inquire how they would be handled. 

Does anyone here use this company for prescription coverage?  Are there other companies I should look into?

I can't believe this has to be done every year...bleh!  I know there are seniors who can't do this for themselves and might not have anyone to do it for them.  What do they do?

---

It sounds too good to be true. $31 a month and no copays is outstanding....if it's true.

Qestions.

• Did you talk to Humana or just to Medicare?  
• Or was it some kind of third party that sells medicare related products?
• What kind of product is it?  Is it a standalone RX policy or part of a Medicare Advantage policy?

I investigated corporate fraud for many years. I'd never sign up through any party except directly with the company. These third party entities make me too nervous. 

---

@CalminHeart we have Wellcare for our Part D coverage and there are no co-pays for what my husband takes.  The 2026 premium will be less than $30 a month.
I question that premium because they did not sign up for Part D coverage when they became eligible and are subject to a penalty for the rest of their lives.

---

@CelticCrafter , I wonder if that penalty comes out of the SS check, so it doesn't show up when you're shopping for Part D plans.

It's easy enough to shop the plans on your Medicare website.  It'll even have your current prescriptions filled in.  Some math may be involved. 

I'll be on my 3rd plan.  Both years, the plan I was on was discontinued and they were going to move me to a more expensive plan.  I got it down to either Humana Value or Humana Basic.  

The difference between the two is that Humana Basic doesn't cover anything until you meet the deductible, but it has a $0 Premium (in my zip code).  The Value plan will cover the Tier 1 generics for free starting at day one.  The deductible is the same for both plans ($600).  The Value Plan's Premium is $37.70.  

So, I just added up all my drugs and did the math for what it said the retail price is which added up to $525.  That's less than the deductible.  For the Value Plan, I only had to add up the yearly price for my 1 Tier 2 drug (subject to the deductible).  Then, I add that to the Premium ($37.70 x 12) and that came to $830.  

Boomer Benefits has a Medicare Q&A Facebook Page and they have been having Webinars on how to go through the process that you could sign up for (free) if you're a member of the page.  

---

The script penalty is added to your monthly premium..The people who we speak to ..to switch..don't know that you have a penalty. they are independent..brokers for each company...So of course the rate they quote sounds good!

Ex: DH's plan was quoted at $202 per month(Eliquis is a killer) his premiums are $264 a month including the monthly penalty for the new year.

[Icegoddess]

---

@conlt wrote:

@Jaynah Thank you, I am a home care RN with 44 years experience working with primarily Medicare Patients. I have seen it all, I also worked many years on the business end of the business and have seen how the insurances work.

Not everyone likes what I have to say about Medicare. Basically, I am usually against Advantage Plans. Sometimes people have to get them because of the affordability. 

We had a patient referral yesterday, a man who was really sick with Esophageal Cancer, he had a feeding tube and a complicated surgical wound. 

They were having difficulty finding a home health agency to see him because of his Medicare Advantage Plan. 

I feel sorry for people like this, because I know the level of care that he needs and he does not need to be fighting with insurance right now.

Part D, is pretty benign though, basically look up your options available to you and choose the plan that covers your medications at the best price. 

I suspect the original poster went on an Advantage Plan. It sounds like it from what she says in her post. People get so mixed up. 

Sometimes the "brokers" have incentives to promote a company. I don't trust them either but don't need one for myself. 

---

@conlt OP specifically claimed that she did NOT get an Advantage Plan back when when they signed up for it. 

[shoekitty]

I have been going to a agent since we enrolled. We always give her every med we take, etc. she puts in computer. Comes up with best value us. I am still with WellCare.  We have always gotten all BP meds free of cost. I also give her any meds I might have to take, likeRA meds. We Lao give her preferred pharmacy.  Although we can go to,can't pharm we want.  An agent is free of charge to us. The company gives the agent a small kick back for each new medical/ rx plan you choose. This year the companies anot giving kickbacks to agents if we choose to stay with same RX plan. So they might be more motivated to find new plans. My agent did tell me the one I had was best plan. It's all gone up, but to be expected. Instead of rewarding me for getting a year older, they charge me. lol