Community Chat

[grammarqueen]

New to Medicare Part D, signed up to an Aetna Rx plan through a SHINE counselor. She showed me 3 different plans, and I chose the one with more expensive premiums but with lower copays. I went to pick up my blood pressure medicine and instead of $5 the copay was $25! I called Aetna and they said it was a tier 4 generic, whatever that means. I mentioned what the SHINE counselor quoted me, and they just played like they were stupid and didn’t know anything. I can’t get ahold of the counselor I talked to until next week, so I have to worry, stew and fume all weekend. These insurance companies are giving people misleading information in order to get them to enroll with them as far as I can see!

[I am still oxox]

Did she ask the name of the meds and specifially check them or was it a general most prectiption are $$$.

Meds have different tier levels and are priced differently, it is that way with any plan

[123s]

Sorry to hear about that. I will be applying for Medicare in a few months. Have been researching and there are a lot of options out there. Hope you can get it straightened out.

[deeva]

Does your Part D plan send you a booklet listing the tiers that your drugs are in? Silver Script sends out a booklet every year. Tier 4 drugs are more expensive than Tier 1 or 2.

Does Aetna Rx have a website you can visit to price your drugs?

I wouldn't waste my time contacting the counselor, contact Aetna Rx.

[CLHS68]

t would be the counslers fault for not explaining it to you. Meds fall into different tiers & with higher priced meds you pay a higher amount. I think it is that way with all RX plans. Ask your doctor if he can put you on something in a lower tier. Maybe that won't work depending on what you take but my doctor changed mine to a lower tier. The $5 is just for tier 1.

[lilypadfrog]

Go to  the Medicare website.   There's a place there which reviews all the plans so you can truly see what your cost is.  I pay $13.40 per month, have blood pressure medicine but I havent paid any copays on any medicine so far this year.  Check out this site,  you might be surprised.

[grammarqueen]

Deeva Yes, Aetna gave me a book, I remember I will look at it tonight. My pharmacist said my PCP might be able to put me on a lower cost generic, so I called but her office hasn’t gotten back to me yet. I’ve got a week’s worth of pills left, so I hope I can get this straightened out by then. I was on the ACA (Obamacare) and everything with Medicare is costing me 3X as much! What in the heck am I supposed to do when I retire and go on my Social Security pittance?

[chrystaltree]

I don't know what this SHINE counselor is but I do know insurance company employees don't know everything, they can get things wrong.  If you really want to know what your benefits are, you have to read the book that has your benefits.  Honestly, you have your medicine and you need this resolved for the next time but I don't see how $20 would upset you so much.  

[CelticCrafter]

Part D falls under the Open Enrollment options.

Now would be the time to make your change for next year.

[lovesrecess]

The higher the tier, the more you pay. DH has a Aetna Medicare advantage plan and he pays zero for most of his blood pressure meds and $15 for one they moved to tier 4. You may lower your cost if you can get a generic version.