Formulary Rx List of Dropped Medicines npr.com - Page 2

terrier3 · ‎03-10-2010

@meem120 wrote:
Youre part D RX coverage does not have to be the same company as you have your supplemental insurance. Part D is a Medicare program, but they farm it out to the insurance companies. Each insurance company has there own formulary, its not just one and it doesnt go by what drug store you have your RX filled. I would check around the insurance companies for the best prices on your individual prescriptions. Of course no one knows what the future holds, but youre not locked in. You can change every year if you need to. For instance my most expensive Rx is Celebrex. AARP had the cheapest price for that so thats who I went with . My other prescriptions are all just $4.00 You have to look around, there was over a $100 diffrence from one insurance company to another per month for Celebrex and thats pretty big!!

Remember too that just as you can change Part D insurers, the insurance companies can also change their formulary - and they don't have to waut for enrollment season to change (same with the provider list too - they can change at will).

terrier3 · ‎03-10-2010

@LTT1 wrote:
@meem120 @Moonchilde @Coquille @Tinkrbl44

I will add my confusion to our list!
The insurance I have (for a few months) is a Cigna plan. When I looked one of mine up (Nexium) I would have to pay $1000 for. 90 day Rx ... NOTHIN DOIN! Lol It is so costly because it is in a certain tier.
Then, there are second tier options, covered at a lower %.

It wouldn't be applicable in my case because the plan we decided on has a high deductible.

You will be paying out of pocket for your meds?

LTT1 · ‎03-09-2010

@terrier3

Yes, this insurance lumps the deductible for Rx s in with the medical deductible. But I will check this again.

I just paid for a proton-pump med (like Nexium) today thru a company called "blinkhealth." The cost was just an introductory deal, I'm sure. Mere pennies.Have not gone to the pharmacy to pick it up yet, so we shall see.

I won't enjoy playing "pill-tag" all over town though if it changes drastically each time I order. : )

~Have a Kind Heart, Fierce Mind, Brave Spirit~

Gooday · ‎03-23-2010

An interesting news article today. Aetna lost 480 million dollars on the ACA. It will be available in 5 states (?). This is the 4th big insurance company to leave the program.

I said over 2 years ago that this will fold like a house of cards. We shall see. Stay tuned folks.

goldensrbest · ‎03-10-2010

@terrier3, i read that you said you worked in the insurance business, i have a question, i turn 65 this december, i simpy do not even begain to understand medicare, i have read on line, but it is so confussingto me, where do i start first? Should i make a appointment with SS office? All this having to buy insuance to cover medications, and then having to buy insurace to cover hospital stays,and what not, it is going to be so much more than my obama care i have now, i live on ss.

When you lose some one you L~O~V~E, that Memory of them, becomes a TREASURE.

meem120 · ‎03-09-2010

I would suggest you make an appt with SS. Medicare is a good program when you have a supplemental insurance. It's really not as complicated as you think. Just take it one step at a time. My Medicare, supplemental AARP, and part D prescription plan cost me around $325 a month. But depending on income you may be able to get help. It's worth a trip to the SS office

Lila Belle · ‎01-24-2013

@GoodayGooday wrote:
An interesting news article today. AetnaAetna lost 480 million dollars on the ACAACA. It will be available in 5 states (?). This is the 4th4th big insurance company to leave the program.
I said over 2 years ago that this will fold like a house of cards. We shall see. Stay tuned folks.

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Aetna has been PO'D ever since their Humana merger went bust. They wanted a monopoly deal like the cable companies now have where they corner the market in chunks.

151949 · ‎03-09-2010

The formularies are set by the insurance companies NOT by medicare - same with what tier a drug is in - set by the insurance company, not by medicare.

151949 · ‎03-09-2010

@Coquille wrote:
I found that out last week when I went to refill a script for my IBS. My co pay with my insurance was $15.00. Without insurance the cost would have been $60.00 (2 months worth). Now, the insurance dropped the medication and I was told the cost now is $863.00. My doctor has put in an appeal so hopefully they will pay for it at least one more time. I'm not counting on it. I go on Medicare in November so, I doubt I can get it with Part D. Good luck everyone.

It seems easy to figure this out -- if the cost without insurance is $60 - then just buy it out of pocket without insurance.

Moonchilde · ‎05-23-2010

@Lila Belle wrote:
@GoodayGooday wrote:
An interesting news article today. AetnaAetna lost 480 million dollars on the ACAACA. It will be available in 5 states (?). This is the 4th4th big insurance company to leave the program.
I said over 2 years ago that this will fold like a house of cards. We shall see. Stay tuned folks.
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Aetna has been PO'D ever since their Humana merger went bust. They wanted a monopoly deal like the cable companies now have where they corner the market in chunks.

That is the crux of their pull-out.

Life without Mexican food is no life at all