Community Chat

[Mom2Dogs]

@Carmie, if you don't mind, can you answer this question for me?

When choosing a drug plan does age and the number of drugs a person takes determine the cost?

My DH has/had Silver Scripts....this year they instituted a deductible, aprox $300.00+.  This has to be paid before they cover any drug costs, so he checked around and found another plan that is less expensive...it also has a deductible but overall the yearly price will be less.  2020 will be the first year the deductible has been added to the plan, we were quite surprised by this new charge.

I am just curious about how the company determines the cost.

 My girlfriend has Silver scripts as well, her cost was only $15.00 ish per month in 2019.  She has not yet received a letter from them for 2020 charges.  She only takes 1 drug and is 15 years younger than my husband.  

thanks.

[twinny70]

After having Silver Script for a few years, I had to change my 2020 drug plan because it won't cover Uloric or the generic version of it.  I was told that I would have to pay $1,115 for a 3 supply.  I was paying $36.30 a month and will now be paying $42.30 a month.

My new plan will be Anthem Blue Cross & Blue Shield.

[Carmie]

@Mom2Dogs   I have always understood that if health insurance rates go up, they go up across the board for everyone who has that plan.

Some people will pay more for RX insurance if they did not pick it up when eligible and they have added late penalty fees.

I am not aware of rates being different because of age or cost of RX or usage.  Everyone pays the same.

It is a good idea to shop around every year for the best rates for you and to make sure your drugs are still covered.  Many people don't and they are disappointed with their coverage, especially if changes were made and they were not  aware.

[ID2]

Yeah, I had SilverScript this year and was so happy with it. But they aren't carrying one of my drugs for 2020 so I had to find another plan. I had no deductible with my SilverScript but looks like just about all the prescription drug plans opted for high deductibles in 2020. Oh well, what else is one to do? They got us by the b*!!s. 

[Cats3000]

This is gonna sound like a broken record, but here goes.

There are 2 legitimate ways to determine the best Part D plan for you:

The Medicare Plan Finder--You follow the instructions including entering the medications you take.  It will give you all of the plans available in your area.  You can sort those plans in a couple of different ways depending on your needs.

Your local "SHIP Counselor"--These are people who are trained to help you with a variety of Medicare issues.  They have no "axe" to grind othefr than helping you navigate the system.  Do search for SHIP Counselors, and find the one nearest you.

We have been using the Medicare Plan Finder each year since it was created.  We've changed plans several years to meet our needs.  We have found that you can either pay a lower monthly premuim and higher drug co-pays or a higher monthly premium and lower drug co-pays.  You've gotta check the plans to find which meets your needs.

[coconut1818]

Here in Kansas it's called Schick.  Your local Senior Center should be able to give you the contact info.  I have served on the local Center for Aging Committee and am currently on the Board for our local Senior Center.  I highly recommend reviewing your coverage every year.  Cost of coverage is always changing and even where you should get your prescriptions filled for the best deal.  2020 will be my third year on Part D and I will be going to CVS instead of a local pharmacy I have been going to.  My company coverage has changed each year.  Good luck!  Also, for anyone that receives "Extra Help", if you were to have a situation where your present plan does not cover a new expensive drug, because you are on extra help you can change your coverage anytime during the year.       

[Mom2Dogs]

Thanks @Carmie    the question was generic....and more curious than anything else.  I was just surprised that my friend pays 1/2 the price for her Silver Scripts than what my DH does...she is younger and only takes 1 medication.  Both friend and DH signed up at the correct time so no penalty for either one.

Thanks for the reply, you never disappoint!

[Mom2Dogs]

@Cats3000   Yes, we know to know to determine what plan DH needs and would work best for him, my question was more generic.  

Thru DH's pension they have a 'connector' that will assist the retiress with their health care insurance needs.

[Lisa now in AZ]

I make an appointment with my local senior center and the Medicare lady makes sure she has the current list of meds I take and finds the best Part D program for me. I have a couple of meds I take that are very expensive, but cost almost the same when I use Good RX, so we took them out of my drug list and I got a program that is considerably cheaper than the one I am in for the rest of this year. So, yes, the medications you take are absolutely what drives your price.

I was also able to switch pharmacies, which is great because I have never been happy with having to use the one that is linked to the drug plan I had this year.

[Carmie]

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@Lisa now in AZ wrote:

I make an appointment with my local senior center and the Medicare lady makes sure she has the current list of meds I take and finds the best Part D program for me. I have a couple of meds I take that are very expensive, but cost almost the same when I use Good RX, so we took them out of my drug list and I got a program that is considerably cheaper than the one I am in for the rest of this year. So, yes, the medications you take are absolutely what drives your price.

I was also able to switch pharmacies, which is great because I have never been happy with having to use the one that is linked to the drug plan I had this year.

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@Lisa now in AZ   Everyone who has the same RX plan that you have pays the same monthly premium.  Some of those people may not use any RX drugs, but some like you, may use expensive drugs.  Doesn't matter.  Everyone pays the same premium monthly.

The plan you choose drives the price, not your age or usage.  Of course, smart people will do their homework to choose that plan that covers all the drugs they use at an affordable price.