Re: Part D 2023 costs.......WOW!

Icegoddess · ‎03-19-2010

When looking at your Annual notice, don't just look at the premium increase/decrease. Also consider deductible increases/decreases, co-pay changes, and also make sure that your prescriptions will STILL be covered by your plan as well as your pharmacy.

For me, my premium went up a few dollars, but my deductible went down by a couple hundred dollars. If you're on an expensive drug, that would mean you'll start paying the co-pay quicker instead of retail, saving yourself some money.

Icegoddess · ‎03-19-2010

@Nuttmeg wrote:
@Icegoddess wrote:
I've only been on SS & Medicare a few months and I also got the yearly change notice. I was surprised since I just started.

I believe it's different by state, but I'm not mad. I'm on BASIC SilverScripts SmartSaver, not Plus and mine is going from $7.40 to $12.30. However, the deductible for Tiers 2-5 is dropping from $505 to $280. Tier one drugs bypass the deductible and those are going from $2/30 days to $0. Tier 2 drugs are dropping from $15 to $5/30 days, Tier 3 from 25% to 24%, Tier 4 stays at 50%, and Tier 5 is going up from 25% to 29%. I don't see any additional deductible for Tier 5. Covered insulin products are capped at $35/mo.

Everything I'm currently on is Tier 1 although I'm going to start something new in a few days and I'm not sure what Tier it is (can't seem to find that info), but since I obviously haven't met my deductible at $2/drug/mo I'll be paying retail for it at ~$25.65/90 days according to my plan's website.

All of my Medicare premiums together don't come anywhere NEAR what I was paying for my ACA plan which was over $700/month Premium with a $7500 deductible.

There should be a formulary list online with tier numbers at your Part D plan. They should have a place to to see the co-pay price.
The five tier thing is confusing for everyone. Three tiers would be fine.
It is just a way for seniors to pay more.

@Nuttmeg I finally found it online after searching for several hours. I downloaded it and will download the new one when available. Of course, it can change throughout the year, but I would hope it's not changing significantly on a monthly basis.

Those Co-Pays are just an estimate. I ended up getting the drug for $10, which I think is the Co-Pay for a 2 month supply of Tier 2 on my plan, but I'm confused by that since I am nowhere near meeting my deductible.

Nuttmeg · ‎03-09-2010

@Icegoddess wrote:
@Nuttmeg wrote:
@Icegoddess wrote:
I've only been on SS & Medicare a few months and I also got the yearly change notice. I was surprised since I just started.

I believe it's different by state, but I'm not mad. I'm on BASIC SilverScripts SmartSaver, not Plus and mine is going from $7.40 to $12.30. However, the deductible for Tiers 2-5 is dropping from $505 to $280. Tier one drugs bypass the deductible and those are going from $2/30 days to $0. Tier 2 drugs are dropping from $15 to $5/30 days, Tier 3 from 25% to 24%, Tier 4 stays at 50%, and Tier 5 is going up from 25% to 29%. I don't see any additional deductible for Tier 5. Covered insulin products are capped at $35/mo.

Everything I'm currently on is Tier 1 although I'm going to start something new in a few days and I'm not sure what Tier it is (can't seem to find that info), but since I obviously haven't met my deductible at $2/drug/mo I'll be paying retail for it at ~$25.65/90 days according to my plan's website.

All of my Medicare premiums together don't come anywhere NEAR what I was paying for my ACA plan which was over $700/month Premium with a $7500 deductible.

There should be a formulary list online with tier numbers at your Part D plan. They should have a place to to see the co-pay price.
The five tier thing is confusing for everyone. Three tiers would be fine.
It is just a way for seniors to pay more.

@Nuttmeg I finally found it online after searching for several hours. I downloaded it and will download the new one when available. Of course, it can change throughout the year, but I would hope it's not changing significantly on a monthly basis.

Those Co-Pays are just an estimate. I ended up getting the drug for $10, which I think is the Co-Pay for a 2 month supply of Tier 2 on my plan, but I'm confused by that since I am nowhere near meeting my deductible.

You may want to call the CS at your drug plan.

You should ask do they sent out Formulary list or an email to the list online.

yamma024 · ‎08-21-2017

@ID2 We might have the same plan, mine did too!! Mine was $11.20 and went to $0.00

conlt · ‎03-16-2010

@wagirl I went on Medicare in June of this year and I am happy about it. I had high deductibles with my old plan and copays. When I signed up for part D, I looked at all the plans in my area, plus what my drugs would cost me, plus deductibles, plus the monthly cost of the plan. It turned out that the least expensive monthly cost for the plan did not equate to the overall lowest cost.

I ended up with Cigna that covers all of my drugs, the monthly cost is $70 but my overall costs for everything is less than the $13 per month plan.

I have been happy with Cigna, but when open enrollment comes, I am going to do the exact same thing. figure out which plan is most cost-effective for me and covers all of my drugs.

Pink123 · ‎07-10-2019

@Icegoddess wrote:
I've only been on SS & Medicare a few months and I also got the yearly change notice. I was surprised since I just started.

I believe it's different by state, but I'm not mad. I'm on BASIC SilverScripts SmartSaver, not Plus and mine is going from $7.40 to $12.30. However, the deductible for Tiers 2-5 is dropping from $505 to $280. Tier one drugs bypass the deductible and those are going from $2/30 days to $0. Tier 2 drugs are dropping from $15 to $5/30 days, Tier 3 from 25% to 24%, Tier 4 stays at 50%, and Tier 5 is going up from 25% to 29%. I don't see any additional deductible for Tier 5. Covered insulin products are capped at $35/mo.

Everything I'm currently on is Tier 1 although I'm going to start something new in a few days and I'm not sure what Tier it is (can't seem to find that info), but since I obviously haven't met my deductible at $2/drug/mo I'll be paying retail for it at ~$25.65/90 days according to my plan's website.

All of my Medicare premiums together don't come anywhere NEAR what I was paying for my ACA plan which was over $700/month Premium with a $7500 deductible.

@Icee I agree. Under ACA I was payng 800.00 a month with 8,000 deductible.

No medicine's at all. It all went towards the deductible. It was awful.

wagirl · ‎03-09-2010

@conlt ---I am with Mutual of Omaha, for my plan N and Rx plan, which has been very good, except now I am taking a very costly med that I wasn't expecting to be able to afford and one that all my previous insurance cos refused to cover---I started with the very basic plan for RX as it covered everything I needed at $18 per month--they have one that is $59 and $99 a month, so I need to figure out which one will do me the most good. BTW--I did apply and get a grant from Healthwell Foundation which provided me with $$ for a year of this new med. Without that I was looking at $500 a dose for 2 doses a month out of pocket and that included what my basic RX would have paid---so will be doing my homework soon---

gidgetgh · ‎03-09-2010

I received my WellCare notice today for next year.

My premium for this year has been $11.50 per month. For 2024, it is going to be 50 cents per month. Yes, 50 cents. Very interesting.

Why is it, when I have a 50/50 guess at something, I'm always 100% wrong?

yamma024 · ‎08-21-2017

@gidgetgh I received my Wellcare premium the other day, it went from $11.20 to $0.00!! I think they have great coverage for tier 1 and tier 2. We use Goodrx for the higher tiers.