Finding new (Rx) insurance

bob2

bob2

New Member
I have Medicare and an insurance company from when I worked. However, the insurance company that pays for 80% of my prescriptions is getting more and more difficult to deal with. They keep insisting that I get generic versions of some prescriptions that my doctor has written prescription for the brand name.
I was wondering if I could "join" another insurance company that might be a bit more lenient with their coverage of prescription medications.
Can I have two insurance companies and use one or the other when getting prescriptions filled? Use the one that is cheaper or will permit brand name medication?

New York
 

You can have 10 medical insurances if you want to pay for them. I am surprised you kept the company policy most cancel you when you become eligible for medicare.
 
Thanks.
I know some insurance companies are not known for their 'favorable' prescription coverage. Do you or anyone else know of one (or some) that have a good reputation with regard to prescription coverage (co-payment, etc.)?
 

We are lucky, in that we are not bound to multiple prescription drugs...I take None, and the wife takes a daily Lisinopril for a minor blood pressure issue. We have Medicare, and a supplemental Humana Choice PPO from the company I retired from. We go to the Walmart pharmacy for the Lisinopril...and they charge about $4 co-pay for a 90 day supply. A couple of weeks ago, the wife had an ear infection, and the doctor prescribed some pills...30 pills for a 2 week supply cost us 85 cents at Walmart. So far, between Medicare and Humana, our drug costs are virtually nothing....Knock Wood.
 
Your current insurer is probably trying to discourage you from continuing drug coverage under their plan, and instead choose Medicare Part D. I could be wrong, but I don't believe you will be able to purchase a new medigap insurance policy that covers prescription drugs.

"Medigap policies can no longer be sold with prescription drug coverage, but if you [already] have drug coverage under a current Medigap policy, you can keep it. If you join a Medicare drug plan, your Medigap insurance company must remove the prescription drug coverage under your Medigap policy and adjust your premiums."
 
Don M...
Wow, you are lucky that you do not have multiple Rx prescriptions.
May I ask if you are paying a premium for the Humana Choic PPO? Or did you just keep it when you retired?
Does the Humana seem easy to use for prescriptions?
Would I be able to enroll with them (guess there would be a monthly or yearly premium)?
(I just don't like the many changes that my Rx company seems to be making constantly. I think they are a Rx management company, but think my (old) company is paying for my Rx prescriptions. I'm just not sure and it is all so confusing to me now at my advanced age.)
I also use Walmart also and wonder what they are going to say next when I bring in a new prescription (which I have to get permission from before refill).

What about this = https://www.humana.com/medicare-secured/plan-details
 
bob2 said:
Don M...
Wow, you are lucky that you do not have multiple Rx prescriptions.
May I ask if you are paying a premium for the Humana Choic PPO? Or did you just keep it when you retired?
Does the Humana seem easy to use for prescriptions?
Would I be able to enroll with them (guess there would be a monthly or yearly premium)?
(I just don't like the many changes that my Rx company seems to be making constantly. I think they are a Rx management company, but think my (old) company is paying for my Rx prescriptions. I'm just not sure and it is all so confusing to me now at my advanced age.)
I also use Walmart also and wonder what they are going to say next when I bring in a new prescription (which I have to get permission from before refill).

What about this = https://www.humana.com/medicare-secured/plan-details
Click to expand...

My old company(IBM) has set up a HRA for its retirees. Every year they give us a selection of choices for Medicare, Part D, vision and dental coverage through an exchange managed by Towers Watson. I think our Humana coverage is about $14 a month. The HRA covers all the premiums these insurance supplementals cost, and leaves enough left over such that I can usually get reimbursed for about 3 months of Medicare. The few times we have used the Humana coverage at Walmart, the only "inconvenience" is waiting 30 minutes for them to prepare the subscription.

I looked at the Humana site you referenced, and they show the Walmart plan at $15.70 a month...plus a $320 deductible. That sounds about right, as I'm sure we get a better discount through the company HRA. Even so, we are quite satisfied with the coverage we have under Humana.
 
I think that you will find that almost all insurance companies will only pay for the generic, if one is available. The only way most will pay for a higher priced name brand is if your doctor says it is medically necessary that you have the name brand. Most doctors won't go down that road.

ALSO, most companies with a three-tier prescription formulary will put the generic in the lowest tier, and the branded one in the highest tier so you will pay a lot more for the brand name one.

What is your objection to generics?
 
Don M.

Thanks and apologize for saying I got my prescriptions at Walmart. I get my prescriptions from Walgreens.
I believe my prescription coverage is managed by Express Scripts.
I was referring to the Preferred at $33.50 a month. https://www.humana.com/medicare-secured/plan-details (Medicare Prescription Drug Plans)
I think the URLs are a bit confusing when you go to them.
 
Butterfly said:
I think that you will find that almost all insurance companies will only pay for the generic, if one is available. The only way most will pay for a higher priced name brand is if your doctor says it is medically necessary that you have the name brand. Most doctors won't go down that road.

ALSO, most companies with a three-tier prescription formulary will put the generic in the lowest tier, and the branded one in the highest tier so you will pay a lot more for the brand name one.

What is your objection to generics?
Click to expand...

It's just that I have been taking the brand name for many years and they have been working for me. I would hate to switch now to generic (eye drops) and find that the "inactive ingredients" caused problems.
 
Find out if the generic drops have the same components as the brand name. If they do, no problem. I prefer taking the generic as it's cheaper for me. For example, I'm paying $17.50 for blood pressure combo pills and cholesterol medicine for 90 day supply. My Nexium is $85.00 for 3 months.
 
LogicsHere said:
Find out if the generic drops have the same components as the brand name. If they do, no problem. I prefer taking the generic as it's cheaper for me. For example, I'm paying $17.50 for blood pressure combo pills and cholesterol medicine for 90 day supply. My Nexium is $85.00 for 3 months.
Click to expand...


Yes, the generic is cheaper and I believe all of them have the same main ingredient, but I am quite sure every generic drug has different inactive ingredients. Many of which are different from the brand name. That is why, I believe, some generic might not have same results as brand name. Because of the different inactive ingredients.
 
AZ Jim said:
You can have 10 medical insurances if you want to pay for them. I am surprised you kept the company policy most cancel you when you become eligible for medicare.
Click to expand...


It's against federal law to have more than one prescription drug plan out a time when you have Medicare.
 

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