What the heck happened with my Part D?

MikeyDude

Done
Location
Texas
I have a med that was covered under Part D last year and there was $0.00 cost to me. This year that same med is now a Tier 2 or 3 and they want $60 for 90 days. And this is only a single med. I have several more. Plus the premium? I can't afford this.

Homeowners Insurance went way up.
Auto Insurance went up.
Medical Insurance went up.

Lessee - do I eat or pay the corporations? Happy 2023.
 

I have a med that was covered under Part D last year and there was $0.00 cost to me. This year that same med is now a Tier 2 or 3 and they want $60 for 90 days. And this is only a single med. I have several more. Plus the premium? I can't afford this.

Homeowners Insurance went way up.
Auto Insurance went up.
Medical Insurance went up.

Lessee - do I eat or pay the corporations? Happy 2023.
Take on a roommate?
Sell home?
Sell car?
Visit food bank, they'll fill you up.

In another forum, there was chatter that many retirees could afford to live alone, or wouldn't ever consider renting out a room, due to privacy issues.

That's the issue with fixed income retirees. The prices go up, but not the income.
 
Are they giving you the 'brand' name instead, which is always more costly?

Nope - the same as always. They just changed the classification.

Take on a roommate?
Sell home?
Sell car?
Visit food bank, they'll fill you up.

In another forum, there was chatter that many retirees could afford to live alone, or wouldn't ever consider renting out a room, due to privacy issues.

That's the issue with fixed income retirees. The prices go up, but not the income.

Done the roommate thing before. I'm married and it doesn't even work.

Selling the home or car - Those are just temporary fixes. Soon I'd be without the meds and the house and car.
 
I have a med that was covered under Part D last year and there was $0.00 cost to me. This year that same med is now a Tier 2 or 3 and they want $60 for 90 days. And this is only a single med. I have several more. Plus the premium? I can't afford this.

Homeowners Insurance went way up.
Auto Insurance went up.
Medical Insurance went up.

Lessee - do I eat or pay the corporations? Happy 2023.
Call the drug company. They all have funding programs. It used to be that Medicare patients were not eligible but that may have changed recently.
 
When I had an expensive med, which Part D didn't cover, well only $10 of it, we saved thousands by buying through a Canadian pharmacy. I am so grateful they are available.

We're doing that with one of my meds. Unfortunately they don't work on all meds.

Call the drug company. They all have funding programs. It used to be that Medicare patients were not eligible but that may have changed recently.

Yep - thats what we're gonna do. We're doing that with some other meds already. Also looking into St Vincent de Paul.
 
what happened to Part D ?
It's under a separate company now. I forget the name of it, but you should have gotten a letter announcing the change and naming this company. The letter says that you have no choice in this matter.

Your prescriptions are now being handled by a Managed Care type of coverage. The company set record-low price limits this year, and maybe your pharmacist will be ok with this, maybe they won't. The company will decide whether or not you should stop taking certain medications and take something else instead, or nothing at all. The company also lowered your doctor's fees; their income. And maybe your doctor will be ok with this, and maybe s/he will advise you to see a different doctor. And the doctors who agree to accept those lower fees are mostly student-doctors, and mostly work at clinics rather than offices, and mostly have crowded waiting rooms and astoundingly long wait times, but they only show up once a week anyway, to check up on how the nurses are doing at pretending to be doctors. But you can always choose not to see a nurse instead of a doctor. You can choose to schedule an appointment with an actual doctor in about 6 months or so.

And that's what Managed Care does....it limits choices, pares them down. It makes many choices for you, exactly the same as it does for billions of others, because no one is *special*....especially to a company that's devoted to saving money for the state and increasing profits for itself....and, of course, devoted to relieving billions of people from the burden of having to ponder choices.

Yes, Happy 1984 2023 to you, too.
 
Okay, I'm far too simple minded for this, if I'm reading correctly not everyone has a change to their insurance? I have UHC Plan F and D and didn't get a letter...at least that I recall, so I looked at the site:

https://www.medicare.gov/drug-coverage-part-d/how-part-d-works-with-other-insurance

"It may be to your advantage to join a Medicare drug plan because most Medigap drug coverage isn't creditable. You may pay more if you join a drug plan later.
Medigap policies can no longer be sold with prescription drug coverage, but if you 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. Call your Medigap insurance company for more information."

o_O
 
Okay, I'm far too simple minded for this, if I'm reading correctly not everyone has a change to their insurance? I have UHC Plan F and D and didn't get a letter...at least that I recall, so I looked at the site:

https://www.medicare.gov/drug-coverage-part-d/how-part-d-works-with-other-insurance

"It may be to your advantage to join a Medicare drug plan because most Medigap drug coverage isn't creditable. You may pay more if you join a drug plan later.
Medigap policies can no longer be sold with prescription drug coverage, but if you 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. Call your Medigap insurance company for more information."

o_O
I just did some talking with the wifey... We didn't get a notification. Also - we are not on an Advantage plan - This is traditional Medicare Part D. The problem is with Express Scripts. They changed their tier ratings the 1st of the year. They said we need to see about getting the doc to say this is "Medically Necessary" and that will change things. Another problem is this is the only medication available for this ailment. I take a couple like this. One is so expensive in the US we have to get it from India. So we'll see what happens.

The messed up part is they make it seem like Medicare is some government run program... In all actuality, it's just another insurance policy. Mine is with Cigna. I guess we know who really runs things in this country, don't we?
 
I have a med that was covered under Part D last year and there was $0.00 cost to me. This year that same med is now a Tier 2 or 3 and they want $60 for 90 days. And this is only a single med. I have several more. Plus the premium? I can't afford this.

Homeowners Insurance went way up.
Auto Insurance went up.
Medical Insurance went up.

Lessee - do I eat or pay the corporations? Happy 2023.
So sorry MIkey! Unfortunately too man seniors are in the position where they have to choose whether to eat, pay their rent or buy their meds. I had read over the years that many were getting meds from Canada because it was less expensive. I don't know if our government (or theirs) put a stop to that. I sure hope you can find better solutions!

Update: Just read @Happy Heart's post (#12). She was nice enough to provide a link for you so apparently that option is still available.
 
Did you try good rx on line to get a coupon on your phone or printable.? I see some folks have issues with their pharmacies using good rx if you have part d and some don't but you can try.You can really save some money on most drugs or at least pay a little less.
 
We received cards from our insurance agent with those squiggly squares on them. My husband checked his card and it asked him to confirm that he was happy with his Plan F insurance which he did. Then he checked my card and we found that someone changed my plan from F to G without any authorization. A call to our agent resulted in her attempting to sell the Plan G while claiming no knowledge of how that could have happened. Yea, sure. Off to find a new agent ...
Pay attention, just because you are paranoid doesn't mean they aren't out to switch your plans :oops:
 
Did you try good rx on line to get a coupon on your phone or printable.? I see some folks have issues with their pharmacies using good rx if you have part d and some don't but you can try.You can really save some money on most drugs or at least pay a little less.
We tried using Good RX for an expensive prescription but if you read the fine print, at least at the time, their card can't be used with government insurance (Medicare). Fred Meyer also has a special drug card but when we tried to use it, they refused to honor it.
 
We tried using Good RX for an expensive prescription but if you read the fine print, at least at the time, their card can't be used with government insurance (Medicare). Fred Meyer also has a special drug card but when we tried to use it, they refused to honor it.

I am sorry that happened, maybe that was how it was when you used it , I even see commercials about older people with insurances using it to get a lower co-pay. We have never had an issue thus far. I just look up meds and call my pharmacy and give them the info on the coupon on line or print and take it to them.
 
Same here. My husband and I are both on Medicare and use GoodRx all the time with no problems.

Edit: This was supposed to be a response to @perplexed. For some reason the "quote" thing didn't work.
 
Here's my experience with GoodRX. I don't have Part D, just A and B. I also have Full private insurance thru my spouse's work. I was rxed a drug that my insurance required an $80 copay. I went to a different pharmacy that had no record of me and used the GoodRx coupon and got it for a $15 copay. Is it a requirement of Medicare that all of your prescriptions be purchased thru you part D? Or can you self pay using GoodRx?
 
It's an either or thing with using discount cards/coupons for prescriptions. You can't use the discount card with Medicare.

Here's what it states on the GoodRx site > https://www.goodrx.com/insurance/medicare/use-goodrx-to-lower-medicare-drug-costs

Here's an excerpt from the full article linked below as to why you can't use both.

"GoodRx Coupons and Medicare Part D cannot be used in conjunction. This is due to a federal government statute, also known as “anti-kickback”, that prohibits Medicare beneficiaries from using manufacturers or discount drug coupons with their drug plan. However, you can use GoodRx in place of your prescription drug plan."

https://www.medicareconcierge.com/c...n-you-use-goodrx-if-you-have-medicare-part-d/

When Should I Use GoodRx Instead Of Health Insurance Or Medicare? > https://patch.com/us/across-america/when-should-i-use-goodrx-instead-health-insurance-or-medicare

Discounts vary for discount cards/coupons. I've found other discount cards/coupons that are cheaper than GoodRX for the same medication. Phone numbers are listed on the websites, and you can call before using the coupon to make sure the prices shown are correct. That's what I do. You can sign up for a card or just print the coupon from the website or download the GoodRx App and bring it with you to the pharmacy or you can call the pharmacy and see if they'll take the coupon codes over the phone.

GoodRX > https://www.goodrx.com/

ScriptSave WellRx > https://www.wellrx.com/

RXGO > https://www.rxgo.com/

Discount Drug Network > https://www.discountdrugnetwork.com/

SingleCare > https://www.singlecare.com/

america's pharmacy > https://www.americaspharmacy.com/

Bella ✌️
 

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