Posted on 01/18/2017 2:12:52 PM PST by originalbuckeye
Sorry for the vanity. I have been on Medicare for a few months. I am paying extra for Part B and Part D, and on top of that, my husband is still working, so we are penalized for the 'one person working' situation.
I suspect that the disparity is due to the coverage offered through your husband’s group insurance. It likely has a “deal” in it for script co-pays.
That is all.
This is entirely up to his employer. They could set the co-pay at anything that want. Some employers set it high, some set it low. I’m sure there are some workers insured through employer plans who pay more than $20.
Am I not in a ‘group’ of retirees who have the same Pharma insurance that I have?
Medicare is a secondary payer, meaning that if someone who has Medicare is also covered under another plan, that other plan is primary.
I am not covered under my husband’s plan.
When I turned 65, Medicare kicked in and we thought Medicare would take care of me.
There is another issue that revolves around how much each senior pays for medicare.
Between the two of us, one pays $110 and the other pays $125 per month and we were told that the newly enrolled will pay $150.
Go figure!
Don’t take this personal, but any drug as cheap as $20 or $4, you ought to be thanking your lucky stars. That is dirt cheap for what a whole lot of people pay for other drugs.
Part B is up to $160/month now. Part D (Pharma) is around $25/month.
This anti-inflammatory is very common. I had to pay a $47 co-pay for an antibiotic two weeks ago. I have never spent so much for common drugs.
But your group doesn’t have a sugar-daddy employer providing the benefits.
A company, if they had enough money, could put in a ridiculous medical plan where the employees pay nearly nothing and have everything taken care of. If they have hundreds of millions of dollars in their bank account, there is nothing to stop them. It is tax-deductible to the company, and not taxable to the employee. Medical care is the only thing where they can do this; if they gave their employees a free lunch, it would be imputed income and taxable to the employee.
I agree with you. I used to be able to get a common penicillin prescription for $2 or $3. Now, my doctor wants to prescribe two antibiotics that rack up to about $200.
“When I turned 65, Medicare kicked in and we thought Medicare would take care of me.”
Sounds like your Medicare Part D plan has a $20 co-pay. Your husband’s pharma plan has a $4 co-pay.
A $20 Part D co-pay is not at all unusual.
You may be, but one feature of your husband’s insurance MIGHT be an attractive/low co-pay. Whatever provisions are in his coverage are likely tailored to the employer’s specifications or anticipated utilization. If the employer group is weighted with younger people, it may be a good feature for them to have low co-pays for meds.
I am just suggesting that there is not necessarily any correlation as to the Medicare vs his private insurance benefits.
My Part B premium is $154/month. My Part D monthly premium is $17 and change.
Medicare doesn’t pay for drugs. You need to get a separate prescription drug plan, Part D. You also need to shop around for a plan that is most favorable for the drugs you take. It’s different for everyone. That’s why they have that form you fill out in Medicare.gov where you input all of your drugs. I’ve been on Medicare for several years, and have chosen a prescription plan that benefits me the best. Don’t blame Medicare necessarily, do some homework and you may find a better plan. Unfortunately, you will have to wait until next open enrollment to make a change.
I disagree with that. Medicare is your primary payer — but only if you are hospitalized. Part B charges at least $104.00 a month by the Govt.
I was under Aetna and when I turned 65 in October, I switched to an Aetna Medicare Advantage Plan. Aetna has it all wrapped up in a pretty package making it easy for you to choose it. I’m certain with a great deal of research and divine discernment, one could find a cheaper way. But for now, Aetna will handle all the billing for me and I go about my life as usual with the same insurance company.
Yet, I have a friend who turned 65 two months after me and she just retired from the Fed govt. Her premiums are higher than mine and even Harry Potter with a magic wand could not understand the extreme nonsense and jargon she had to wade through.
I only take BP meds so my pharmaceutical is minimum. But I realize I am lucky one.
Hope Trump will be able to release Big Pharma.
Is your Part D a policy through an insurance company?
You should be able to choose a Part D policy, but you need to compare the rates. Check the back section of of your Medicare and You 2017. It or Medicare online lists policies available in your area.
I have used Medicare Advantage for several years instead of Medicare. Most MA plans had $zero deductible and $3 to $6 co-pays for most generic prescriptions.
You may have other options. The ‘enrollment period’ is still open for selecting 2017 plans. Check your Medicare and You 2017.
Deductibles, co-pays, and costs can vary greatly.
Some generics and name brands cost significantly more, even under the approved Part D drug plans.
Correction: Enrollment for 2017 was between October 15 and December 7.
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