Posted on 07/07/2020 7:58:06 PM PDT by metmom
I have Humana for Rx.
I’ve heard great things about them.
My problem is basically the meds I’m on are extortionately expensive and the co-pays and coverage gap doughnut hole will kill us financially.
The usual config is to sign up for Medicare A and B(with a small premium) and a supplemental from AARP or UHC or some other carrier to catch copays that MCR won’t cover. For medications, either Medicare D or private insurance should suffice but you should check if you have special (ie expensive) medications you will need.
Compare GoodRX with WellRX. They function exactly the same, but for two drugs we’ve used (generic Tamiflu and telmisartan), it was cheaper by nearly $10 each.
thank you for the info
interrsting
I neglected to mention the organization she works for, which is called Boomerbenefits.Com
No endorsements is implied, it is just someone you can call up and ask questions. I signed up for my part G through her, but I don’t think that they are commissioned sales people. I could be wrong about that, I did not investigate every single nuance.
I am 71 and wife is 70. Medicare part A, B and D are not enough in this day and age. You need a Medicare Advantage plan, sometimes called Part C. Others like Part F.
Part C plus my Medicare A,B&D payments are much less than my portion of what my company health plan cost me and much, much less than what I and my employer paid on a monthly basis.
What I have found is the different plans treat different pharmaceuticals differently. There are two prescriptions I take that are either not covered or very expensive under my health insurance plans. What I do for those is look on the Internet for other ways to purchase those medications.
One of them I have compounded at a lower cost than the standard prescription. The compounding is not covered, but my out of pocket (non-copay) about half the cost.
The other I use GoodRx coupons an go to a pharmacy that GoodRx includes and pay cash. That one is about 1/6th the cost of what my co-pay would be.
I also have friends that get prescriptions and either go to Canada or Mexico for short vacations and stock up on 3-6 month supplies after carefully researching quality pharmacies that stock name brands.
I have attended a number of Medicare Supplemental and Advantage presentations. Most people attending are unhappy with their current plan and medication costs is a big part of why they change plans.
My conclusion from attending these presentations is that on average, the average person will pay just about the same amount of money no mater which plan they get. The trick is to pay enough attention to detail so that if you are not “average” you will get a plan that is much less expensive than average.
Good luck. There is no “one size fits all.”
Ask you doc if there are other (older) meds which are similar to your current meds. Some older meds fall out of favor when newer (and improved?) meds get in to the marketplace. The older meds are effective still and off patent, which makes them affordable. Always ask for generics, which is the same drug just not “brand name”.
The new and improved drugs are released just prior to the old drug going off patent. It’s amazing how they do that
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www.goodrx.comhttps://www.goodrx.com
GoodRx is the #1 medical app for iOS and Android. Get prescription drug prices on-the-go, with coupons built into the app. Just show your iPhone or Android smartphone to the pharmacist to save.
I use Kaiser. They have their own pharmacy And yes it’s KP Medicare
If you’re having money issues over cost of routine meds have your doc set up financial hardship with the mfg. they will give it to you for free or very low cost. Does it depend on you being poor just that the meds are expensive
My mom did this for her diabetes meds
save for later read
I am over 65 and still employed and covered by my employer healthcare. My husband is covered on my plan.
The rule states I do not have to get coverage from Medicare while I am still working and covered by employer coverage.
https://www.medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b/should-i-get-parts-a-b
Join AMAC and look into their programs.
If your spouse is still working, I suggest your spouse contact the company’s benefits specialist to see about coordinating medigap insurance through them. Alternatively, contact an insurance broker to independently get medigap quotes.
Medigap has several components and levels. Primary components are medical, dental, prescription and vision. Levels for medical for example are HMO, PPO and doc of your choice. Choose what you want based on preference and cost. What is covered at each level is defined under federal law.
This is something a person wants to jump on quickly. There’s an initial open enrollment window at 65yo where a health physical is not required and no waiting a year for preexisting condition coverage. Premium payment is via direct deduction from the monthly social security payment, no monthly check to write. YMMV on cost but as an example, my cost for full supplemental medigap coverage at the highest levels is about $155/mo plus the standard Medicare hit to the SS payment that lands in the checking account.
I’m suspecting that the meds will be cheaper at a different pharmacy than the one I used this last time.
We just moved to this area and don’t know all our options. We’re going to be checking that out as soon as possible.
Thanks.
Mr. mm is going to talk to his insurance person today about all this.
Probably. I get confused with all these different terms, but then I am old, so... ;-)
From the Medicare website https://medicare.com/medicare-advantage/medicare-advantage-plans/
Some common types of Medicare Advantage plans have provider networks, and some may not. Here are some common types of Medicare Advantage plans. This list doesn’t include every type of Medicare Advantage plans.
Medicare Advantage HMO – Health Maintenance Organization: Usually you have to receive care from providers in the Medicare Advantage plan’s network. You select a primary care physician who coordinates your care through referrals to specialists when necessary.
Medicare Advantage PPO – Preferred Provider Organization: You can get your care outside the plan’s network. You pay more for non-emergency care if it’s outside the network. Normally, you don’t need a referral to receive plan benefits when you see a specialist.
Medicare Advantage PFFS – Private Fee-for-Service Plan: Usually you must ask the provider before you receive services if he or she will accept the Medicare Advantage plan’s approved reimbursement as payment. If not, you will be responsible for charges not paid by the Medicare Advantage plan.
.....
“... there different types of Medicare Advantage plans.”
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