Posted on 11/26/2021 7:23:44 PM PST by SoCalTeresa
I have been fortunate to have great health most of my life with no prescriptions. I now have a prescription for a thyroid problem for the past few years and has never been a problem getting filled. Not life threatening. I have Medicare Part A and B, Wellcare Prescription coverage, private insurance through my employer and am told that my $13 a month prescription can't be renewed because it is being reviewed. I pay close to $5,000 a year for medical insurance. Is this normal?
I could see that. Although my understanding is that there is a period after private insurance is done that one can still enroll without penalty.
That makes sense - sure with Medicare would allow somebody to opt out after then join, then rejoin after private insurance is over. Seems like they're forcing double jeopardy in a way.
How much does your employer pay ? $0 ?
It’s probably a good plan.
Do retirees get a subsidized policy as a benefit?
I don't understand that. I pay $420 every three months, includes A, B, D, F, and have no complaints (yet). Is most of your premium money going to your private insurance? Why even have the private insurance (other than a supplement) if you have to pay large premiums?
I love my levothyroxine. Not only is it cheap but it gives me back energy I haven’t had in many, many years. No adverse side effects noted.
Thank you all for your comments. I am looking at dropping Part B Medicare coverage, but am so scared I won’t have enough health insurance which could wipe me out financially. I am currently 66, and expect to work for my employer until I am 72 assuming I stay healthy. I work for a great company with incredible benefits, but I want to plan for the worst case scenario.
Thanks for your comment. I pay about $500 per quarter for Mediare Part A, $150 for Part B, $17 per month to cover Wellare for prescriptions, $100 per month for private insurance through my employer and $2,000 yearly deductible. So maybe it isn’t quite $5,000, but still wondering with all this coverage why a $13 a month prescription is “under review.” Fortunately, this is not a heart mediation that would kill me if I didn’t take it.
Same here..
With a 14,000 deductible
And have killed people because some paper pushing bureaucrat decides that they can just switch the patent to something that his doctor did not proscribe because he was allergic.
Nothing like rushing your husband to the hospital in the middle of the night because PPB decided a sulfa allergy was not really important.
Doctors mess up daily
Less then insurance PPBs do.
Also doctors get bonus/trips my drug companies if they write so many prescriptions
So sorry but that is against the law and has been for at least a decade. Possibly longer.
But you just keep on letting some one pity hire idiot nephew decide what drugs you should take. It is really fun to watch your loved ones turn blue.
Sometimes new side effects or effectiveness issues come to light, or it just doesn’t make them enough money. They providers review the medication, and may discontinue coverage.
Talk to your doc about an alternative, a prior authorization, or bypass insurance and use something like GoodRX to draw down costs without coverage, especially if that med works for you.
I’m in Chicago, but I’ve been there with drugs being removed from coverage. Not fun.
That was the question I had with my medication as well. I'd been prescribed it for many years without question. Then all of a sudden, last year, it had to be "authorized" for a six-month period. In the past, the script was written to take 3 pills a day, or as needed. They'd filled the same medication without question, dispensing 180 pills in one bottle. And that bottle would last me a long time, to the point where the script would expire before I even refilled it. All of a sudden last year, they would only dispense it as 1 tablet twice a day, and sent me only 45 pills with no refill. My plan allows me to order a 3 month supply for the same cost as one month, so I always have my doctors write the script for a three months supply. This is the only medication CVS Caremark won't do it for.
Do not drop your Medicare coverage, your company insurance will pay for anything Medicare will not pay for, please check with your insurance on Monday about why your medication is under review.
I have both Medicare A & B. Once I went on Medicare, it became my primary provider. My Empire Plan then became secondary, so they always bill Medicare first, then submit to United Health Care through The Empire Plan. I’ve had Medicare since 2005, and it’s always been that way.
Agreed. I do not plan to drop any medical coverage. I want to have more than less, and am very thankful I have wonderful coverage. What I am upset about is that my thyroid medication that has been subsribed and paid for the past three years is suddenly “under review” IT has been 10 days. I will call on Monday. It is a $13 a month prescription that I could pay easily. The question is why. I did not get notice except for an email from Walgreens about it being reviewed. Is this how they handle all presriptions? What if this was life threatening>
“So sorry but that is against the law and has been for at least a decade. Possibly longer”
Ha ha yeah right. They just no longer call it a kickback but a bonus. 60% of US docs get some form of payment back from Big Pharma if they prescibe certain drugs. trips, outings, bonuses which is not considered a kickback
“But you just keep on letting some one pity hire idiot nephew decide what drugs you should take. It is really fun to watch your loved ones turn blue.”
Wrong. One doctor and one nurse have to sign off on treatment for these reviews.
Ypu do not know what the heck you are talking about. I have been kin health insurance for 36 years. I know what the scoop is.
Is the entire prescription $13 or just what you are paying for?
Is it $13 total per month or is it $150.00 per month and you are paying $13 of that?
Drop B?
Never heard of doing such a thing.
A top quality Supplement is about $300 /mo.
So, you’re spending is typical
The prescription is $13.00 per month so it is really strange that it is “under reiew.” Thankfully I will not die because they are reviewing the prescription. This is just an example of how screwed up our health care system is. I have incredible insurance through Medicare and private, and I have a $13 monthly prescription held up for “review.” Maybe if I was on Medicaid I wouldn’t be going through this.
What does Part B provide? Specifically. Just wondering sine I have reviewed my insurance payments over the past year (I am new to Medicare) and don’t see what the paid for.
My understanding is that Part A is for Doctor visits, etc., while Part B is for hospitalization.
Could be wrong - still trying to learn.
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