Make sure you analyze your RX plan at renewal every year.
My wife works in this arena and when she went to run my moms medications through the tool she found that IF my mom stayed with her current plan that her cost was going to go from $2400/year to over $9000/year.
It's always advisable to check this every year at renewal as the covered drugs under each plan can change drastically.
Fortunately my wife did the research and was able to find her another plan that will keep it down to $2800. Still an increase but manageable.

Bottom line, you can't just let take a "let it renew it will be ok attitude". If you do, you will likely pay a steep price.

Thanks for the reminder, I've got to take a look at mine.

Good info. Not yet, but I'll be facing this soon.

Curious: what's the benefit of the plans where you would pay $9000 instead of $2400? Who would get such a plan? I can't imagine that premium differences would justify them. If nobody, how do these plans remain in existence?

I don't know about that figure. But with Medicare you pretty much get what you want. Medicare Advantage may be less but your doctor may not be in the plan since he is paid less plus there is preauthorization to contend with.

quote:

Originally posted by konata88:
Good info. Not yet, but I'll be facing this soon.

Curious: what's the benefit of the plans where you would pay $9000 instead of $2400? Who would get such a plan? I can't imagine that premium differences would justify them. If nobody, how do these plans remain in existence?

That's just it, there isn't any benefit for the additional money spent.
This is why those on Medicare need to run their RX's through the plans they choose. Different plans pay different amounts for different drugs.
What happened in my moms case, is that the provider changed her cost on several medications. Say Januvia cost her $50/month this year. Same plan stops "subsidizing Januvia" and its now $400/month next year. They do this crap on purpose because for every person who doesn't check ends up paying more of the drug cost and they make more money.
Each of the various plans pays different amounts for different drugs. You need to match up to the plan that fits the drugs you are taking and do it every year.

quote:

Originally posted by ZSMICHAEL:
I don't know about that figure. But with Medicare you pretty much get what you want. Medicare Advantage may be less but your doctor may not be in the plan since he is paid less plus there is preauthorization to contend with.

I'm specifically referring to the RX supplements. Your comment is basically correct about the Medicare base coverage. But the RX supplements change radically from year to year on what they cover and how much.

This is where the insurance companies play games as it differs from plan to plan. If you are on basic drugs for HBP not a problem it is more expensive drugs that you have to worry about. It is wise to check beforehand if you can.

We are in the process of choosing a new plan. After doing a lot of research we found out that some of the drugs that are not covered or are really expensive WITH insurance are a lot less expensive if you use Good Rx or Kroger's version, Visory Health, instead. If you haven't checked out their prices give them a try.

Great advice.

My dad got screwed with this, his doctor moved his appointment last year, and one of his meds got changed after he renewed.

He always checks, but the change caught him off guard. He uses GoodRx for that one prescription and is ensuring it will be covered this time.

There's no way to know what prescriptions I might end up with next year!

What I do take is so cheap I will never reach any deductible, so I just go with the cheapest premium plan.

Everything about Medicare sucks.

I disgree, Medicare Advantage sucks but the rest is pretty reasonable particularly with hospital care.

From the other Medicare drug thread...Yes, do your homework.

Docs do not always know the cost of drugs and are visited by Pharmaceutical sales people on a regular basis. There are generally cheaper generics that will work just as well,

quote:

Originally posted by konata88:
Good info. Not yet, but I'll be facing this soon.

Curious: what's the benefit of the plans where you would pay $9000 instead of $2400? Who would get such a plan? I can't imagine that premium differences would justify them. If nobody, how do these plans remain in existence?

It’s a game played by the insurance plans. They change their formulary as to what is or isn’t covered.

People should check every year during the open period October 15 to December 7.

Yep, it’s on our radar as well. Initially we had a couple of years where we needed to negotiate with our locally owned pharmacy to get cash pricing on my Rxs, as our insurance provider choices stunk. But things sorted themselves out and it’s all going well.