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My new drug insurance is costing me money.


Longjohn
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I looked at that stuff, there are all kinds of plans. I currently have an HMO type plan. When things turn south, I'll need a plan that suits my needs better. They have a free program here in Ohio to help people wade through all the plans and get the one that suits. Unfortunately the window to opt in only happens annually or something like that.

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Just now, Airehead said:

Oncologist loves you I bet. 

I had a good time with her at my appointment today. When what they do works it makes everybody happy. They were not real happy when they had to stop chemo and call an ambulance for me back in August. I wasn’t real happy either, I had to pay for the ambulance ride (same road, about a mile and a half) and the emergency room. That was on my disadvantage plan.

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5 minutes ago, donkpow said:

I looked at that stuff, there are all kinds of plans. I currently have an HMO type plan. When things turn south, I'll need a plan that suits my needs better. They have a free program here in Ohio to help people wade through all the plans and get the one that suits. Unfortunately the window to opt in only happens annually or something like that.

Don’t wait until you need it, they won’t accept you with pre-existing conditions. The only company that will is AARP United Healthcare and because of pre-existing conditions I have to pay twice the monthly rate.

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On 1/13/2022 at 8:10 AM, Further said:

I always said I would work until I died, but I thought I’d be dead by now 

Me too.

whelp my new insurance is saving me money on medical care, doctor bills, hospitals, emergency rooms, etc. but my new drug plan isn’t very good. I scheduled surgery on my other eye today and they called in prescriptions for eye drops. $90. Co-pay.

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12 hours ago, Longjohn said:

Me too.

whelp my new insurance is saving me money on medical care, doctor bills, hospitals, emergency rooms, etc. but my new drug plan isn’t very good. I scheduled surgery on my other eye today and they called in prescriptions for eye drops. $90. Co-pay.

What the large print giveth, the small print taketh away! :(

 

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On 1/12/2022 at 8:14 PM, Longjohn said:

The Medicare disadvantage plan that I was on ever since I retired was costing me too much in out of pocket. It had a yearly $7000 out of pocket. It included a drug plan that wasn’t awful. My Brilinta had like a $40 co-pay. I just picked up my Brilinta under the new plan. $435 co-pay. I think this is the last I will have to take of it.

On the bright side I just had an oncology appointment today with no co-pay. :party:

I can't believe no one gave you the $5 card for the Brilinta. I would have told the pharmacy to keep it at that price, especially if you're on your last month of it.

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I will be dead by then:

hopefully my mid 20's nephew if he lives and works forever in the U.S., health care insurance will improve by then. Somehow, doesn't seem hopeful, since your system so entangled with too  many for-profit parties at different levels. And if majority patients offered truly a better system, they still won't believe it. 

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Never ever Advantage Plan. If you ever want to do something unAmerican, like travel, you are suddenly out of network. We know seniors don’t like the travel when they retire…right? Insurance say may be covered. But at what costs out of network. Staying with regular Medicare and Plan F. Drugs…was with AARP Walgreens @ $32/mo. Was happy when saw reducing to $27, but the devil is in the details. Two of my relatively common generics were moving to Tier 2 and gaining a copay. Additionally, free was mail order only, pick up at pharmacy was now $5/Rx. Estimated annual cost for current med was $485 in addition to the monthly. Switched to Silverscripts (CVS) $6/mo and estimated annual cost with the same $5 copay/Rx is $42.

@Longjohn check cost with GoodRX.com. When had higher tier Rx to treat acute illness, such as an inhaler for congestion, GoodRx was cheaper.

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Good RX was $415 

22 minutes ago, Tizeye said:

Medicare and Plan F. Drugs…was with AARP Walgreens @

That’s the plan I just signed up for it started January 1st. So far I’ve filled five prescriptions and they all had a large co-pay. Good RX has a price of $415 a month for BRILINTA. My $435 was for 90 day prescription. My old plan that was part of my disadvantage plan my eye drops were covered but they raped me on hospital visits, doctor visits, cat scans, MRIs, etc. The Brilinta website has a discount card you can get if you qualify that drops your co-pay down to $45 a month. I shouldn’t need to take it after what I have runs out because my heart attack was the end of February and you only have to take it for a year.

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You will love Plan F, it is the Rx plans that are the problem.

Entire cost of my recent surgery as well as pre and post appointments, radiology exams, plus all other outpatient care and tests during the year...$0. I can live with the monthly charge. In fact, I've gotten some rogue bill demanding payment that I knew was an accounting error. It was just a matter of convincing the billing clerk of that as I point out her error.

RX requires special oversight. One thing I have in my back pocket is the VA. I've known several people that, while they had care outside the VA, they have had a VA doc rewrite their expensive cancer or transplant medications and filled at the VA.

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My cousin in NJ does a lot of checking when choosing a Medicare Advantage Plan and checks it against what Medicare Covers as well as the Veteran's Administration - her husband has heart and bouts-of-senility problems and they're handled at a veteran's hospital.  There are tradeoffs of one-plan vs another and she takes the best bet.

Personally, I have retirement health insurance through my employer, who pays 3/4 of a near-Cadillac Medicare Supplemental Plan and I pay $170/month with Health, Prescription, Dental, and Vision coverage.

There are a lot of small copays ($15, $30, etc.) but the whole idea is to prevent huge expenses for health and prescriptions.

Of course, I never gave it a second thought when I became a teacher in my 30's, but now I figuratively pat my younger self on the back for taking a pay-cut to go into teaching but getting "delayed pay" in a good pension and benefits.

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