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Post by brucemacneill on Oct 5, 2015 17:53:03 GMT -5
Has anyone else started looking at the 2016 Medicare stuff? Rates are up here. Drugs are up here. I can't find a Part D plan that makes any sense to me. We have the AARP plan D but even after paying the premiums and Mary passing the $320 deductible they still never paid a dime on any of her scripts. I of course never came close to making the deductible so it was all pay in, no benefit. In 2016, that plan goes up from $38/mo. to $49 and the deductible goes up to $360. There's a 0 deductible version but it's $60/mo in premium and still won't cover anything we use. Our meds are on the formulary but the plan pays nothing because the co-pay is more than the retail cost. This was all outside my understanding of Medicare when I retired. We may be able to get some break if we go to Walmart or use the mail-order pharmacy but I can't get a straight answer on how much of a break.
How are the rest of you old farts getting along with Medicare?
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Post by Rob Hanesworth on Oct 5, 2015 18:15:58 GMT -5
You need to ask your doctors for more expensive drugs. They are out there. My Crestor, for example. By paying my $135 copay for my three month supply, I get to force my insurance to kick in $565 for their share. I get some benefit from my insurance and stick it to them. If I can get my doctor to switch more of my drugs to brand names, I can really put it to them.
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Post by factorychef on Oct 5, 2015 18:24:08 GMT -5
My wife and I are happy with what we have. I even get some meds for free.
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Post by brucemacneill on Oct 5, 2015 18:29:12 GMT -5
My wife and I are happy with what we have. I even get some meds for free. What do you have? Is it something regular people can get or something from work? There are 23 drug plans available here and they're pretty much all the same. |
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Post by Hobson on Oct 5, 2015 18:45:37 GMT -5
I'm not on Medicare yet, but Mr. H is and I'm the one who keeps track of such things.
He has the Humana Walmart plan for Part D. His premium goes up from $15.70 to $18.40 in 2016. He only recently met his deductible, so we don't have much experience with the next tier. During the deductible stage, anything that's a generic has a flat copay, which is only $4 if it's a preferred generic drug. Except for one drug that isn't covered at all, everything that he takes is generic.
I really don't get how your copay can be more than the retail cost. But if that's the case, try Costco online. The best price we've found for the one not-covered drug is at Costco. My understanding is that you don't have to be a Costco member to use the pharmacy.
For Part B, I couldn't be happier. Mr. H has a Plan F supplement. About $20,000 billed to Medicare so far this year. Medicare usually whacks off about a third of what's billed to get to what's allowable. Everything that Medicare doesn't pay has been picked up by the supplemental insurance. We've paid nothing out of pocket except the $147 deductible. All of this for a Medicare premium of $104.90 per month and a supplemental premium of $180 per month.
It's insurance and you have to have it. Not using it is a good thing. I wish I was on Medicare and not using it. I have a $6,300 deductible on my BCBS plan. The premium goes up from $489 to $610 per month next year. And they're putting me into an HMO because they're no longer offering individual PPOs in 2016, at least in Arizona and some other states. I'll be looking at other options.
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Post by brucemacneill on Oct 5, 2015 19:23:40 GMT -5
I'm not on Medicare yet, but Mr. H is and I'm the one who keeps track such things. He has the Humana Walmart plan for Part D. His premium goes up from $15.70 to $18.40 in 2016. He only recently met his deductible, so we don't have much experience with the next tier. During the deductible stage, anything that's a generic has a flat copay, which is only $4 if it's a preferred generic drug. Except for one drug that isn't covered at all, everything that he takes is generic. I really don't get how your copay can be more than the retail cost. But if that's the case, try Costco online. The best price we've found for the one not-covered drug is at Costco. My understanding is that you don't have to be a Costco member to use the pharmacy. For Part B, I couldn't be happier. Mr. H has a Plan F supplement. About $20,000 billed to Medicare so far this year. Medicare usually whacks off about a third of what's billed to get to what's allowable. Everything that Medicare doesn't pay has been picked up by the supplemental insurance. We've paid nothing out of pocket except the $147 deductible. All of this for a Medicare premium of $104.90 per month and a supplemental premium of $180 per month. It's insurance and you have to have it. Not using it is a good thing. I wish I was on Medicare and not using it. I have a $6,300 deductible on my BCBS plan. The premium goes up from $489 to $610 per month next year. And they're putting me into an HMO because they're no longer offering individual PPOs in 2016, at least in Arizona and some other states. I'll be looking at other options. I can't complain about part A and B and the AARP Plan F. My operation last February was billed about $40K and something cost me $20 above what they paid. It's the Part D I can't square. I think I'll go with the AARP 0 deductible. It will cost an extra $240 for the both of us but cuts out $720 in deductibles before they'd pay anything and then I'll see if I can get some sort of break at least on Mary's maintenance drugs from the mail order pharmacy. We've never used one and she's not happy about it but the only "Preferred" pharmacy here is Walmart and she's not happy about that either and it's a 40 mile round trip. I never knew how good my and her old insurances were when we were working. |
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Post by Doug on Oct 5, 2015 20:11:29 GMT -5
I only have part A and Medicare pays the VA and I don't do enough income so there is no copay except drugs. 3mo of any drug is $24. BTW the highest copay at the VA is limited to $50 last I looked and very few people going to the VA make enough to have to pay that.
Chris has A, B and D. Her B changed last year from a $92 copay to a $73 copay. But for some reason here brace Medicare only paid 80% so her copay was $129. Chris' part D cost her $2.69 for 3 mo. Her part B is an AZ thing where the state pays it for low income, family less than $x (I don't remember the amount but we qualify). I think that because of the state paying the $104 you don't get any choice. We don't have a gap insurance.
BTW vets the VA will take your insurance.
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Post by theevan on Oct 5, 2015 20:20:54 GMT -5
It's a damn book. How am I supposed to read all that?
Still waiting to see all the crazy charges Nancy's misadventures rack up. Neurosurgery, a procedure by an ENT, a bevy of other professionals and two freaking weeks in the hospital has go to do some serious cha-chinging. And what of Don Clark??? Yow!
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Post by coachdoc on Oct 5, 2015 20:26:50 GMT -5
The VA in my experience as a provider, is great with chronic illness, not so hot with acute disease. But their research projects on managing chronic illness is top notch.
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Post by Rob Hanesworth on Oct 5, 2015 21:44:35 GMT -5
I wish there was a program where I could plug in my health problems, diabetes, high BP, high cholesterol, etc., and the medicines I take, and then the program would churn through the available Medicare options for my area, bells would go off, lights would flash, and in big letters on the screen would appear my recommended plan.
You would think that computers would make that possible, but if it exists, I have not found it.
When I first went on Medicare, I tried to go through the hundreds of pages of info I got from a dozen companies to pick the best plan. I finally gave up and settled on AARP Medicare Complete. There was no monthly premium then ($29 now), and I figured I would get smarter before the next renewal period and I could change if I needed to.
I didn't get smarter, it all still baffled me, so I stayed with them. Now, it is time again. They have changed a few things, some costs up, some down. Doing the math to determine the net effect is beyond my capability, or at least my energy level, and no other company is jumping out of the pack as obviously superior, so I will probably renew. They probably count on my laziness/inertia. Hook me once and I stay hooked.
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Post by TKennedy on Oct 5, 2015 22:28:40 GMT -5
I pay $35/mo which is subtracted from SS and $110/mo for a Blue Cross Aware Gold supplement. Since I went on I have had four cardiac ablations and a pacemaker plus 20+ cardioversions and my wife has had a total knee and a couple of hospitalizations for serious infections and we have not paid a penny. To me that's a hell of a deal.
Drugs are cheap for the most part but before the pacemaker I was on two really expensive antiarrthymic drugs that cost me $300/mo even with the supplement.
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Post by jdd2 on Oct 5, 2015 23:11:50 GMT -5
Listening to info about medicare plans seems as baffling as listening to cricket results.
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Post by jdd2 on Oct 5, 2015 23:12:33 GMT -5
I wish there was a program where I could plug in my health problems, diabetes, high BP, high cholesterol, etc., and the medicines I take, and then the program would churn through the available Medicare options for my area, bells would go off, lights would flash, and in big letters on the screen would appear my recommended plan..... I wonder what you could charge for an app like that? |
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Post by Marshall on Oct 6, 2015 7:51:53 GMT -5
Your local Senior Center should have somebody on staff that will help you through the morass. In our town, Catholic Charities gets paid (late and short) by the state of Ill to council seniors. My wife does that.
The gist of the issue is we have a competitive private insurance system. So, each year the private companies pick a strategy to increase their customer base or limit their liability. In doing so, they decide what pricing strategy they will have for the drugs that people need. So, every year you have to re-examine your plan as the company you were with last year might have been low balling your drugs to increase enrollment in their plans. And now they are going to raise the rate while they've got you in their wheel-house to cover their CEO's nut.
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Post by Hobson on Oct 6, 2015 9:49:02 GMT -5
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Post by Marshall on Oct 6, 2015 11:31:06 GMT -5
Listening to info about medicare plans seems as baffling as listening to cricket results. Yes, it's a sticky wicket. |
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