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I have Medicare A&B plus BC thru the employer I'm retired from. So I don't have Part D. Even though my BC has the drug benefit. I'm plagued with huge copayments each month for insulin and it's supplies. I've been a diabetic much of my life, so I take Health Insurance very seriously.
My advice is at age 65 the few cheap generics one takes, won't last. Other health concerns will develop requiring expensive drugs. I can tell you the drug companies and ins companies are out for profit. The increases in cost for insulin is out of control, and I'm positive many can't manage the cost. I'm fed up nothing is being done about it , like was done over the epi pen cost.
Don't gamble going without coverage. The cost of scripts each month can literally, take a massive amount of your income. Believe me I know what I'm talking about, I've been a Diabetic since my 20s.
I'm going to follow your mom's plan. It's true, if you don't have great insurance and ask your doctor for the most affordable treatment options, they do work with you and can recommend lower cost options. Just imagine if they always did that, how much our country could save on health care. My mom has one medication that is extremely expensive with her Part D. She told the doctor and they let her take samples from their office. It's been 2 1/2 years of samples so far. It never hurts to ask.
I think it's a good idea, although I'm not sure how well it would work all the time for someone who has a serious medical condition that's treated with some of those jaw-droppingly expensive prescription drugs (such as cancer, MS or autoimmune diseases). I know samples given out by physicians can help at least some-it's great that your mother has been able to get her samples, hopefully that will continue.
But even if those samples become unavailable, from what I've seen most often the drug manufacturer will offer financial help in paying for the drug, in the form of a discount card or through a specialty pharmacy, and this help may be available with or without prescription drug coverage. The caveat with this kind of help, though, is that it's not available to people with prescription drug coverage under government programs ( such as Part D Medicare, Medicaid, Tricare), and that is thanks to the laws that were passed by Congress with the initiation of the Part D Medicare plans in 2005. Congress agreed that these programs would not bargain for the lowest drug prices ((can you see the fine hand of the pharmaceutical lobbyists in this?). IMO that's even a better reason, under the right circumstances, not to have the Part D coverage, and if we didn't have our secondary insurance through my husband's former employer (we are retired), that included drug coverage, I'd consider not having a Part D plan either.
My husband's Cardiologist gives him meds from his sample closet. He has insurance. Last time his doctor gave him a 6 month supply. "Why pay when I get samples for free?"
Yes, they will do this, even though another poster says they don't. Just depends on the doctor.
It also depends on the availability of the samples. My daughter has also gotten a significant number of drug samples from her cardiologist as well, but has told us that samples of drugs to treat rheumatoid arthritis and other autoimmune diseases are much more limited, packaged in smaller quantities and fewer given to the physicians, so not many are available. She learned this from working with a rheumatologist in a multi-physician practice (she is a nurse.).
I have Medicare A&B plus BC thru the employer I'm retired from. So I don't have Part D. Even though my BC has the drug benefit. I'm plagued with huge copayments each month for insulin and it's supplies.
This sounds like injectable insulin which would be covered under the BC drug benefit with copayments. When used with an external pump, insulin and supplies are covered under the Medicare Part B DME benefit and the Part B cost share should be covered by the BC plan.
To file for Insulin on Part B the Pharmacy needs to receive a "CMS-10125 - External Infusion Pumps" form from the Doctor. After they got this my cost went to $0 / 90 day supply.
Do any of you 65 and older and on Medicare not purchase Part D Prescription Drug coverage? If you do not purchase it, what is your philosophy or point of view on it, and do you worry at all about not having the coverage it provides?
The drugs I take for high blood pressure and high cholesterol are all available for only $4 per month (or $10 for 3 months) at walmart.com without insurance. I will keep purchasing these thru walmart.com with or without Part D insurance, as nothing is cheaper than $4 per month.
So purchasing Part D Prescription Drug coverage would benefit people like myself only if they happen to need a specialized drug for a disease or condition sometime in the future - which I realize is the nature of insurance.
That is like saying, I am young and don't need insurance, but then suddenly you develop a life threatening disease and now you want insurance. Isn't it better, for a few $$s a month to be safe than sorry?
Don't gamble going without coverage. The cost of scripts each month can literally, take a massive amount of your income. Believe me I know what I'm talking about, I've been a Diabetic since my 20s.
would Part D save you some money? have you tried it?
Medicare Advantage Plans? You have to be signed up for Part D to get a drug plan under those.
You may be confusing that with Part B. It is only Part B signup which is required in order to enroll in Advantage.
Most Advantage plans include drug coverage and is the primary reason many people join Advantage. They don't doctor much, but take a number of drugs. However plans must be compared as prices and formularies vary widely among insurers. A Tier 1 drug under one Advantage plan could be a Tier 4 under another.
Quote:
Originally Posted by brava4
Does the price of Part D vary on initial sign up? Or is it basically the same across the board?
Part D premiums vary by insurer and formulary. Medicare offers a compare tool to help people choose the most cost-effective Part D plan based on their prescription needs.
Quote:
Originally Posted by flashlight
would Part D save you some money? have you tried it?
He doesn't need Part D - his employer plan through Blue Cross already covers drugs. His best option is to do as suggested in Post #44 - try to get some of his supply costs covered through Medicare Part B.
Does the price of Part D vary on initial sign up? Or is it basically the same across the board?
They vary quite a bit in cost.
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