Medicare part D 2021 questions

[Dustyroad70]

Originally Posted by JRR

Not much else you can do except pick a plan based on the cost information for the drugs at this time. There isn't really any way to know if a plan might make a change to raise a drug price or drop coverage during 2021. It might seem that since celecoxib is a generic that the chance of it being dropped or having a large price increase would not be a big one.

From my own experience with six years of Medicare, I have never had a drug dropped or increased in price during the policy year. But you never know.

Eight years of Medicare here and this is a first for me. I had been on mobic since twenty twelve when I went on medicare and Celebrex which I had been on was higher than a kite. Mobic doesn't work as good for me, my hands hurt all the time. The generic of Celebrex is celecoxib it became available maybe two years ago, I am not sure. What I am sure about is this year after my first 3 months supply the celecoxib has gone up and up by leaps and bounds. So thanks for your thoughts, I will do something even if it's wrong.

[GWoodle]

Originally Posted by Dustyroad70

I've been comparing part D plans on Medicares website. Can someone explain to me the term "drug cost" as they call it? It seems to me the drug cost changes from pharmacy to pharmacy, plan to plan and every which way. A huge variation in price. Also, if a drug is listed as a tier 2 on a plans formulary, can they change that drug to a tier 3 or 4 in the middle of the year or whenever they want? I probably havn't explained these questions very well, so if you don't know what I'm getting at just pass me by.

The most important cost may be the Retail Price. Depends on the drug, quantity & frequency. A box of 100 needles may cost $51.99. This is for any prescriptions you get at pharmacy or mail order. Part of the drug cost may vary from pharmacy to pharmacy over the difference between retail & wholesale cost.

In stage 1, before deductible pay $51.99 to $440 depending on plan. In stage 2, get some coverage to $4130 plan limit. In stage 3 Coverage Gap pay 25% until Troop reaches $6550. In Stage 4 pay 5% or $3.70 generic or $9.70 brand name to the end of the year. TROOP= Total Retail Out Of Pocket. Between you & the plan somebody pays.

Depending on the plan Tier 1/2 may be generic drug at network or not. Sometimes drug can change when you get different manufacture & country of origin. Be nice if all were made in USA.

[rothbear]

Another point of interest is that the drug price can change according to whether it is a tablet or capsule. One drug I take comes in both forms and I have had both along the way. I have found that the capsule works a bit better and what I was taking when I started Medicare. But when I started looking into part D plans 3 years ago the difference in price was horrendous! The capsules were about 10X higher than the tablets. So I changed to the tablets. Not quite sure why a tablet would be tier 2 and a capsule tier 4 of the exact same generic drug.

This year my DH's 2 common generic drugs ranged from $0 copay at CVS to $30-40 copay each at WalMart with the new Aetna plan, which is 1/2 the monthly premium. Every year it seems we have to change pharmacies.

I was thinking that my parents and in-laws would have gone ballistic having to deal with the way Medicare is now.