Medicare Prescription Woes

[Grayfox]

Just a heads up for the many seniors on medicare on this site.
I got a letter from my insurance company, Mutual of Omaha, saying that they will no longer offer my Medicare supplement prescription plan next year. My coverage will end 12-31-24.
I've been talking to an independent insurance agent and he tells me that due to changes in the laws last year that several of the larger insurance companies are completely dropping all Medicare prescription coverage. Further, he said to expect more changes next year.
There are alternatives, but my problem is that many don't cover one of my drugs at all. He's working on it.
I strongly suggest you check your coverage now.

 

[AJ]

Have not heard a word from Medicare or Tricare about this. Is this Medicare Part D?

 

[Grayfox]

Is this Medicare Part D?

Yes it is.

 

[Super Trucker]

FYI: the law passed in the 4th quarter of 2022 and takes effect in Jan 2025.

 

[Onomea]

I think the lowering of the cap on out of pocket expenses for some drugs has made medicare coverage less profitable for insurers so some are pulling out, reducing what they will cover, or charging monthly premiums whereas formerly they did not.

We have found the help/guidance of a licensed medicare insurance broker to be very helpful in figuring this out. You can give them a list of your current docs and meds, and they will search among many insurers to find the best fit.

 

[Kinman]

I think the lowering of the cap on out of pocket expenses for some drugs has made medicare coverage less profitable for insurers so some are pulling out, reducing what they will cover, or charging monthly premiums whereas formerly they did not. You can give them a list of your current docs and meds, and they will search among many insurers to find the best fit.

We have found the help/guidance of a licensed medicare insurance broker to be very helpful in figuring this out.

I agree completely that without the care and guidance of a licensed Medicare broker just about anyone is going to have trouble. A very kind broker explained everything to us when I first retired and four years later to my wife when she did the same. There are many different methods of getting the right plan and some are geared towards those who need medication and frequent care and those like my wife that are not on any medication while pushing 70 and used the medical system rarely. She was just delighted to find that she is entitled to a ton of acupuncture treatments at only $10 a pop. Even the VA only allows me sixteen a year and the rest I am out of pocket which is covered by my disability allotment, I have no complaint. Just mentioned that although she does not receive the care I do regarding annual physical and very detailed blood work, she does get some benefit that has at last worked in her favor.
I just learned the other day that next year one of the benefits United Healthcare has been giving me is being cut in half. They used to allow me $100 per quarter to be used on over the counter items usually from Walmart, this has been helpful as I go through certain items quickly. That amount is being reduced to $50 or removed totally, I have not gotten a straight answer and may go back to that kind insurance broker for an explanation.

 

[grover99]

Lot of changes for 25. My agent explained them to me and still a bit confusing. Deductibles are getting so high that next year they will allow you to pay your drug costs spread out over the entire year. That way you aren't hit with a $600 deductible right out of the gate in January. One interesting thing is after you hit $2000 out-of-pocket the rest of your drugs will cost you nothing.

 

[Denverd0n]

Small plug here. I have one drug that I require that my medicare plan does not cover. I buy it mail-order from dirxhealth dot com. Costs about 1/5th of what my local pharmacy wants me to pay. They do not take any insurance, so it's really just for those things your insurance will not cover.


Good luck, in any case.

 

[moosedog]

Expect those laws to change with the new change in command.

 

[AJ]

Yes it is.

Glad I do not have Part D then.

 

[Doug M.]

We have volunteer staff in this state who help folks with picking plans. When I first got medicare (early due to ESRD), I had no idea what I was doing. That lady was very helpful. Same thing this year with the changed plans, as mine is ending. There are a couple of things that are not as well covered and she pointed out other resources for getting them.

 

[H Richard]

Keep in mind "Good Rx". Any time your drug is very high, or not covered, have the pharmacy check the Good Rx price and you may be astounded. I had one arthritis drug I take that was going to cost me $535 but with Good Rx it is $68 for 90 days. My wife just finned a new prescription and was going to be $60 but with Good Rx was $18.

 

[CalifEd]

I have had some luck with using Costco Pharmacy.
They price their drugs on a cost plus rate rather than a discount from suggested retail.
Consumer Reports said they were cheaper than many other Pharmacies for some drugs.
You don't need to be a Costco member to use their Pharmacy but they do have a Member Prescription Program that may be cheaper.

 

[Tom S.]

I have had some luck with using Costco Pharmacy.
They price their drugs on a cost plus rate rather than a discount from suggested retail.
Consumer Reports said they were cheaper than many other Pharmacies for some drugs.
You don't need to be a Costco member to use their Pharmacy but they do have a Member Prescription Program that may be cheaper.

One of my dogs was on a heart medicine and the money I saved over Costco's regular price when buying a Costco membership actually paid for the membership. Either way, Costco was still cheaper than other pharmacies.

 

[Alk8944]

The year after my wife died in 2019 I started paying for my prescriptions out-of pocket. Its cheaper than paying the deductibles and annual required out-of-pocket my Advantage Plan carrier charged! My Advantage Plan is with my states retirement system, not a private carrier, so this may not work for you.

 

[ladder13]

Funny how this wasn't announced previously.


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