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One more Medicare Part D question
Posted by: rgG
Date: October 16, 2021 08:54AM
I am most likely going to switch my mom's Part D plan. I have never switched her plans before.
She has had the same D plan forever and it is not really the best fit for her anymore.
She is with AARP United Healthcare for Part D now, but I will most likely be switching to a different provider.
I know I don't have to cancel her old plan. The Medicare site says just sign up with the new plan and the old one will self cancel, as of Jan. 01, 2022

Here is the question:
Is it better to sign up for the new plan through the Medicare.gov site or go directly to the new provider site and sign up there?


Edit: I know I am probably overthinking this, but I really don't want to mess up my mom's coverage. If it is mine, I can deal with it, but she gets very twitchy when I suggest changing something. grinning smiley





Roswell, GA (Atlanta suburb)



Edited 1 time(s). Last edit at 10/16/2021 09:08AM by rgG.
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Re: One more Medicare Part D question
Posted by: Ombligo
Date: October 16, 2021 09:35AM
Can't answer the question but just be sure to check the new plan's formulary for her meds and pharmacy. You may also want to check her meds against GoodRX prices - I saved $40/month with GoodRX vs my insurance cost.



“No persons are more frequently wrong, than those who will not admit they are wrong.” -- François de La Rochefoucauld

"Those who cannot accept the past are condemned to revise it." -- Geo. Mathias
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Re: One more Medicare Part D question
Posted by: Ammo
Date: October 16, 2021 10:01AM
I also recommend checking out Good RX. It’s weird that I can get much better prices on some of my prescriptions by not using my Part D insurance. It’s important to shop around different pharmacies to compare costs - they can vary widely depending upon where you have your prescription filled. In my area (for my meds) Costco and Hy-Vee usually beat other drug stores, Walgreens and CVS are usually much worse.



Where is there dignity unless there is also honesty? - Cicero

Be kind, for everyone you meet is fighting a battle you know nothing about. —Wendy Mass
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Re: One more Medicare Part D question
Posted by: mspace
Date: October 16, 2021 10:09AM
If you do not renew with her current company, they will automatically NOT cover her for 2022.

That is why you must either renew or sign her up with your new choice during the open window. Whoever you sign with will start her coverage Jan 1, 2022.

Also, Medicare agents are free to the consumer. They are paid by the companies they represent and the commission is the same. The key is to pick one that handles a number of companies, so they are not steering you to just the one they work for.

While I could easily do my sign ups directly with the companies I choose, I use an agent to help with the fine details and let him sign me up so he can make his money, as he has been a big help at times with the whole process.
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Re: One more Medicare Part D question
Posted by: rgG
Date: October 16, 2021 10:27AM
Quote
mspace
If you do not renew with her current company, they will automatically NOT cover her for 2022.

That is why you must either renew or sign her up with your new choice during the open window. Whoever you sign with will start her coverage Jan 1, 2022.

Also, Medicare agents are free to the consumer. They are paid by the companies they represent and the commission is the same. The key is to pick one that handles a number of companies, so they are not steering you to just the one they work for.

While I could easily do my sign ups directly with the companies I choose, I use an agent to help with the fine details and let him sign me up so he can make his money, as he has been a big help at times with the whole process.

Her coverage always renews with her current company, has for as long as she has had part D, from when it first started, so she will have coverage, if I don’t do anything. This is also true for my husband, his policies always renew, if we don’t make a change.





Roswell, GA (Atlanta suburb)
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Re: One more Medicare Part D question
Posted by: rgG
Date: October 16, 2021 10:31AM
Quote
Ammo
I also recommend checking out Good RX. It’s weird that I can get much better prices on some of my prescriptions by not using my Part D insurance. It’s important to shop around different pharmacies to compare costs - they can vary widely depending upon where you have your prescription filled. In my area (for my meds) Costco and Hy-Vee usually beat other drug stores, Walgreens and CVS are usually much worse.

I agree about shopping around, but my 90 year old mom has CVS as her only option. She lives in a very small town.
I might be able to get her to try a GoodRx card, but luckily right now she only has a generic BP med on a recurring basis. It might be good to have her ask the pharmacist to check the GoodRx price on any other stuff she has to get.





Roswell, GA (Atlanta suburb)
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Re: One more Medicare Part D question
Posted by: mspace
Date: October 16, 2021 10:46AM
Quote
rgG
Quote
mspace
If you do not renew with her current company, they will automatically NOT cover her for 2022.

That is why you must either renew or sign her up with your new choice during the open window. Whoever you sign with will start her coverage Jan 1, 2022.

Also, Medicare agents are free to the consumer. They are paid by the companies they represent and the commission is the same. The key is to pick one that handles a number of companies, so they are not steering you to just the one they work for.

While I could easily do my sign ups directly with the companies I choose, I use an agent to help with the fine details and let him sign me up so he can make his money, as he has been a big help at times with the whole process.


Her coverage always renews with her current company, has for as long as she has had part D, from when it first started, so she will have coverage, if I don’t do anything. This is also true for my husband, his policies always renew, if we don’t make a change.

I would check with a Medicare agent to find out the exact way to handle a transition to the new company you want, so you have seamless coverage. Do a search with the zip code it will be for. Each state is different and has different company coverage.

You have the time right now to find it all out.
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Re: One more Medicare Part D question
Posted by: Grateful11
Date: October 16, 2021 11:07AM
I have a local insurance agent that contacts me every year, either in person or by phone, to explain all the in's and out's, changes and so forth of all the plans available in our area. We didn't let her come in the house last year and we won't be letting her in again this year either as I'm sticking with UHC regardless.



Grateful11
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Re: One more Medicare Part D question
Posted by: Ombligo
Date: October 16, 2021 11:35AM
Just some quick comparisons of retail prices at various pharmacies. It can pay to shop

Simvastaton
Winn Dixie - $4.00
CVS - $27.00
Costco - $12.88
Publix - $8.00

Sildenafil
Winn Dixie - $188
CVS - $1287
Costco - $48
Publix - $24.52

Zonisamide
Winn Dixie - $103
CVS - $196
Costco - $34
Publix - $29.60

Metformin
Winn Dixie - $4
CVS - $21
Costco - $12.99
Publix - free


Cumultive --
Winn Dixie - $299
CVS - $1531
Costco - $107.87
Publix - $62.12
GoodRX cheapest locations - $33.67



“No persons are more frequently wrong, than those who will not admit they are wrong.” -- François de La Rochefoucauld

"Those who cannot accept the past are condemned to revise it." -- Geo. Mathias



Edited 1 time(s). Last edit at 10/16/2021 11:47AM by Ombligo.
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Re: One more Medicare Part D question
Posted by: rgG
Date: October 16, 2021 12:03PM
Quote
Ombligo
Just some quick comparisons of retail prices at various pharmacies. It can pay to shop

Simvastaton
Winn Dixie - $4.00
CVS - $27.00
Costco - $12.88
Publix - $8.00

Sildenafil
Winn Dixie - $188
CVS - $1287
Costco - $48
Publix - $24.52

Zonisamide
Winn Dixie - $103
CVS - $196
Costco - $34
Publix - $29.60

Metformin
Winn Dixie - $4
CVS - $21
Costco - $12.99
Publix - free


Cumultive --
Winn Dixie - $299
CVS - $1531
Costco - $107.87
Publix - $62.12
GoodRX cheapest locations - $33.67

Yeah, it is a snake dance, for sure. Unfortunately, she has a CVS and one independent pharmacy in her town and CVS is where she shops, so not much shopping around will be possible for her.
If she gets on some high priced maintenance drug, I would check into the mail-order provider and maybe handle it that way.
It is just crazy the way the prices are all over the place.
I think, because CVS owns Aetna now and CVS is basically her only choice, that one of the Aetna plans will be the best for her, for the Part D.





Roswell, GA (Atlanta suburb)
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Re: One more Medicare Part D question
Posted by: JoeM
Date: October 16, 2021 01:04PM
Quote
rgG
Quote
Ammo
I also recommend checking out Good RX. It’s weird that I can get much better prices on some of my prescriptions by not using my Part D insurance. It’s important to shop around different pharmacies to compare costs - they can vary widely depending upon where you have your prescription filled. In my area (for my meds) Costco and Hy-Vee usually beat other drug stores, Walgreens and CVS are usually much worse.

I agree about shopping around, but my 90 year old mom has CVS as her only option. She lives in a very small town.
I might be able to get her to try a GoodRx card, but luckily right now she only has a generic BP med on a recurring basis. It might be good to have her ask the pharmacist to check the GoodRx price on any other stuff she has to get.

I've used GoodRx and I generally change my Part D plan every year if I see the rates are set to go up on renewal. The thing to keep in mind with GoodRX is while the savings can be substantial for some drugs using it will not help you meet your Plan D deductible. You'll need to figure out if that is acceptable when it comes to other drugs or the possibility that an expensive drug might be prescribed for your mom in the near future. It's weird but sometimes you'll actually save more in the long run by paying more for a few drugs upfront and meeting your deductible as soon as possible. IF your mom uses few medications and they are not high cost, than it might pay to never meet your deductible and take the GoodRx savings.



JoeM
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Re: One more Medicare Part D question
Posted by: mspace
Date: October 16, 2021 01:22PM
Quote
JoeM
Quote
rgG
Quote
Ammo
I also recommend checking out Good RX. It’s weird that I can get much better prices on some of my prescriptions by not using my Part D insurance. It’s important to shop around different pharmacies to compare costs - they can vary widely depending upon where you have your prescription filled. In my area (for my meds) Costco and Hy-Vee usually beat other drug stores, Walgreens and CVS are usually much worse.

I agree about shopping around, but my 90 year old mom has CVS as her only option. She lives in a very small town.
I might be able to get her to try a GoodRx card, but luckily right now she only has a generic BP med on a recurring basis. It might be good to have her ask the pharmacist to check the GoodRx price on any other stuff she has to get.

I've used GoodRx and I generally change my Part D plan every year if I see the rates are set to go up on renewal. The thing to keep in mind with GoodRX is while the savings can be substantial for some drugs using it will not help you meet your Plan D deductible. You'll need to figure out if that is acceptable when it comes to other drugs or the possibility that an expensive drug might be prescribed for your mom in the near future. It's weird but sometimes you'll actually save more in the long run by paying more for a few drugs upfront and meeting your deductible as soon as possible. IF your mom uses few medications and they are not high cost, than it might pay to never meet your deductible and take the GoodRx savings.

There’s stuff we use that keeping all of that in mind, I still have to buy from Canada.
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Re: One more Medicare Part D question
Posted by: deckeda
Date: October 16, 2021 01:59PM
If there's cost difference show it to her and let her decide if it's worth changing.

And if it's not worth changing ask her why she's frittering away your inheritance. Bwahaaa I love messing with my dad about what he buys! smiling smiley
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Re: One more Medicare Part D question
Posted by: rgG
Date: October 16, 2021 02:20PM
Quote
deckeda
If there's cost difference show it to her and let her decide if it's worth changing.

And if it's not worth changing ask her why she's frittering away your inheritance. Bwahaaa I love messing with my dad about what he buys! smiling smiley

Ha ha. That’s what I tell my daughter when I make a big purchase, “I am spending your inheritance.”

I know my mom will say, “do whatever you think is right,” so I will either be the hero or the goat. Lol





Roswell, GA (Atlanta suburb)
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Re: One more Medicare Part D question
Posted by: TL
Date: October 16, 2021 04:17PM
1.if you already have a Part D plan, with no action your plan will roll over to the next year. The only exception is if the plan does not offer part d the next year, and even then you are going to be be rolled over to a similar plan with the same company whenever possible (eg, Humana might offers plans a, b, and c this year but drop c for next year. They will move people in plan c to plan a or b automatically unless you actively choose something else).
2. There can be significant changes to a plan each year, including to premium, copay structure, drug coverage, and network, so you should always review the Annual Notice of Change your plan sends.
3. If you do pay out of pocket for a drug, you actually can submit the information to your plan by paper claim. You may not get any money back, but it will count toward your drug spend (total drug cost - what gets you into the coverage gap) and your True Out of Pocket costs (what you pay plus manufacturer payments in the gap on branded drugs - gets you into catastrophic coverage).
4. You don’t really need a broker. if you do need personalized help, every state has state health insurance assistance program (SHIP) counselors available to help for free. Georgia’s program is through Georgia Cares: [mygeorgiacares.org] . These folks are experts in all things Medicare and more and are great at navigating enrollment choices, claims issues, and much more.
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Re: One more Medicare Part D question
Posted by: rgG
Date: October 16, 2021 04:26PM
Thanks again for great info.
I am sure it is helpful for others and not just me.

Quote
TL
1.if you already have a Part D plan, with no action your plan will roll over to the next year. The only exception is if the plan does not offer part d the next year, and even then you are going to be be rolled over to a similar plan with the same company whenever possible (eg, Humana might offers plans a, b, and c this year but drop c for next year. They will move people in plan c to plan a or b automatically unless you actively choose something else).
2. There can be significant changes to a plan each year, including to premium, copay structure, drug coverage, and network, so you should always review the Annual Notice of Change your plan sends.
3. If you do pay out of pocket for a drug, you actually can submit the information to your plan by paper claim. You may not get any money back, but it will count toward your drug spend (total drug cost - what gets you into the coverage gap) and your True Out of Pocket costs (what you pay plus manufacturer payments in the gap on branded drugs - gets you into catastrophic coverage).
4. You don’t really need a broker. if you do need personalized help, every state has state health insurance assistance program (SHIP) counselors available to help for free. Georgia’s program is through Georgia Cares: [mygeorgiacares.org] . These folks are experts in all things Medicare and more and are great at navigating enrollment choices, claims issues, and much more.





Roswell, GA (Atlanta suburb)
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Re: One more Medicare Part D question
Posted by: deckeda
Date: October 16, 2021 05:35PM
Quote
rgG

I know my mom will say, “do whatever you think is right,” .../quote]

Oh yeah I know that response. You're doomed, sorry.

Loved my mom, but I took those statements at face value without regret. The guilt trip never worked on me.
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Re: One more Medicare Part D question
Posted by: graylocks
Date: October 16, 2021 05:51PM
Big thanks for this thread. Got my Annual Notice from Kaiser today for my Medicare Advantage plan and might has just tossed it as simply my monthly statement. But because of this thread I actually read it.

My Kaiser a
Medicare Advantage plan, for which I pay $0, is actually improving; they are including dental and a number of services are reducing in price also. The Advantage Plus plan I pay $13 for is going down to $9.



"Success isn't about how much money you make. It is about the difference you make in people's lives."--Michelle Obama
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Re: One more Medicare Part D question
Posted by: rgG
Date: October 16, 2021 05:57PM
Quote
graylocks
Big thanks for this thread. Got my Annual Notice from Kaiser today for my Medicare Advantage plan and might has just tossed it as simply my monthly statement. But because of this thread I actually read it.

My Kaiser a
Medicare Advantage plan, for which I pay $0, is actually improving; they are including dental and a number of services are reducing in price also. The Advantage Plus plan I pay $13 for is going down to $9.

smiley-music039
Great news for you!





Roswell, GA (Atlanta suburb)
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Re: One more Medicare Part D question
Posted by: rgG
Date: October 16, 2021 06:00PM
Quote
deckeda
Quote
rgG

I know my mom will say, “do whatever you think is right,” ...

Oh yeah I know that response. You're doomed, sorry.

Loved my mom, but I took those statements at face value without regret. The guilt trip never worked on me.

Unfortunately, my mom indoctrinated me early and well. I try not to feel guilty, but I usually do. sad smiley





Roswell, GA (Atlanta suburb)
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Re: One more Medicare Part D question
Posted by: Michael
Date: October 16, 2021 08:39PM
As an FYI, you might look at Script Hero for med discounts. They focus on independent and small pharmacies and their prices are pretty good. As an example, I put in Sildenavil and it came up at $12.19 at several pharmacies near me.

[www.scripthero.com]
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Re: One more Medicare Part D question
Posted by: Buzz
Date: October 16, 2021 09:38PM
FYI for youngsters.... Once you're on Medicare, you need to sign up for Part D unless you have viable Rx insurance. Good Rx is not viable, so if you're gonna use Good Rx, then you sign up for the cheapest Part D plan available to satisfy the requirement, which here in SoCal is about $7/mo., and then buy whatever is cheaper thru Good Rx. If you fail to sign up for Part D w/o viable Rx insurance, you'll be penalized, and the longer you wait, the bigger the penalty grows.

90 y.o. mom w/ only a generic BP med is awesome, but reading between the lines, it seems like keeping her in her comfort zone is the real issue. It kinda doesn't seem like there's a plethora of choices for her, and that whatever spikes as best on the Medicare widget is gonna be OK. As stated above, a multi-line agent could prove quite helpful. Good luck.
==
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Re: One more Medicare Part D question
Posted by: rgG
Date: October 16, 2021 10:38PM
Thanks all.
I think I have enough info to talk to mom about this now.
I appreciate all the input.





Roswell, GA (Atlanta suburb)
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Re: One more Medicare Part D question
Posted by: GGD
Date: October 17, 2021 12:54AM
Are you possibly over thinking this local pharmacy restriction?

Is your mom on a number of drugs that she takes on a regular basis, but she currently gets them filled at a local CVS?

Have you considered switching her to a mail-order pharmacy, with 90 day supplies? Those usually have the lowest prices and don't require a local pharmacy. For the Aetna/CVS plans they use Caremark for their mail order.

You could potentially handle the ordering for her too if that simplifies her life.
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Re: One more Medicare Part D question
Posted by: AllGold
Date: October 18, 2021 01:28PM
To answer your original question, it really doesn't matter how you sign up for the new plan. Medicare.gov or direct to the insurance company's web site makes no difference. You can also do the switch by phone either through Medicare or the insurance company.

One small tidbit that probably won't matter but just so you know...

During the "open enrollment" Annual Enrollment Period (AEP) that runs from Oct. 15 through Dec. 7 every year, you can make as many changes (selections/signups) to your Part D or Medicare Advantage plan as you want. The last one in is the one that goes into effect on Jan. 1. So if you discover something better after you've already signed up, as long as it is Dec. 7th or before, you can still make another selection.
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Re: One more Medicare Part D question
Posted by: rgG
Date: October 18, 2021 09:12PM
Quote
AllGold
To answer your original question, it really doesn't matter how you sign up for the new plan. Medicare.gov or direct to the insurance company's web site makes no difference. You can also do the switch by phone either through Medicare or the insurance company.

One small tidbit that probably won't matter but just so you know...

During the "open enrollment" Annual Enrollment Period (AEP) that runs from Oct. 15 through Dec. 7 every year, you can make as many changes (selections/signups) to your Part D or Medicare Advantage plan as you want. The last one in is the one that goes into effect on Jan. 1. So if you discover something better after you've already signed up, as long as it is Dec. 7th or before, you can still make another selection.

Thanks!
Those were exactly the things I was wondering about.
Glad it doesn’t matter where I sign up.





Roswell, GA (Atlanta suburb)
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