Medicare part D plans? trying to pick one

[marlinfshr]

Now that I have applied for medicare part A & B it is time to start thinking of the add on's. I have been looking some at the part D plans and think I have a basic idea as to how they work. But there are so many that range in prices from what seems to be 30 or so dollars/month to a BCBS plan that is 170/month.

My question is what is a good plan to go with that works for those of us with kidney issues? I'm not really on much medication now except for generic plavix and lipitor but I am thinking ahead to post transplant---whenever that may be. I was given a list of potential drugs and punched them into the site showing part D plans and it seems to show different costs associated with them in different plans. That is why I'm wondering what any of you have come up with and if you're happy with you're current plan. As an example, it seems the most expensive BCBS drug plan really doesn't seem very good as OOP costs for drugs are also more. From my quick check, it seems one of the cheaper plans was actually better. Perhaps I'm mis-understanding. Any ideas? BTW, I'm under 65 if that affects anything.

Thanks

[Shaks24]

I would key in on the premium, the medicare rating, deductibles and co pays as well as their prescription drug formulary to see the coverage and ratings on drugs you currently are taking and may take in the future.  It sounds like you are on the right track.

[Shaks24]

I got my medicare card in the mail today with an effective date of 9/1/2013 for medicare A and B for 104/month. Monday I am going to sign up for medigap F through United Healthcare in Tennessee for 350/month. Also will sign up for prescription D through Wellcare Extra PDP for about 40/month. Their mail order prescription service gives me the best result for the 6 meds (mostly BP) that I currently take. All in all for just under 500/month this should give me very complete coverage. Thank heavens for this.

[Shaks24]

Things are falling into place for me on insurance. Got my Well Care Extra PDP card yesterday. Based on the meds I currently take, My costs will be about 700 per year including premiums for prescriptions. If I do it by mail it would be about 100 less. I also got the paperwork for medigap F. The monthly premium will be 351 but goes up in April of 2014. So like I forecast, for about 500 a month including medicare A and B I will have coverage that should exceed an Obamacare Platinum Plan. I got a bill from medicare yesterday too. It was dated for 9/1/2013 - 2/1/2014 for some 600+ dollars. Will send that check out pronto. I also cancelled the junk private policy I have had since 2002. That will give me about 400/month to put towards these new medicare policies. I see hope!

[Jean]

You mentioned SSDI in another post. If you get that, your income will be lower I presume and you should get the government subsidy for your insurance. Or, am I totally confused? ( always possible).

[jeannea]

There's often confusion of SSD vs. SSDI. I know I get them messed up.

[Shaks24]

Actually I think its SSI which is based on financial needs and SSDI which is based on how much you paid in during your working years.

[marlinfshr]

Thanks for the reply's. I just got approved for the part A & B though it will go back to August. I can't get them to change it till Jan. It just doesn't make sense since my current insurance has been covering my dialysis and I went through my deductible and OOP max the first day in the hospital back in April. Oh well, though it sucks to have to pay six month's of part B premiums I guess it's good that I can start moving on to something that will cover a later transplant and some meds.

I guess at the moment, due to funds I'm planning on a medigap part A. My only other option in this state for me is part F which is a better plan but the only real difference I can see is that it covers the deductibles as well. I'm type O so I don't see a quick transplant so I wonder if I can change to a medigap F in 2 years as a possible transplant comes closer. The difference in the premiums are 300/month. Looking at it that way, 300/month is equivalent to 3 part A deductibles in the course of the year.

Decisions, decisions, decisions!

[Shaks24]

I think you can change during open enrollment season. I hear you as to paying the back months as I sent medicare a check for 600 plus yesterday going back to September coverage.

[big777bill]

 SSDI is social security disability insurance. This is the only way you can get medicare if you're under 65.

[KarenInWA]

SSDI is social security disability insurance. This is the only way you can get medicare if you're under 65.

I'm under 65, have Medicare, and am not on SSDI. The only ways you can get Medicare if you're under 65 is if you have ESRD, ALS or are permanently disabled in some other way. I signed a paper stating I did not want SSDI, I only wanted/needed the Medicare. I have insurance through work, but they kept sending me letters about my Medicare eligibility. My Medicare will end in November 2014.

KarenInWA

[Jean]

Any body on this post live in California. No, it aint the golden state, however, I have Medicare, at what, $104.50 and a Medigap Plan, Scan, which is free and between them they pay for everything, including dialysis and all those goodies and then up to $2970.00 annually for RX. And the rest of the plans, D especially, is only for the lower income folks.

[jeannea]

Why is Part D only for low income? Anyone can buy Part D to get prescription drug coverage and it can really help.

[nursey66]

I don't get that either. Anyone on Medicare can get part D unless they have a Medigap/part C or Advantage Plan that already has RX drugs included. Part D will pay untill you use up about 2850 dollars, then you are pretty much on your own ,[ there are small discounts, and 50% on Brand drugs, but we usually only get generics,]. It takes about 4750 dollars out of pocket to get out of the donut hole ! My hubby's binders were 139 [in the donut hole] a month after the discount, the Dr just doubled his dose so I suspect his next refill will cost us 278 dollars. At that cost. in 2014 he will be in the donut hole pretty fast, the binders will be over 560 a month.  I just try to plan we will have to budget for it. All other bills have been covered 100%. I don't understand why they have to hit people with the Donut hole !!! Of coarse, it doesn't affect me, my drugs are few and cheap, so far.Why are the binders so darn expensive ?

[Sydnee]

You are right part D is NOT only for low income. "extra help" is only for low income. medicare has a short survey on their website to see if you qualify for the Extra Help. extra help covers the part D premiums and lowers copay on almost all drugs, with the extra help there is NO donut hole. Ed's prescriptions are all $2.65 if they are on the formulary.

If your income is from a job they only consider 1/2 of it.   

[Jean]

Well, I have applied for D and been turned down because our income is too high. ( HA!!! ) So, that is why it is so confusing.

[nursey66]

I checked for extra help too, income is too high. Our only income is social security ! His SSDI, mine regular SS - I am 67 years old. His binders copay alone takes up half his  monthly SS check, yet we don't qualify either !!  Can't get the help from the Drug Co. either, cuz we are on Medicare. Thank God my house is paid for !! We have to live off my SS check, he hasn't been able to work for 12 years.

[jeannea]

Please check out http://www.medicare.gov/Pubs/pdf/11469.pdf. This shows that anyone can buy Part D but if you earn more than $85,000 single or $170,000 couple your premiums may be higher. However, to qualify for help with your copays and the donut hole, I am sure those income restrictions are more stringent http://www.ssa.gov/prescriptionhelp/.

[Shaks24]

I think all the different medicare letters and their associated plans confuse the heck out of people.  C is really wacky cause there is Medicare Advantage that is C and there is a C medigap policy too. D is exclusively prescription drugs.