Community Forums

TXiceman · 03-23-2013, 06:44 AM

It is hard to understand some of the drug plan the drugs covered. I was one two drugs that was a combination of two drugs. One was almost $200 for a 90 day supply and the other was a bit over $200 for 90 days. The DR. wrote the prescription for 4 separate drugs and tow were free and the other two were $12.00 each for a 90 day supply. So the drugs went from about $400 for the 90 day supply to $24 for a 90 day supply.

So not I count out 4 pills rather than 2. For $388 I can count to 4.

The problem is the coverage seems to change a bit each year, so yo wind up checking the drugs each years and getting the DR to make some adjustments in your drugs.

Ken

John How · 11-20-2013, 09:40 AM

We're not fulltimers and may never be but we will spend a good amount of time on the road. My wife starts Medicare in Feb 2014, I still have about three years to go. We're trying to decide on a plan for her. We've looked at the couple of advantage plans available in our area and now are trying to figure out the difference between that and using original Medicare with some medigap plans. Anyone care to comment on the difference or advantage/disadvantage to either one. She will definitely need a good part D coverage. I've read somewhere that the ACA will cause some advantage plans premiums to be increased going forward from 2014.
Myself, I'm trying to find a tweeter plan for me but have not made a lot of progress. I was able to set up an account here in California but have not selected a plan yet. Trouble is I have just retired so my income will be drastically reduced for next year and I'm unsure about how much to estimate. Guess it'll all work out but I think this whole exercise could be simpler.

DGBPokes · 11-20-2013, 10:15 AM

We have Medicare A & B, and use AARP United Supplement. plan F. Seems funny to me, that while I worked we had good medical insurance at a low price, with reasonable co-pay. Now that I am retired, my coverage is better than when I worked...with zero deductible and lower costs. Seems backwards to me.

Prescription drugs is a mine field! Every year I do a detail cost/ feasibility study to determine the best way to go. For the last three years it has been significantly cheaper to NOT participate in a formal plan, just buy direct from Canadian on line companies. For 2014', I have a new expensive prescription and it was best for me to sign up ( yes, pay the penalty) and go with Humana/ Wal-Mart. For the DW still better to not sign her up, and stay with Canadian. Using this approach, we save $700 this year on hers, and $1100 on mine.

The trick is getting your doctor to keep you on Tier 1 or Tier 2 meds only. Not always possible, but if you can, t makes a huge difference

paz · 11-20-2013, 10:23 AM

Quote:

Originally Posted by John How

We're not fulltimers and may never be but we will spend a good amount of time on the road. My wife starts Medicare in Feb 2014, I still have about three years to go. We're trying to decide on a plan for her. We've looked at the couple of advantage plans available in our area and now are trying to figure out the difference between that and using original Medicare with some medigap plans. Anyone care to comment on the difference or advantage/disadvantage to either one...

Most Advantage plans are less expensive than Medicare plus a Medigap policy. Many Advantage plans cover more preventative services than regular Medicare and many also include prescription coverage. However, the way I understand it, subsidies for Advantage plans are decreasing so the plans are becoming more expensive.

The down side to many Advantage plans is that they are PPOs or HMOs and are therefore regional. They may cover 80% of costs in-network (near home) but only 70% or less out of network. You can schedule regular appointments and checkups when you're at your stick house, but emergencies may prove to be costly if you get hit with one when you're traveling.

Original Medicare coverage is national and is the same anywhere in the country as long as you go to a doctor or medical facility that accepts Medicare. Medicare pays 80% of the cost of covered services. Various Medigap policies cover variations and combinations of the other 20% of the costs not covered by Medicare.

Original Medicare does not include prescription coverage. A Medicare Part D plan is required for that.

The 3 Bears · 11-20-2013, 10:43 AM

Hi John,
I herd this past weekend that if you are planing to go on Medicare with in the next year to go with the original Medicare and to wait, if possible, for anything else for now until everything settles down around 'Obama Care' for there are a lot of changes coming to Medicare. He also suggested if anyone needs more information to go to a real insurance agent that handles a lot of different polices. Good luck.

CampDaven · 11-20-2013, 10:55 AM

Quote:

Originally Posted by The 3 Bears

Hi John, I herd this past weekend that if you are planing to go on Medicare with in the next year to go with the original Medicare and to wait, if possible, for anything else for now until everything settles down around 'Obama Care' for there are a lot of changes coming to Medicare. He also suggested if anyone needs more information to go to a real insurance agent that handles a lot of different polices. Good luck.

I went on Medicare last month with an Advantage plan for $60 more per month. I will save about 4 times that on meds alone. You do not need to wait.

okmunky · 11-21-2013, 07:37 PM

I decided to stay I WA state because I could sign up with Kaiser-Permanente. It is an HMO, but it has a 5 star Medicare rating. In the first 20 days of coverage I have had a TON of services. What I save on prescriptions alone pays for my high option Advantage plan. One of my medications is not in their fomulary. I could still get it thru K-P, but it's cost would put me into the gap by April. Instead I get it from Canada.

If Congress really wanted to enact affordable medical care they would reign in the US drug companies. This 1 medication cost me less than $3/pill 8 years ago. It is now $7.87/pill!! I take 2/day. I can get them from Canada for $1.93 each or $0.75 each for the generics.

It should be against the law for any company to sell a product to another country for less than they do Americans! And it should be illegal to raise the price on a drug by more than 10%/year or more than 50% total. I'll agree to an adjustment for inflation, but not the highway robbery they are getting away with now.

John How · 11-22-2013, 02:54 PM

What are some of the pharmacy company you guys use in Canada?

okmunky · 11-22-2013, 07:33 PM

Quote:

Originally Posted by John How

What are some of the pharmacy company you guys use in Canada?

Canadian Pharmacy | Canada Pharmacies | Big Mountain Drugs

DGBPokes · 11-22-2013, 07:33 PM

I started with Northwest Pharmacy. After a year or so, had a couple of problems including theft of my credit card number. My brother recommended Cheapo Drugs. Been happy with them. In January they had a price increase, as usual I challenged it. And was told that they had made a major decision for quality reasons to no longer do business with any suppliers from India. They said quality control was not reliable.
I checked some of the other Canadian pharmacies, and they were still getting some drugs from India.
So, pretty impressed that they are concerned enough to make that kind of decision.