Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account

New Posts   Today's Posts

Medicare Part D is nearly worthless.
Since my former company dropped salaried employee medical benefits as of 01 August 2014, I've had to deal with Part D.

It's a gift from Congress to the insurance companies. The doughnut hole (coverage gap) is going to hit me hard in 2015.

If I understand correctly, one reason they dropped us is because the ACA (aka: obamacare) ended their tax deduction for providing retiree care.

Post Reply Post Reply
I hope you review your plan during open enrollment every year from Oct. 15 through Dec. 7. Each year plans and cost changes. If you need help doing that I have a link in my signature for SHIP that is a free service that helps with that and many other Medicare questions.
Your actual drug plan costs will vary depending on:
The drugs you use
The plan you choose
Whether you go to a pharmacy in your plan's network
Whether the drugs you use are on your plan's formulary
Whether you get Extra Help paying your Medicare Part D costs
Look for specific Medicare drug plan costs, and then call the plans you're interested in to get more details.

If you have limited income and resources, your state may help you pay for Part A and/or Part B. You may also qualify for Extra Help to pay for your Medicare prescription drug coverage.
For free Medicare assistance for your state check out this page. http://www.seniorsresourceguide.com/dire...onal/SHIP/
or here http://www.medicareinteractive.org/
Post Reply Post Reply
Thank you Mike1953. I did compare plans for next year. In fact I switched plans after looking at how the 2014 plan moved some of my generics to more costly tiers. (Another racket.) My means fall in the middle where I do not qualify for help; but, the cost of the doughnut hole really bites into my income. I was on Medicare with an Rx plan provided by my former employer; and there was no doughnut hole.

Companies who break their promises, especially those on the government dole, should be flogged in the town square (Their CEO and Board that is.) And, as for Congress: People should be heating up tar and sharpening their pitchforks.

And, the way the Part D plans get to count toward the hole is criminal. It's not their actual cost that gets tallied; it's the MSRP of the drug.
Post Reply Post Reply

I don't really understand the donut hole because it hasn't affected me. I don't know if that is because I am on an advantage plan (doubt that is why as I have to follow medicare guidelines) or not.

What does irritate me is that I have used Patanase, which is now available in a generic form, but, the generic form is only a few dollars less than Patanase. I know that in the past when the "patent" ran out that other forms of the medication came out and it was so much less expensive.

I also think medicare makes a huge mistake not covering some items, i.e., compression stockings and things like A1C testing that can save lives and a lot of money in medical expenses. I don't know about you, but, if you look at your EOB's, you will see that in a lot of instances, the insurance company pays very little to the allowed amount and we are paying the big majority of it through our copay. So, we pay big premiums and pay the copay which pretty much covers the cost of the visit. Yea, I get that if we didn't have insurance that the office visit would be more expensive and we would be responsible for all of it.
Post Reply Post Reply
The costs of generics have skyrocketed. Some of my generics under part D seem to be more expensive than if I just shopped several pharmacies with cash in hand and said, "can you beat XYZ's price?"

Some drugs seem to run on patent longer than others. Lipitor seemed like must have gotten extended. Now the generic price is not much less than name brand.

It is the case that before a patent expires, some pharma companies will license generics while they still hold a patent. The license agreement is advantageous to the patent holder.

I look at all my EOBs. In fact, I just appealed to CMS because they now say I can test my blood sugar only 3 times daily; not 5. So, I will be injecting insulin without measuring first... Medicare can pay for the ER room when I have to have a dextrose infusion. They are saving penny's at the expense of Dollars.Dont-know
Post Reply Post Reply
I know that one of my wife's drugs was generic, but due to federal guidelines they had to change it and voila, now lo longer generic. A lot of folks who were using some of the oxycontin/oxycondon had this happen when they made the pills tamer proof - i.e. can't crush them. New patent, new drug.

I am lucking that all of my maintenance drugs are considered generic and I can get them at great savings using mail order. Takes a little planning on my part (I don't like auto-refill) but usually get them in 3 days from ordering.

One of our cats has a small cell lymphoma and one of his pills ran $12 each ($150 for 12) and he took this one twice a week. Found the joys of compounding vet pharmacies and the cost plummeted to $49 for 24 pills and overnight delivery.

Post Reply Post Reply

Enroll in VA. You can keep all your existing physicians and medicare if you wish and just use VA for what you want. Specifically prescriptions in your case. $8.00 a copy and you're done. No doughnuts. No muss. No fuss.

Or, wait until the doughnut hole closes, which I believe is next year? Unless Congress dumps it? That's part of the ACA too.
Post Reply Post Reply
My two types of insulin run me into the doughnut hole quickly.

They did the same with albuterol inhalers. They used Dichlorodifluoromethane (same thing as R12.)
[Image: 100px-Dichlorodifluoromethane.png]

R12 being banned because of the Chlorine, they now use 1,1,1,2-Tetrafluoroethane (same as R134A) as a propellant.
[Image: 100px-1%2C1%2C1%2C2-Tetrafluoroethane.svg.png]

Different propellant -- new patent!
Post Reply Post Reply
It will be some time before the Doughnut hole shrinks.
[Image: 11493_Page_6.jpg]
Post Reply Post Reply

Possibly Related Threads...
Thread Author Replies Views Last Post
  US Medicare numbers to change from the SSN. justMongo 9 575 04-03-2017, 02:52 PM
Last Post: AlanE
  Medicare Part D quantity limits justMongo 1 441 03-19-2017, 08:32 PM
Last Post: Mosquitobait
Information [News] Medicare unveils far-reaching overhaul of doctors' pay ApneaNews 0 439 10-14-2016, 05:27 PM
Last Post: ApneaNews
  Diabetes Testing under US Medicare justMongo 21 1,508 07-18-2016, 05:33 PM
Last Post: 0rangebear
  US Medicare Medigap Question justMongo 5 722 11-14-2015, 02:49 PM
Last Post: eplantz
  Medicare and B12 me50 12 2,189 07-09-2015, 09:50 AM
Last Post: Mosquitobait
  How do you sue Medicare -- I mean take 'em to the woodshed. justMongo 9 2,135 02-04-2015, 11:55 AM
Last Post: archangle

Forum Jump:

New Posts   Today's Posts

About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.

For any more information, please use our contact form.