Medicare stand alone drug plan

Was wondering if anyone from the U.S. who has regular medicare with a  stand alone drug plan.  What plan you have that covers any anticoagulant, incase i need in the future.  The plan i have now(Silver Script,Atena) does not cover any.   Does not even cover the antibiotic, i need to take because of my shoulder replacement for teeth cleaning.

  thanks

new to pace


5 Comments

Medicare Part-D

by AgentX86 - 2021-10-21 15:55:58

I assume you're talking about Part-D coverage (since it's stand-alone).  Yes, I believe they all cover anticoagulants, to some degree.  Some are pretty poor and NOACs are damn expensive.

I'm new to this (will retire in four weeks ;-) but I've been studying Medicare, as much as any mere mortal who is not a government bureaucrat, can.

If you go to the medicare.gov site, you can shop for part-D insurance.  You enter your zip code and county if zip codes span county lines, all the drugs you take, and five (I think) convenient pharmacies. It will return the cheapest policies and the costs at your chosen pharmacies.

Shock: I found that Walmart, Costo and Sam's weren't the cheapest - by far. Weird.  Mail order, though their chosen company, is often the most expensive. Really weird.  You might try playing with different pharmacies (they don't make this easy) to see which is the best.

Eliquis costs something like $550/mo retail but it's more like $100 for the medicare policy I was quoted ~$100.  It's way morevcomplicated than this but that's sorta what it averages out to over a year, for me.  I have four other drugs that are similarly expensive if bought with cash but they're more like $20-$30 average with Part-D insurance.

The bottom line is shop for insurance.  Don't go with what you had last year.  It's probably not the best this year. Medicare makes it fairly easy to find the best policy but makes what's under the covers as opaque to all but the best forensic CPAs (it's not quite that bad).

Medicare Part D Plans

by Marybird - 2021-10-21 16:14:08

I'm not really that familiar with Part D Medicare plans ( we have our prescription drug coverage through our secondary FEPB- hubby is a federal retiree), but I'd be surprised to learn that they don't all cover the anticoagulants that sooooooooo  many retirees take. And I always assumed ( maybe wrongly), that Medicare Advantage plans (Part C) included drug coverage, is it possible that in some part C plans these are limited ( as in don't include too many drugs) and the subscriber has to get a separate Part D plan for coverage?

In any case, New to Pace, just for the heck of it I looked up available drug plans under the Aetna Silver Script Medicare plans in your county ( Sarasota- you are just north of me) and saw that they had three prescription drug plans listed:

These were: 1)Smart Rx (PDP), 2) Silver Script Plus (PDP) and 3) Silver Script Choice (PDP). I looked in the formularies for each for 2021, and see that they all cover the anticoagulants Eliquis, Xarelto, warfarin, some antiplatelet drugs ( Clopidigrel, etc) and heparins. These were listed as Tier 3, with the exeption of Eliquis in the Smart RX plan, which was Tier 4. I've posted the links to each plan below, so you can look them up if you want.

https://www.aetnamedicare.com/documents/individual/2021/formularies/FORM_2021_SMARTRX_EN.pdf

https://www.aetnamedicare.com/documents/individual/2021/formularies/FORM_2021_PLUS_EN.pdf

https://www.aetnamedicare.com/documents/individual/2021/formularies/FORM_2021_CHOICE_EN.pdf

 

drug covererage

by new to pace.... - 2021-10-21 16:34:13

Thanks, Marybird will check them out.

new to pace

Medicare drug plan

by islandgirl - 2021-10-24 18:38:50

I start Medicare Nov 1 and you should start working on it 3 months before the month you turn 65.  I take xarelto and it's going to continue to be very expensive--no generics.  I have worked with a company called Boomer Benefits, as several of my friends are very happy with the company.  They also confirmed the supplement I was looking at was by far the best for me. I gave them a list of the prescriptions I take and the dosages, and they came up with Wellcare Value Script Plan (I'm in Florida).  The manufacturer for xarelto also has a discount program for Medicare recipients--that will at least help with the cost for several months.  You can easily change your drug plans annually and it follows a calendar year.  I made sure I had all of my prescriptions filled to get me through the end of the year, as I have met my out of pocket and deductibles with my healthcare.gov plan.  

stand alone medicare drug plan

by new to pace.... - 2021-10-24 19:29:59

thanks Island girl.  Once i was old enough for medicare always had the lowest premium cost  for a drug plan as do not take any drugs. Would change the plan when the premium would go up..

  When i put in my zip code on the Medicare website for drug plans, always would come up Silver Script and their 3 plans. Suspecting now since that is my current plan.

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