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Just filled my first prescription under the new Medicare part d auto enrollment, thought I’d give this a chance, despite having to leave my trusted long term pharmacy. However, what had been costing me $28 a month for this particular prescription under the old program is now $60 under part D. So I’m headed for opting out.
What do you mean heading to opt out? Have the pharmacy price it with Good Rx. It may be cheaper
What do you mean heading to opt out? Have the pharmacy price it with Good Rx. It may be cheaper
It's an optional conversion of the prescription benefit of the FEHB health insurance, thus it can be opted out into the standard prescription benefit of the plan.
What do you mean heading to opt out? Have the pharmacy price it with Good Rx. It may be cheaper
Far as I know, Good Rx is a stand alone drug discount program, it doesn't work with a user's prescription drug program. As least with our drug plan I've never seen a price for any med I've checked that was cheaper with a Good Rx coupon than it was with our prescription drug program copay. That goes for both the generic and the more expensive brand name drugs. I suspect at least for the FEHB insurance plans drug coverage, this may also be true, though others'experience may vary.
The issue here was one of federal retirees currently covered under private prescription drug plans ( in our case the federal employees Blue Cross Blue Shield plan as a secondary to Medicare) being pushed into a Medicare Part D drug plan to replace the private plan. On the surface the plans don't seem that different, and it may be that some people may benefit from the new Medicare drug plans, in particular those who get a lot of expensive drugs, as these offer an out of pocket maximum of $2000/year which is not offered by the traditional BC drug plan ( for example).
The opt out option was to remain in the insurance company's current drug plan. My rationale to opt out and remain in the Blue Cross plan was that I don't particularly care for the federal policies that base the premiums of their Part D plans on a subscriber's income, ie, over a certain level, they pay more for the same coverage ( though we are not in that higher income category), and also the penalty attached to premiums for not enrolling in the Part D plan the second one becomes eligible.
And the biggie- which does affect me. Medicare Part D, as well as Medicaid, and other government sponsored programs do not permit the use of manufacturer's coupons, or many other coupons for their subscribers to bring down the cost of expensive brand name drugs. But we could use those coupons with our private drug plan under BlueCross. It seems the pharmacy I use ( probably many other pharmacies as well) has recently been limited in the amount of Eliquis they can dispense to each customer, it is now limited to a 30 day supply. I should have done this before, but I checked out the manufacturer's ( Bristol Meyers Squibb) website and found the offer I know they've had for a number of years for a coupon that will allow the customer to purchase a 30 day supply of Eliquis for $10, lots less than the $100 copay I was paying. The catch for this coupon was that it requires the person to have drug coverage, and not be enrolled in one of the Medicare or other government programs. I signed up, got the card, and gave the information to the pharmacy when I requested an Eliquis refill. So now, I will get my 30 day Eliquis refillsfor $10. Had I stayed in the MDPD drug plan we were transferred to, instead of opting out and remaining in the BC commercial drug plan, I would not have been eligible for that discount card.
I gave BCBS’s new perscription plan a chance just to see if by chance my costs would either be the same or cost me more. So I have paid an extra $120 this month compared to $55 last December. So I am Opting out asap, BCBS is probably getting a pretty good kickback from Medicare for this initiative, I am not amused !
I gave BCBS’s new perscription plan a chance just to see if by chance my costs would either be the same or cost me more. So I have paid an extra $120 this month compared to $55 last December. So I am Opting out asap, BCBS is probably getting a pretty good kickback from Medicare for this initiative, I am not amused !
I believe OldRetiredFed (think that's his name) did not opt to pay for Medicare Part B so he is just running bare naked with just his BCBS.
They are messing with my most expensive med. Sent me a generic even though my prescription is Dispense As Written.
I gave BCBS’s new perscription plan a chance just to see if by chance my costs would either be the same or cost me more. So I have paid an extra $120 this month compared to $55 last December. So I am Opting out asap, BCBS is probably getting a pretty good kickback from Medicare for this initiative, I am not amused !
I'm certain our medication costs would have been higher had we not opted out of the BC MDPD ( new Medicare plan). I have to breathe a sigh of relief every time I think about it.
I'm certain our medication costs would have been higher had we not opted out of the BC MDPD ( new Medicare plan). I have to breathe a sigh of relief every time I think about it.
This little wrinkle buried in the BC MDPD just snagged me the other day. I received all the advance literature about BC/BS's newfangled retiree drug plan and had been dithering over opting out. I didn't act, so ended up being auto-enrolled.
Take this as a cautionary tale and FWIW.
I only take two prescriptions but will probably always take them. One is an inexpensive generic. Co-pay under this or that insurance plan doesn't make much difference. However, I failed to double check the co-pay for Eliquis (I now take an anti-coagulant because of the arrhythmia SVT). It isn't inexpensive. Without insurance, the average retail cost for a 30 day supply of Eliquis is about $700. I've been applying a manufacturer co-pay card to re-fills ever since my cardiologist's practice first provided it to me 4 years ago. It reduced the co-pay very, very well. With one important caveat. The card cannot be used in conjunction with any "government" health insurance programs such as Medicare or Medicaid.
The previous BC/BS health plan I had while employed and transitioned to be my supplemental coverage after enrolling in Medicare was considered "commercial". The Eliquis co-pay card was applicable. BC/BS's new drug plan is essentially a Medicare Part D plan. That means it now identifies as governmental, not commercial coverage. By not opting out of the new drug plan, the co-pay card cannot be used. My co-pay for a 90 day supply of Eliquis shot up from about $35 to over $200! Actually, the co-pay for the cheaper med went up too!
So, I am now in the process of opting out of BC/BS's newfangled retiree drug plan based on the two meds I now take. No one can predict what if any other meds they might need to use in future or what if any benefit staying enrolled might provide. You can only make decisions based on what you know. One other feature of the new drug plan is that you can opt in or out once per calendar year.
I have to admit the BC/BS drug plan phone rep was well informed about this problem, understanding, and quite easy to work with. Obviously, BC/BS is getting a lot of push back from retirees who are finding the "new" plan isn't such a great deal after all.
Last edited by Parnassia; 03-16-2024 at 02:21 PM..
This little wrinkle buried in the BC MDPD just snagged me the other day. I received all the advance literature about BC/BS's newfangled retiree drug plan and had been dithering over opting out. I didn't act, so ended up being auto-enrolled.
Take this as a cautionary tale and FWIW.
I only take two prescriptions but will probably always take them. One is an inexpensive generic. Co-pay under this or that insurance plan doesn't make much difference. However, I failed to double check the co-pay for Eliquis (I now take an anti-coagulant because of the arrhythmia SVT). It isn't inexpensive. Without insurance, the average retail cost for a 30 day supply of Eliquis is about $700. I've been applying a manufacturer co-pay card to re-fills ever since my cardiologist's practice first provided it to me 4 years ago. It reduced the co-pay very, very well. With one important caveat. The card cannot be used in conjunction with any "government" health insurance programs such as Medicare or Medicaid.
The previous BC/BS health plan I had while employed and transitioned to be my supplemental coverage after enrolling in Medicare was considered "commercial". The Eliquis co-pay card was applicable. BC/BS's new drug plan is essentially a Medicare Part D plan. That means it now identifies as governmental, not commercial coverage. By not opting out of the new drug plan, the co-pay card cannot be used. My co-pay for a 90 day supply of Eliquis shot up from about $35 to over $200! Actually, the co-pay for the cheaper med went up too!
So, I am now in the process of opting out of BC/BS's newfangled retiree drug plan based on the two meds I now take. No one can predict what if any other meds they might need to use in future or what if any benefit staying enrolled might provide. You can only make decisions based on what you know. One other feature of the new drug plan is that you can opt in or out once per calendar year.
I have to admit the BC/BS drug plan phone rep was well informed about this problem, understanding, and quite easy to work with. Obviously, BC/BS is getting a lot of push back from retirees who are finding the "new" plan isn't such a great deal after all.
I agree about opting out of the new drug plan in BCBS.
I wanted to ask you your decision point on signing up for Medicare versus just riding into the sunset with BCBS (as Old Fed has)???
It just seems to me as though BC/Medicare were trying to get as many federal retiree BC subscribers into the new "improved" medicare part D plan ( MDPD) as they possibly could. Not only did a choice of staying with the current BC plan require getting through the BC/Medicare quagmire to "opt out" of the new plan, both the written information, ie, letters and brochures mailed to subscribers, and the information posted on the federal employee ( retirees) BC website describe the new MDPD plan in the most glowing terms, listing the advantages of the plan such as saving money on brand name prescriptions, increased numbers of pharmacies available within the network, an annual out of pocket spending limit, and being able to get specialty drugs from in network retail pharmacies. Maybe I missed it somewhere, but I looked through all the information on the topic on their website, and didn't see anything but the upsides of the new drug plan. They were obviously not hiding the fact that it was a Medicare Part D plan ( exclusively for BC federal retirees, no additional cost, they trumpeted), but I saw nothing there about the downsides of such plans. That would be things like the " not having continual credible coverage" penalty, or the premium amounts added for subscribers making over a certain income, which add to the cost of the MDPD premium for some people. That information was sent to subscribers once they were enrolled in the new plan.
And while BC continues to pay the premiums for the MDPD program, it would seem that those who might pay the extra amounts in their premiums, they, not BC, are on the hook for that. I'd have to find the source I read again, but it stated that those extra amounts are paid by the individual, not an employee or other entity as part of the premium. The source stated that these are either billed directly to the subscriber, or may be deducted from the subscriber's monthly SS income.
And I guess a number of us are now in the process of finding out about other downsides of the new improved MDPD.
It just seems to me as though BC/Medicare were trying to get as many federal retiree BC subscribers into the new "improved" medicare part D plan ( MDPD) as they possibly could. Not only did a choice of staying with the current BC plan require getting through the BC/Medicare quagmire to "opt out" of the new plan, both the written information, ie, letters and brochures mailed to subscribers, and the information posted on the federal employee ( retirees) BC website describe the new MDPD plan in the most glowing terms, listing the advantages of the plan such as saving money on brand name prescriptions, increased numbers of pharmacies available within the network, an annual out of pocket spending limit, and being able to get specialty drugs from in network retail pharmacies. Maybe I missed it somewhere, but I looked through all the information on the topic on their website, and didn't see anything but the upsides of the new drug plan. They were obviously not hiding the fact that it was a Medicare Part D plan ( exclusively for BC federal retirees, no additional cost, they trumpeted), but I saw nothing there about the downsides of such plans. That would be things like the " not having continual credible coverage" penalty, or the premium amounts added for subscribers making over a certain income, which add to the cost of the MDPD premium for some people. That information was sent to subscribers once they were enrolled in the new plan.
And while BC continues to pay the premiums for the MDPD program, it would seem that those who might pay the extra amounts in their premiums, they, not BC, are on the hook for that. I'd have to find the source I read again, but it stated that those extra amounts are paid by the individual, not an employee or other entity as part of the premium. The source stated that these are either billed directly to the subscriber, or may be deducted from the subscriber's monthly SS income.
And I guess a number of us are now in the process of finding out about other downsides of the new improved MDPD.
I suspect part of the problem is a matter of scale. There may be "advantages" to a group as a whole, but those "advantages" tend to dissipate at the individual level...for some individuals. Kind of like statistics. They can be informative about a group, but they don't tend to apply very well to any single member of that group.
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Opting out of MDPD
