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Medicare Part D cost comparisons

October 20th, 2024 at 02:13 pm

So, wow.

On my to-do list was double-checking that my current Part D drug plan, Wellcare, was still a good choice for me in 2025 given that I learned Wellcare will no longer work with Boomer Benefits, the insurance agency that helped me sign up for Medicare.

The huge advantage that Boomer Benefits offers (you can find their very active Facebook page) is that unlike most any other agency, they readily intercede on your behalf should you have a billing issue or some other matter that requires contacting the insurer. I felt this was such a valuable benefit that I decided to enroll in a traditional Medicare plan that was slightly higher cost than the lowest cost plan, solely because the lowest cost plan one did not work with Boomer Benefits.

So since I had to go on the Medicare site to pay my quarterly premium (which comes out to $174 a month, or $525 a quarter), I checked Part D/prescription drug plans for 2025. Turns out my current (Wellcare) drug provider is the cheapest plan based on monthly premium costs + deductible. This year, my monthly premium has been .50; next year, it will be $12.40.

What also makes a big difference, aside from which pIan/provider you choose, is what pharmacy you fill your prescriptions at. I do take one generic drug intermittently on as as-needed basis, which so far has been every other month, and lately I've been relying on Stop  & Shop Pharmacy. Based on that rate of frequency, I will never reach the point of paying the $590 annual deductible in full, BUT IF I DID, then CVS or Walgreens would be cheaper than Stop & Shop.

Just by way of example, my lowest annual cost for this one generic drug (on my current plan) is $172, but the same drug/dosage cost $532 on a different plan. Not to mention a big difference in prices between a "Preferred" pharmacy and an "In Network" pharmacy. In the past I never bothered comparing prices between pharmacies. It just seemed like too much of a hassle, but now, with Medicare's convenient pricing tool, you can compare drug costs at up to 5 different pharmacies in your area quite easily.

So it's really important EACH YEAR during open enrollment time to review whatever meds you're on and compare costs on the Medicare site. This is something I wasn't accustomed to doing when I was on either Obamacare or a private employer-sponsored plan where you had no such choices. So I'm beginning to appreciate what Medicare can do for me. It's easy enough to do, though if someone had multiple medications, I can see how things could become more complex.

I've also never tried using my yellow RX card, so maybe next time I have to fill a prescription, I will first try using it to compare costs.

 

 

5 Responses to “Medicare Part D cost comparisons”

  1. Dido Says:
    1729462666

    Good for you for reviewing!

    Where did you find the information about the pharmacy making a difference? Is that available on the Medicare site as well? That isn't something that I've heard before; good to know.

    While reviewing your Part D formulary is important every year, it matters even more this year because there are a lot of changes due to the Inflation Reduction Act that are leading plans to reduce the number of drugs on their formularies and increase their premiums. But in return, the cap out out-of-pocket costs for Part D is now $2,000 and the infamous "donut hole" is history.

    If you do use that yellow Rx card or Good Rx or similar (or buy drugs from Canada), then the money you spend won't count towards your out-of-pocket costs. I suspect you know this, but perhaps not everyone who reads this discussion will.

  2. patientsaver Says:
    1729466137

    Hi, Dido.

    Yes, you can do pharmacy comparisons for the same drug on the Medicare site. They have made it super easy. You can compare up to 5 different pharmacies; I wish you could do more as I would be willing to travel to a pharmacy outside of town if it was a significant savings. (I don't actually know if 2 different locations of the same pharmacy might have different prices....I wouldn't think so, but I should check that.)

    That's a good reminder that the Good RX card or similar cards won't count toward deductible. (I think that's what you meant?) No, I hadn't really known that, but it makes sense I suppose.

  3. Dido Says:
    1729545242

    Yes, that's what I meant. It won't count towards the deductible, NOR will it count towards your Out-of-Pocket Maximum for Medicare. GoodRx and its ilk are going outside of the Medicare system so they can't be used to satisfy anything for the Medicare system.

    Medicare is your insurance. GoodRx etc are used INSTEAD of your insurance https://www.goodrx.com/insurance-and-goodrx

  4. Dido Says:
    1729545391

    See the link above--it's out-of-network coverage and your insurer has the right to determine whether they will count it towards your deductible or OOP-Max. It's possible but I wouldn't count on it.

  5. rob62521 Says:
    1730061850

    Good for you for doing your homework!

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