Tag Archives: PDP

Thyroid prescription issues

In my daily efforts to assist people in selecting a Part D Drug Plan (PDP), I have many clients who take prescriptions for thyroid issues. It usually comes down to the brand, Synthroid or the generic, Levothyroxine. As the generic has a substantially lower cost than the brand, it is preferred. In many cases, I have clients who fear the consistent quality of the generic. And because of this, they pay substantially more. This causes them to question if they need to pay more.

I came across the article linked below which describes some good strategies to make the generic an easier path. Take a look and see if it helps you.

https://advertiser-tribune.com/news/333873/bones-sometimes-show-up-in-unlikely-places/

Feel free to contact me if you have any questions or need assistance with selecting a Medicare Plan.  I don’t charge any fees nor increase your cost.

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

New 2021 Medicare Costs at a Glance

Happy New Year!  As I do every new year, I wanted to post the key, new Medicare numbers that will be in effect for 2021.   These are the key changes to Medicare’s premiums and coverages.

  • Part A deductible – Will be $1484 up from $1408 (per 60 day Benefit Stay)
  • Part B Deductible – Will be $203 up from $198 (Annual deductible)
  • Part B Premium – Will be $148.50 up from $144.60
  • Part D Maximum Deductible – Will be $445 up from $435 (Some plans don’t have a deductible and most have a “hybrid” deductible.)
  • Part D Premium National Average – Will be $33.06 up from $32.74 (Is used to determine Part D Penalty)

Feel free to contact me if you have any questions or need assistance with selecting a Medicare Plan.  I don’t charge any fees nor increase your cost.

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

New 2020 Medicare Costs At A Glance

New 2020 Medicare Costs at a Glance

Happy New Year!  As I do every new year, I wanted to post the key, new Medicare numbers that will be in effect for 2020.   These are the key changes to Medicare’s premiums and coverages.  A highlight is the average costs for Part D drug plans have gone done and the infamous “Donut Hole” (aka Coverage Gap) name no longer applies as costs for people who do reach this stage now only pay 25% of the cost for Brand or Generic drugs.

  • Part A deductible – Will be $1408 up from $1364 (per 60 day Benefit Stay)
  • Part B Deductible – Will be $198 up from $185 (Annual deductible)
  • Part B Premium – Will be $144.60 up from $135.50 (Excluding Irmaa)
  • Part D Maximum Deductible – Will be $435 up from $415 (Some plans don’t have a deductible)
  • Part D Premium National Average – Will be $32.74 DOWN from $33.19 (Is used to determine Part D Penalty)

Feel free to contact me if you have any questions or need assistance with selecting a Medicare Plan.  I don’t charge any fees nor increase your cost.

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

Why Step Therapy When You Have Already Proven Need?

Many times in meetings with my Medicare clients, they are concerned about having to go through Step Therapy again if they change plans.  I usually then give a quick reminder of the beneficial reasons for Step Therapy that will lower costs for all involved, including my client.

A recent article by Dr. Harry Gewanter went deeper into the pros and cons of Step Therapy.  The good news is generally about 80% of people who have already gone through Step Therapy are able to avoid having to repeat Step Therapy with the help of their doctor.  The other 20% of the time is still a problem which is getting more attention.  The 2018 Virginia General Assembly will hopefully be addressing this next year.  A link to Mr. Gewanter’s article follows:

http://www.richmond.com/harry-l-gewanter-let-doctors-and-patients-decide-the-best/article_7f629382-6fca-5c13-be68-76765afe4af5.html

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

National Check Your Meds Day and AEP

A pharmacy trade group association has declared Oct. 21st, National Check Your Meds Day.  I think this is a great idea especially with Medicare’s Annual Election Period (AEP) right around the corner beginning Oct. 15th and ending Dec. 7th each year.

Many people and especially seniors, take a large number of medications.  While many are needed, many are not needed as they are duplicates doing double duty with other medications that do the same thing.  The worst case scenario is some of the medications can be lethal when taken with other medications.  You would think this can’t happen because the doctor should know better.  Unfortunately, many times the doctor does not know what else someone is taking.  Some people have several doctors treating different medical conditions and not aware of other prescriptions.

So, everyone that is taking more than several medications should take advantage of this special day to proactively have them all checked.  It is as simple as taking all of your prescriptions (the actual bottles) to your pharmacy for a review.  They can tell you if there are any potential problems and perhaps check with your doctor about any issues raised.

This is good timing because you should also check your Medicare Part D drug plan for any changes.  Your Annual Notice of Change booklet from your Drug plan will alert you to the plan changes effective the coming Jan. 1st.  Also, your prescriptions could have changed and worth taking a look at your options.

This is what I do for clients day in and day out.   Let me know if I can answer any questions.  David Higgs

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

Medicare Part D Drug Plan Premiums Lower for 2018!

Here is something you don’t see very often.  CMS who oversees Medicare has projected that the average Medicare Part D Drug Plan premium is expected to decrease in 2018!  Based upon the bids by insurers for their 2018 Drug Plans, the national average premium is about $1.20 less than 2017 national average of $34.70.

This is in spite of the fact that Medicare Drug costs are rising faster than other Medicare costs primarily due to high-cost specialty drugs.  So, while this is  not a lot, it is a change in the trajectory which is good.

You can read more about it at the article linked here:  https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2017-Press-releases-items/2017-08-02-3.html

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

Causes of Drug Price Increases and What Can You Do About it?

We are all affected by drug price increases.  There are many reasons for this phenomenon but several factors have been more significant.  While we all want to know why this is happening, we also want to know what can we do.

As noted before, this issue arises a lot with my Medicare clients.  So, what can my clients do about it?  I have blogged before about some easy things to do such as:  ask your doctor for samples, shop around different pharmacies, ask for generics, etc.  I find the biggest thing to do is to compare your plan options.  If you are on a stand-alone Part D drug plan, you should shop each year.  If you are on a Medicare Advantage plan, you will need to consider both Plan medical benefits and drug copay costs.   Of course, I help my clients each year with these comparisons.  It usually starts with keeping drug lists current in Medicare’s comparison site where I can then help decipher the options including all costs (premium, deductible and copays).

A recent article goes into more detail on causes of increases. A link to that article follows:  http://khn.org/news/candidates-decry-high-drug-prices-but-they-have-few-options-for-voters/

The main takeaway for me was, people need a good Independent Agent who specializes in Medicare.  If you have questions about Medicare, call me, with no cost or obligation.  This is what I do and enjoy it.

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

News Update on Mergers (Aetna/Humana & Anthem/Cigna)

Lately, there has been a lot of attention in the news to the pending mergers between Aetna and Humana as well as Anthem and Cigna.  The latest news is about the federal suits to stop the mergers.  The main thing I want my clients to know is that with or without the mergers, their Medicare Plan will remain in place.  This will mainly pertain to Medicare Advantage Plans and Part D drug plans.  If there are going to be changes, they will occur at the Annual Election Period (AEP) where they can make a change if needed.  In addition, if the merger(s) proceed, it will be years not months.  As usual, I will help my clients with this.

Feel free to call me with any questions as this process continues.  David.

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

Medicare Beneficiaries Should Get in the Habit of Asking

Another constant reminder I recommend all my Medicare clients do is to always ask about prescription alternatives.   A recent study showed that doctors are easily influenced by drug company reps in what they should prescribe.  In many cases, these prescriptions are for costly Brand name drugs in which there is a lower cost alternative.  The study found that in many cases, a $12 complimentary meal to the doctor could end up costing patients hundreds of dollars more than the cost of a suitable equivalent.  I am not against the free market and how a company chooses to promote its products, but I want my clients to be aware of their choices.  If you want to read more about this study, you can click on the following link:  http://well.blogs.nytimes.com/2016/06/20/drug-company-lunches-have-big-payoffs/?_r=0

So, my recommendation to my clients anytime their doctor prescribes something, is to always ask the doctor if there is a generic or lower cost drug available, do they have any samples they can provide and if the drug is totally necessary.

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

Medicare Patients are the Customers!

I am always reminding my clients, especially my Part C Medicare Advantage clients, that they are the Customer.  They can and should ask how and where they can lower their medical costs.  If a doctor prescribes a test, they should ask why it is needed and more importantly, where can they get that test done that will cost them the least based upon the specific Plan they have.  Most of us are not accustomed to asking our doctors these types of questions.  We think “they are the doctor, they should know best.”  In many cases they don’t have any idea of the variances in costs for certain medical tests.  Costs vary widely based upon where a test is administered and which Plan a patient has.

This is less of an issue for my Medicare Supplement clients; however, this concept of asking, also applies to prescriptions.  As almost everyone has a Prescription plan (whether it is a stand-alone Part D drug plan or it is embedded in a Medicare Advantage Plan), there are many variables to lowering drug costs.  Here too, ask for lower cost alternatives such as Generics and shop around at different pharmacies.  A recent article describing proof that both doctors and patients are missing opportunities to lower costs is linked below:

http://khn.org/news/by-not-discussing-cost-issues-doctors-patients-may-miss-chances-to-lower-out-of-pocket-expenses/

The bottom line is Medicare Beneficiaries should get in the habit of asking questions regarding how, where and when they can save money when something is prescribed.  I do it and I recommend my Medicare clients do it.

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com