Part D Drug Plans Suck!

I HATE MEDICARE PART D DRUG PLANS!!  I have said this before, but it is even more true today.  

What a stupid, confusing, inefficient program!

Now is the time (October 15 – December 7) to review your drug coverage if you have a “stand-alone” Part D plan.  That’s because your plan may change for 2020 – a little or A LOT.

NOTE: This does not usually apply to people with a Medicare Advantage plan.

I don’t usually name names, but I must do so this year.

The Humana Walmart Part D plan that has a $26.30 premium in 2019 will cost $55.30 next year.  I’m pretty sure Humana has millions of people enrolled in this plan – and I have over 50 clients in it.

I have been in contact with most of my clients and asked them to give me a list of their medications so I can run them through the Medicare.gov Plan Finder

I have spent the last two weeks finding plans that will give my clients the lowest cost for their meds.  In some cases, the new Humana Walmart plan will work for a client.

But quite a few people have more prescriptions now than they did a few years ago and I am telling them to enroll into another plan.  If I don’t represent that plan, I give them instructions on how to enroll into a different Part D drug plan.

MY QUESTIONS FOR OUR FEARLESS LEADERS ARE:

  • Why are there 31 Part D drug plans to choose from?  Who needs that many choices?
  • Why are Part D plans allowed to double their premiums from one year to the next?
  • Why can plans treat generics drugs like brand drugs? That means higher prices for the consumer.
  • How is it that 31 drug plans can “negotiate” prices better than Medicare?
  • Why not have one plan (or maybe 2) so people don’t have to review this every year?

The truth is that 85% of people do not look at their Part D drug plan each year, and many are paying $50 – $80 for their Part D plan when they take only generics.  They should be in a plan with a $13 premium.

I am finding some shocking prices for drugs that people need to stay alive or be able to function like a normal human being.

One client takes Viberzi, which costs $1,500 per month.   No Part D drug plan covers this drug in 2020, but my client needs it to control her gastro intestinal problems.  It’s the only drug that allows her to leave her house. She will have to ask for a “formulary exception”, but I don’t know what she will have to pay for this drug.

Another client takes Afinitor and it costs….. $17,500 per month.  He has spent over $15,000 this year on this chemotherapy drug.

And then there is Enbrel.  There are lots of commercials on TV for Enbrel, but it is costs over $5,000 per month.  The good news is that a Part D drug plan will cover most of the $60,000 annual cost.   The bad news is that people who take this drug must pay about $5,000 out of their own pocket.

The distressing news for each of these expensive drugs is that people on Medicare do not qualify for the Patient Assistance Program that provides help paying these outrageous costs.

I feel so bad for my clients who are hit with huge costs for their medications.  One woman told me she can’t afford to continue to take Enbrel when she gets on Medicare.

It’s sad to learn that folks who were healthy the last time I spoke with them now have serious medical problems.  And their problems are compounded by trying to figure out how they can pay for their medications.

What a stupid, terrible system! 

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One Response to "Part D Drug Plans Suck!"

  1. Scott Whitehead says:

    This paragraph got my attention:

    And then there is Enbrel. There are lots of commercials on TV for Enbrel, but it is costs over $5,000 per month. The good news is that a Part D drug plan will cover most of the $60,000 annual cost. The bad news is that people who take this drug must pay about $5,000 out of their own pocket

    because I am 66, still on my employer’s health plan and take Enbrel. Retirement could be forced on me at any time so I am VERY concerned about this.

    Which plan are you referring to when you say ” a Part D drug plan will cover most of the $60,000″ ?

    By the way, I am in Texas, not Arizona, but I keep your site in my browser to read new articles when they come out

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