Medicare is a basket of elements

Medicare Part ‘D’ Drugs! (You’ll love this)

We’re finished with part one of this blog. It focused on some truths about Social Security and Medicare. This blog concentrates on the drug plan part of Medicare, otherwise known as Medicare Part ‘D’. It warrants some scrutiny all on its own, as you’ll soon see.

Now, for the drug plan story, Yeah, we’re not done yet! And it only gets worse. The prescription drug service is required and once again it costs money, every month. The Medicare website, has a useful part on their site devoted to helping you pick the best drug plan choice for your needs. It’s called the ‘formulary.’ You list the meds you take and the formulary lists the best choices for you. These choices consist of the plan, which is administered by a medical insurance company like Cigna or Well Care.

You Pay A Monthly Fee!

You pay them a monthly fee as well as an annual deductible for your drugs. The other part of the drug program is choosing the pharmacy from the list of providers from whatever plan you pick. This is a two part gig, the plan provider as well as the drug provider (Pharmacy.) You go through this routine every fall. It’s in your best interest to spend a little time with this. You have plenty of time to choose from the day it becomes live on the website until the drop dead date in December.

You Can Change Plans Annually

This year we once again changed plans but were lucky enough to be able to stick with our pharmacy as it was on the plan list of preferred providers. You don’t have to go to a preferred provider but it will cost you more money if you don’t.

This becomes important depending on which pills you must take. My dear wife takes very few meds. Her annual bill is small. I, on the other hand, take many more meds. It takes over 50 pills a week to keep me going. Not a laughing matter. She spends a lot of time studying which plan is the best for us. We do not always use the same plan either.

Three Quirky Things To Know

There are three quirky things that go along with the part D prescription program. Quirk one is called ‘The Doughnut Hole.’ Don’t ask me why, I don’t know the government wisdom behind this doughnut hole thing. It wouldn’t surprise me if there wasn’t one. The government is here to help, after all, right??

The Doughnut Hole

The doughnut hole rule works like this; Your great drug price is only until you hit a certain amount (for me it’s $4600. This reflects the amount I have paid out of pocket, as well as what my insurance provider paid.) Then you are in that insidious doughnut hole and your drug costs accelerate. And no, no, they do not all go up the same percentage. Name brand drugs are much more costly than generic drugs. The doughnut hole period lasts until you spend a whole lot out of pocket, then, you go back to a lower price. I don’t know what that is because I have never gotten there. I usually end up in the D.hole around July through the end of the year. Then we start all over again and pay another deductible before we get cheap drug prices.

The Second Quirky Thing

Now, here’s the second quirky thing about this drug stuff. Say sometime during the ensuing year you go to the doctor and are prescribed a new drug that you simply must take. Hold on to your hat! It may not be on your plan. If it’s not, you’re on your own. It may be on your plan, but more expensive than it could have been with another plan. That’s just tough cow pies for you. You have to suck it up until the next year at plan selection time. You can’t change in the middle of the year.

And The Third Quirky Thing

And, the third quirky thing about drugs, the prices vary from time to time throughout the year. Has nothing to do with the doughnut hole. They don’t always go up either. You can’t count on the prices. It plays hell with the old budget, I can tell you that. You do have a budget, right??

Three More Things

Before I end, I have three more things about all this. The first thing is all the drugs fall into groups called tiers. The expensive designer drugs are in the most expensive tiers. Those are often things like cutting edge heart meds and cancer meds. Bottom line, you pay more for them. Yeah, the one you cannot live without. There are some in such a low tier that they are actually free. My wife has a couple of those.

The Second Of Three

The second of this group of three things is, that generic drugs do not always work. My wife takes a thyroid med. She has tried the generic. It had no positive effect on her. When she went to the name brand, it made a world of difference. Generics are not the same as the name brand. If they work for you, good enough, if not, it’s more important that you be well. Spend the money. You owe it to your family.

Third And Finally!

Third and finally, I promise, sorta; some drugs only come in the name brand. The drug companies hold patents on new drugs. They last quite a while. You’re stuck. I take a heart med that only comes in the name brand. This has its own quirk to it. I take 2.5 mg twice a day. By mistake, I got a script for 5.0 one time. The pharmacist told me I could split them in half with no problem. I bought a $4.00 pill splitter. Now, why would I do that? The price was the same, exactly the same, no kidding. My heart doc admitted that a lot of his patients split them. He could have told me years ago! He should have. I save about $912 a year now.

Number Last!

And now number last. Some pharmacies count down until your next refill from the date they fill the order, not the date you pick it up. It’s important that you get into the habit of picking your meds up ASAP so you don’t run out. A few days late here and there will accumulate. You will regret it. Since I am a punctual person, I have no idea how to help you with this problem if you have it.

How I Organize This Mess

So, how do I keep all this stuff straight? I have a spreadsheet. Actually, I have many spreadsheets. It is almost like keeping a diary. I have one with columns for the drug name, the dosage and frequency, the quantity purchased, the last date purchased, the next due date, and the prices each time they are purchased. Also, I check it a couple of times a month, less I forget. It can happen!

Spreadsheets And Evernote

I have different spreadsheets with the price and purchase frequency of gasoline for the car. There’s one for doctor appointments too. You get the picture. I have an app that syncs my computer and phone. It’s called Evernote and is my fav. price too, free. You can’t beat that. My spreadsheets are kept in Evernote. I have seriously declining memory issues from a health event in 2019. This is my way of compensating. There are other age related issues that I’m cursed with, but I’m not dumb. adjust we must. I no longer need to remember to forget. Getting old isn’t for sissies!

In Case You Missed It!

In case you missed it, part one of this article covers more about both Social Security bennies and the basics of Medicare. You can find it here.