So...on a Medicare Advantage Program....but cannot see the doctors at the UCSD Cancer Ctr and have lost confidence with the limited doctors in my plan...so have to switch to regular Medicare coverage to go see whoever accepts Medicare. Since I have APC...and it is 24 months after signing up...I can not buy a Medicare Supplemental Plan to help pay the 20% coverage I now have to pay. I now need to buy a Medicare Part D Drug coverage. I had RP 14 months ago, on Firmagon (Part B coverage), and getting radiation in 2 months. What kind of self-administered drugs might I bump into next? What Part D coverages have people found to be best for these drugs. I know it is a broad question...just trying to make an informed choice at this point. Many thanks.
Medicare Part D coverages for APC Dru... - Advanced Prostate...
Medicare Part D coverages for APC Drugs (not covered by Part B administration).
Medicare, BCBS supplemental Plan F, BCBS Premier RX (PDP) works fine for me. I never liked the Medicare advantage plans. They make it sound like your getting more for your money but for those of us with serious medical problems they are limiting.
Who told you that you can not buy a supplemental policy? I thought during open enrollment you can switch. The key is that you had prior coverage.
United Health Care and all other brokers have told me the same thing. Without purchasing a supplemental plan in the first 24 months of signing up for Medicare...and then being diagnosed with a serious illnesss in the time period....NO ONE will underwrite you for a supplemental plan. Sounds like NY and Conn. are the exceptions. Gee...maybe the Trump Health Plan will addresss that one for us! Ha ha ha ha ha....
During your initial enrollment period you can choose whatever you want and the carriers have to take you. But if you want to change plans later on during open enrollment periods they can deny you based on preexisting conditions (such asPCa). It's important to make your first choice the right choice because of this.
That sucks. I am signing up for regular Medicare in January. I learned here not to pick an advantage plan so I can choose my Docs anywhere in the country.
Open enrollment has no health questions. Your premium may be higher because you're older that's about it.
Actually if I moved to another county....or state. I could get a supplemental plan at that time. Not willing to do that at this time. BUT, if Tuesday is like 4 years ago....Canada is looking good as an option! At least wing nut hasn't built a wall there yet.
Yes, unfortunately Medicare supplements don't work like Obamacare re pre-existing conditions.....with ACA , you can switch plans without discrimination for pre-existing conditions.
Too true. I work as a volunteer for AARP working with lobbying local politicians. If we get a landslide of sanity Tuesday...hope we can work to change the pre-existing situation for Supplemental Medicare with an administration that cares about the average Joe 
Please leave your politics in the voting booth.... Thank you!!!
Good Luck, Good Health and Good Humor.
j-o-h-n Saturday 10/31/2020 6:17 PM DST - Treat or Trick
The world of healthcare is politics. Or haven't you noticed???? Please refrain from lecturing others.
But JR...our Prez is promising comprehensive better and cheaper coverage for all....we'll see his his plan any day now? don't despair !
I was not lecturing.... but it's a free country so say whatever you want.... I was just trying to warn you from starting a small war here.... so don't forget to vote early and often....
Good Luck, Good Health and Good Humor.
j-o-h-n Saturday 10/31/2020 8:29 PM DST - Treat or Trick
Thanks for the "warning". Often....you mean like Agent Orange has advocated...absentee and then the polls? LOL Nuf said.
You can switch during open enrollment.
Yep...that's why I posted the question Oct 15 - Dec 7 is open season.
In answer to your original question, two of the most used drugs are abiraterone and enzalutamide (Xtandi). Plug those into the Part D calculator at medicare.gov and see what you end up with. The calculator is tricky because they think that your preference for a pharmacy is more important than price. So you need to try several different pharmacies and sometimes you'll hit the jackpot on one that has lower prices in a specific plan. I am currently on a Cigna plan because of reading in this forum that abiraterone was less expensive through some specific pharmacies. That advantage isn't as clear as it was before since abiraterone is available in generic now.
Switched Part D plans for my husband for next year because it will result in thousands of dollars of savings even with generic abiraterone
Which plan was the one you found best?
It will vary where you live. The Medicare.gov tool will tell you if your drugs are covered by a plan, and then which plan will be the least expensive for you...including the premium , deductible, and drug costs. He will switch from current WellCare to BCBS. (AARP’s plan looked good for him too. ).
Thanks. I have Part D with Humana-Walmart. Very low premium. But for some
meds I call my (legitimate) pharmacy in Canada and they can mail 90 day supplies with a prescription faxed.
I also found that for some meds the “cash pay price” not using Medicare or other insurance was cheaper than the copay! Caveats are that you have to use a pharmacy where they do not have any insurance or Medicare history with you. Then just ask for the cash pay price. They will not offer it up front but are required to if you ask for it. This is in Oregon so not sure about other states.
Thanks. Yes, I found using the free GoodRx.com site gave me prices MUCH better than isurance coverage for some Tier 1 and 2 drugs. Like Imiquimod 5 % was $348 at CVS and was $38 at Costco with GoodRx. Thy make it so difficult to make the right choices. healthcare and insurance is becoming a full-time job
I just had a discussion with my nurse practitioner at Dana Farber two days ago about what drugs I might be given if my psa goes up in order to choose my Part D plan.
She said: Abiraterone (Zytiga) 4x250 or Enzalutamide (Xtandi) 4x40mg or Apalutamide (Erleada) 4x60mg or Darolutamide (Nubeqa) 4x300mg. The choice will depend on what scans show at the time, she said.
Thus I will have to do what Concerned-wife said for all four drugs and pick a plan that has all four on the formulary and then make an educated guess as to what I'll be given. Personally, I would not like to take Xtandi first because of the fatigue which is reported by those who take it.
Many thanks for sharing with all. Tis the season (open season).
This is good advice. Plug all four into the Medicare Part D finder and see who turns out to be the best. What I found doing this in my zip code is that a couple of plans had a WAY cheaper price for abiraterone, but their price for the other three was about $500 higher annually.
I dread the day I have to go on Medicare, so I'm following this conversation....
Thanks to everyone for your input.
So true..I just started...a nightmare from the beginning....still keeping my regular insurance and watching to see how it all works out!!!
Unfortunately, the government does not allow for a learning curve. Pay close attention to deadlines for Part D (7 months) to avoid permanent penalties and Supplemental deadlines. (24 months)...or you are screwed!
Cost of abiraterone acetate
Zytiga Co-Pay
How much do you pay for Nubeqa with Medicare?
What to do when Medicare doesn’t cover your prescription drug
