for profit insurance driven health care

Has anyone else experienced researching as carefully as possible a drug plan, typing in meds, in the online comparison tool, then verifying by phone with a company rep. then when your told everything is covered with no co-pay sign up only to find your first refill comes in with $100 co-pay. and if so is there any recourse?

[NorasMom]

It's not much help, but if the company itself won't fix this, I'd contact your State Attorney General and report them.

[CatsandCars]

I'm guessing this is either a Medicare Advantage or Medicare Part D plan? If so, try the link below for more info:medicare.gov/claims-appeals...

Best of luck.

[Hidden in reply to CatsandCars]

Thank you so much going to try the compliant link and see

[CatsandCars in reply to Hidden]

You're welcome. 😊

[mrsmike9]

I'm going on Medicare this May and I am researching! I have found a plan that seems to cover all I want/need. Medicine is something else. So far GoodRx has the cheapest meds. Using their coupons, even just today, took what would have been $120 to $54! I now get generic Aubagio from Mark Cuban's pharmacy. It looks like everything else I will be changing to filling at Meijer with GoodRx. That is the least expensive plan I've found. So no more CVS or Walgreens. Meijer, while not super handy for me, is not too terribly far away and will save me the most. There is a "gold plan" with GoodRx which saves even more that costs under $10/month.

[CatsandCars in reply to mrsmike9]

Good rx is great for saving money, but it's not insurance. I think there are some downsides to using it instead of Medicare Part D. Of course, it's up to you, but this article explains some of it. It has to do with creditable coverage, deductibles, and catastrophic coverage, which limits you to paying $7,400 out of pocket with Medicare Part D if I understand this correctly.

medicarequick.com/medicare-...

[mrsmike9 in reply to CatsandCars]

Good article! When I am on Medicare, part D will be part of it. When I compare the medication price with that plan and GoodRx, GoodRx beats the Medicare prices, big time. My generic Aubagio is less than $30 for 90 days than my current insurance will pay (copay of over $3000). But this article brings up good points. I have an agent who has always helped us with our health insurance. I will be asking a ton of questions, per this article. Thanks for attaching it!

[CatsandCars in reply to mrsmike9]

You're welcome. You're going to be an expert yourself soon! I also saw that the infamous donut hole is going away in 2025. I'm on Medicare, but I have insurance through my husband's job that pays for most of my prescriptions. He doesn't retire for a while yet, but I'm trying to pay attention to how some of this stuff works. 😊

[mrsmike9 in reply to CatsandCars]

It's a pain! I have a spreadsheet with lots of information from the Medicare book so I can see things side by side.

[hairbrain4]

Did you check to see how much deductable you have. Most drug plans have at least a $250 deductable. After your Out of Pocket Deductable is met then those they told you will go into effect.

[Hidden in reply to hairbrain4]

Yes I know my deductible, and no that isn't it but thank you for your attention and concern

[Elle61]

Check Mark Cuban's low cost plus drug program for meds. I get Ampyra there and saved a lot of money.

[Hidden in reply to Elle61]

Thank you I will look into that

[CalfeeChick2]

I'm a"Former Bicycle Chick." Riding 200-300 Miles a week until I couldn't take the heat and had my friend's son come rescue us. I found out later I had enough white spots in brain to be DX'd with MS. My balance was so bad there was no more bicycling, walked with a cane. Stayed away from Hot weather!

[Hidden in reply to CalfeeChick2]

I hear you I used to take part in the MS Society's fund raising ride, which was always in June , sometimes crazy hot , no problem before diagnosis but after big! problem did it for a few years after heat sensitivity got bad with cooling vest but eventually gave up