Medicare Adviser?

What are the meds? I was the administrator for state government accounts w CVS for years. A little more info would be good for discussion. Sounds like a Part D donut hole IYAM

He’s pretty much SOL until open enrollment in October and of course that is for plans starting in 2023-
most manufacturer coupons do not allow them to be used with people who have government insurance ( Medicare)

Then, I’d suggest maybe you helping him out here.

Gather his drugs that he takes, make one list. Be prepared before you call Medicare.

Hopefully you can get someone who speaks serviceable English

When enrolling for 2023’s part D plan,

A) make sure whatever pharmacy he uses/likes is in the preferred pharmacy ( doesn’t do him good to have to switch drugstores to people he’s unfamiliar with )

B) make sure all his expensive drugs are considered formulary for whatever plan you’re enrolling. Make sure to ask about what the monthly premium is and what the deductible will be ( I see it way too often come January, people don’t realize they have a $1,000 deductible and have to decide if they can get their insulin or pay their rent .)

C) ask what his copays will be for the expensive ones .

Very important tasks to be completed and it’s sad how the elderly are just thrown to the wolves and they don’t know the questions to ask when enrolling.
Or people will say “ give me the cheapest plan” and of course it’s probably shittey and they’re out of pocket is a lot

I dealt with this with my Mom, on a very expensive med for PAH, there are often manufacturer patient assistance programs for brand name meds for people who are under-insured. Some Medicare patients will qualify for them based on annual income. She had money in savings, just not a large annual income. Just something to look into and doesn't hurt to apply. It covered all of the drug for my Mom for a year with option to apply annually. I'm not talking about the manufacturer coupons, I'm referencing the patient assistance programs.

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How are elderly folks, who sure as hell not computer literate, supposed to make heads or tails of all of this?! Ridiculous.

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Great question. The enrollment people don’t know anything either, they’re just getting folks to sign up, so they don’t give a damn if you’re enrolling in a good plan for you or not . Strictly a numbers game for their patient rolls.

And then you get a crappy that you’re stuck with for the entire year potentially all because you assume when you enroll that the person is actively trying to help you out .

I was having this exact discussion with someone last week in fact I have it often come open enrollment time later in the fall

Having someone around who can have the meds organized and can assist can save potentially thousands out of pocket when it comes to enrolling


Edit: sorry I can’t really help you out with this current situation with all these high costs , but I can hopefully help to prevent this from occurring next year for y’all.

Joe Namath

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It's about 23 when all OOP is met

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What is “OOP”?

Yes
List out the medications

MARC insurance
Local. Ask for Alan.
Tell ‘em Rocklicker sent you.

He will literally come sit in your living room and explain it all if that’s what you want. He did the same for my parents and in-laws.