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Author Topic: Choosing Medicare Part D Plan???  (Read 442 times)

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Offline Blkpoznc34

  • Member
  • Posts: 14
Choosing Medicare Part D Plan???
« on: August 21, 2014, 07:32:08 PM »
Finally got approved for SSDI and received my Medicare card.... :). In the process of choosing part D coverage and have narrowed it down to three plan/providers. Express script, Silver scripts or AARP which uses Optumrx. I am looking for any advice or experiences any of you may have with these plans. I live in the state of South Carolina. Thank you fir any advice.

Offline OneTampa

  • Member
  • Posts: 2,274
  • "Butterflies are free."
Re: Choosing Medicare Part D Plan???
« Reply #1 on: August 21, 2014, 09:12:28 PM »
Just want to extend congratulations Blackpoznc34 on getting your SSDI approved!

I am sure other Board Members will weigh in with some very good advice as you asked as I do not have experience in that area.

Take care.
"He is my oldest child. The shy and retiring one over there with the Haitian headdress serving pescaíto frito."

Offline Blkpoznc34

  • Member
  • Posts: 14
Re: Choosing Medicare Part D Plan???
« Reply #2 on: August 21, 2014, 10:10:43 PM »
Thank you One Tampa for the Congtrats...it was a long battle. I have only had very good employer based insurance all my adult working days was just curious about Med part D plans and what to expect. Not just for South Carolina.

Offline leatherman

  • Member
  • Posts: 6,272
  • Google and HIV meds are Your Friends
Re: Choosing Medicare Part D Plan???
« Reply #3 on: August 21, 2014, 10:28:15 PM »
You might want to check with your local ASO. The SC HIV Task Force (http://schtf.com) produced a detailed evaluation of ALL the plans available in SC and ranked them. The Task Force then sponsored a statewide case manager training session. We believe that all the ASOs in the state have access to this information and should have someone available to assist PLWHs with obtaining good ACA insurance. The Task Force (which is comprised of all the ASOs in our state) created access to this information and disseminated it in SC since Medicaid Expansion was not accepted by the state government or Governor.

If you need help finding the ASO near you that can assist, please send me (the Communications Chair of the SCHTF) an email at communications @ schtf.com and I'll find out who you should contact with your insurance questions ;)
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Since1993

  • Member
  • Posts: 108
Re: Choosing Medicare Part D Plan???
« Reply #4 on: August 22, 2014, 02:29:19 AM »
Finally got approved for SSDI and received my Medicare card.... :). In the process of choosing part D coverage and have narrowed it down to three plan/providers. Express script, Silver scripts or AARP which uses Optumrx. I am looking for any advice or experiences any of you may have with these plans. I live in the state of South Carolina. Thank you fir any advice.

I don't typically call-out drug manufacturers or insurance companies.  But I must make an exception in this case so you don't locked into a year of difficulty.

I would avoid Express Scripts home delivery (Acredo) because I've heard several state ADAP programs complain how difficult Express Scripts home delivery is to transact with.

Most other mail order pharmacies who know you participate in a copay assistance program invoice your medications upon order, then ship.  You get your medications and invoices.  You send your invoices to ADAP who would write a check to the mail order pharmacy.  In and done.  However, Express Scripts requires payment upfront once your balance hits $100 and won't mail your ARV specialty medications unless you pay in advance, without first issuing invoice.  All AIDS assistance programs have to receive an invoice before they can reimburse the medical entity directly. One state's ADAP had to request a special credit card from the state to pre-pay medications co-pay electronically before Express Scripts shipped medications. 

Point being, Express Scripts home delivery can be problematic.  Your ASO/ADAP should have someone who works specifically with Medicare Part D/Medicare issues that has a short-list of available Part D plans.  Some states cap ADAP Medicare Part D premium assistance to $50 monthly. 





Offline mitch777

  • Member
  • Posts: 3,589
Re: Choosing Medicare Part D Plan???
« Reply #5 on: August 22, 2014, 04:35:55 PM »
Definitely stay clear from Express Scripts AT ALL COSTS! They are a nightmare!

I'm not sure where I heard this from but I thought once one was on Medicare that you couldn't be forced to buy meds from a mail-order/specialty pharmacy. Has this changed or am I off base here?
32 years hiv+ (oct. 2013) with a curtsy.

 


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