I just finished investigating 2019 drug costs under my Medicare Advantage Plan, which I've been in now for 3 years. Sneaky details:
I've used the mail order drug delivery service for 3 years because with my previous, employer sponsored plan (also though UHC), was the cheapest option. Ahh, the devil in the details. Somehow I missed that my new Advantage plan has a somewhat complicated system wherein tiers drugs above Tier 1 have varying co-pays depending on whether you use mail service or a local pharmacy: LocalMail service Tier 1 $0 Copay $0 Copay Tier 2$9 Copay $0 Copay Tier 3 $47 Copay$131 Copay Tier 4 $100 Copay $290 Copay Tier 5 33% Coinsurance 33% Coinsurance
So, Tier 5, best not need that! Ibandronate sodium for bone loss is a tier 3 drug. My others are tier 2. The Final tally is I will save $164 in 2019 if I switch to local. That is a useful sum although the mail order is wonderful.
The second surprise, however is they changed baclofen and Neurontin to Tier 2 drugs, where they were tier 1 in previous years. I am suspicious this may mean that next year they will up the price. We really have to keep an eye on these folks.
The bone loss drug is particularly vexing because my test results do not indicate any benefit from the expensive drug. On the other hand, one can argue that maybe my results would have been worse without it.
It would be useful to hear of other people's experiences with insurance coverage for medications.
I step in the water, but the water has moved on...
those tiers are exactly what made me cancel my pres. drug plan, all my meds were tier 3, which had me pay $450 per drug and then get a 22% copay. this was bs to me so a useless drug plan thru medicare by humana imho.