It's that time again to review your health care plans.
Whether you have Medicare and a prescription plan or an all inclusive Advantage plan, check your selections. Changing plans ends this week.
The difference for 2025 is mainly drugs, but it's a big one. Previously, tier 3 drugs averaged a co-pay about $49, but now, co-pays have changed to 25% of the drug's cost. Example - Eliquis in tier 3 had a co-pay of $49 for me. 2025 my cost would be 25% of the drug's $600 a month cost, or $125, quite a difference. The ten drugs that will have a lower cost are not in effect in 2025, that starts in 2026.
The first amount is the new price in 2026, the second is the current price.
Even then, the 25% in tier 3 and up is higher than a co-pay, but hundreds of other widely used drugs are not lowered yet that many people need. The majority of plans are as such, very few still offer a co-pay for tier 3, and most all now have a +-$590 deductible.
The other big change which will help those with high drug costs is the death of the donut hole. Now, once you pay $2000 out of pocket, all is free. It's about time that Medicare seniors are given the same benefits of drug plans as those on commercial drug plans.
Single Care and GoodRx are great options and we pay less than with our drug plan. BUT. Generics only.
Hope everyone had a nice Thanksgiving. We are all struggling, can't seem to go anywhere without seeing items we routinely picked up for her, or make meals and recipes we shared. I think my brain is allowing reality to slowly enter because the dry cry is more frequent. Either way, you've all been through this, so I apologize for mentioning grief again.
I thought a little about stitching, but the eye bubble doesn't seem any smaller so it will be a while before I could anyway. Picking up my order at Kohls today brought an unexpected situation. My knee. Almost as bad as when using the chair, good thing hubs was there to help me. It has felt different since my fall, and I believe the damage from it has reared its head.
Can't see, can't walk, can't cry with no tears! Even bitching isn't as fun anymore. But I'll keep trying.
Be well, be safe. Getting closer each day to summer.
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12 comments:
Ugh! Health and drug insurance plans are just so confusing. I am thankful my current scripts are just the basics but we know that can change in an instant.
Hoping you feel better soon. It's always something and I'm sure Carole's passing has left a huge hole in your and Mark's heart. It's never easy ;-(
Marly, never apologize for mentioning your grief. It’s a long process and (I believe) an important one to share. You have made many caring friends herein blogland.
Marly, you and Carole were so close and you did so much for her. Her passing will take much time and I’m sure most all of us understand. I hope your eyesight improves soon so you can move on from that. Medicare is confusing and the drug plans have gone up significantly but we have the insurance that we won’t pay more than $2000 a year out of pocket, should the unforeseen happen, thanks to Pres. Biden. Cherie in WI
You are scaring me.... I'm on one of those speciality drugs and pay $6000+/mo. (despite having a separate supplemental plan and paying a substantial amount in premiums and a high deductible) until I hit catastrophic coverage. I have tried finding alternate plans but none will cover the one I'm on. On the bright side (???), it doesn't seem to be working well for me anymore and they are going to try to transition to me to an infusion (vs. injection that I do now). It makes it impossible to choose a plan not knowing what will happen. Sometimes I feel like what I pay in health care premiums, deductibles, and out of pocket expenses is enough to provide insurance coverage for a small village. Lucky are those who can say they don't pay more than a few grand a year out of pocket. That is NOT even a remote possibility for some of us. And I agree 1000% with Maureen said...Never apologize for mentioning your grief. You have earned every bit of that entitlement. Hope the eye issue resolves quickly and you have a needle in your hand soon. ~Robin~
I'm so glad I'm not on any of those medications. Not yet anyway. Cool that the donut hole is gone, never really understood the idea. Other than if you're a little bit or a lot sick, you're covered. If you're middling sick - tough sh... Yet they allow the drug companies to advertise on TV incessantly. Like we have much say over what doctors will or can prescribe.
I'm sorry the knee is worse from your fall, hope it's having a short term fuss about being banged about and will recover to what it was before. As to your grief, no apologies needed. We all handle it differently. And a person will handle it differently depending on who it was that passed on, and under what circumstances. And don't worry about not having any stitching to write about. I doubt I'm the only one who started reading your blog for that but would keep returning if you never picked up a needle again. I hope the retina continues to heal well and the bubbles go away soon.
Good reminder! I think we are all set (keeping what we have had). I hate that I have to re-look at it each year.
Marly, please never apologize for your grief. Feeling and living your grief is one of the most important steps in the healing process. All of us here understand that and encourage you to let loose whenever you feel the need. Hugs to you.
I echo the "don't apologize" comments...your grief corresponds to your deep love and caring. Here is hoping the healing of your eye is short term and your
needle is in hand soon. Ditto with your knee. "Let us cause the disease and then claim to have a long-term treatment at great profit to us.." hmmm?? Read that somewhere... It is called greed.....
Do not apologize for your grief and it’s a journey that none of us want to take so be kind to yourself. We lost my MIL very, very unexpectedly Nov 22 and I was ok until we had her services today. My husband (her only child) giving her eulogy just unraveled me along with realizing I lost my momma 5 years ago this week.
Merry Christmas Marly and Family: Its a shame drugs are so expensive, I am also taking Eliquis and the prices go up and up on health care. shameful isn't it.
Merry Christmas
Catherine🎄🎄🎄🎄🎄
Marly,sharing is caring -- no apologize for this! It is just a short time ago that you have let her go, so take your time to grief in your own way.
So sorry to hear that the bubble in your eye is still there -- hope it will disapear very soon as will your knee feel better.
Take care,stay save and sending lots of love and prayers, Truus from Holland
Losing my sister ten years ago was devastating. I completely understand your grief. Losing her was worse than losing mother. Hubby and I are not on any meds. We were mad about paying 50 a month for a drug plan apiece. I understand that the price now will be more than double. He wanted to drop it but I’m afraid to do that even though we don’t use it
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