2023 MC PDP Plan Finder - Insulin $35 copay not built in

[Yagents]

Who else showed up for the grand CMS show today.

$35 insulin copays will NOT be reflected in MC Plan Finder PDP searches.

You need to remove the insulin at first from drug list, then do search with other meds, find best plan, add $420/yr ($35x12), then re-insert insulin, and confirm it's on the drug formulary.

CMS is NOT capable of getting changes done this year.

I wonder if they've figured out the Y2K computer crash yet?

 

[somarco]

Will Search & Save work or will they have the same issue?

 

[Yagents]

Will Search & Save work or will they have the same issue?

I dont know, but its not run by govt, so probably yes

 

[Russ]

Who else showed up for the grand CMS show today.

$35 insulin copays will NOT be reflected in MC Plan Finder PDP searches.

You need to remove the insulin at first from drug list, then do search with other meds, find best plan, add $420/yr ($35x12), then re-insert insulin, and confirm it's on the drug formulary.

CMS is NOT capable of getting changes done this year.

I wonder if they've figured out the Y2K computer crash yet?

They don't have time for that. Too busy preparing for call recordings

All for $46

 

[somarco]

I dont know, but its not run by govt, so probably yes

Just got this from Scott . . .


I’m told by Connecture ( our data vendor) that yes we will be ready (insulin $35). I’m posting the email from them later and sending out the email response to all our subscribers

 

[kstein]

But to compare plans I thought I was supposed to go to Medicare.gov.... here's a 15 page pdf to fig it out...
Good luck

 

[kgmom219]

Here’s my issue with Search and Save, Sunfire, Connecture and whatever else is out there: what do you do in January if it’s wrong?

I use Medicare.gov, print it out (well, save to PDF) and move on. If it’s wrong and you’ve got a print out, they let you switch after 1/1. Takes 1 call. There’s no OEP for Part D, just MAPD.

What happens if Search and Save (or whatever) is wrong?

 

[Russ]

Here’s my issue with Search and Save, Sunfire, Connecture and whatever else is out there: what do you do in January if it’s wrong?

I use Medicare.gov, print it out (well, save to PDF) and move on. If it’s wrong and you’ve got a print out, they let you switch after 1/1. Takes 1 call. There’s no OEP for Part D, just MAPD.

What happens if Search and Save (or whatever) is wrong?

I read there's an SEP all of 2023 on PDP plans.

 

[TwoCents]

I read there's an SEP all of 2023 on PDP plans.

Before anyone gets SEP happy, it's not for use by agents. Beneficiaries must call 800-Medicare.

From the CMS Memo:
Special Enrollment Period
Since MPF will reflect Part D sponsors’ insulin benefits and cost sharing as they were submitted in their CY 2023 bids, CMS is granting a Special Enrollment Period (SEP) for Exceptional Circumstances to allow beneficiaries to add, drop, or change their Part D coverage if they find a better option after the 2022 Annual Enrollment Period (AEP) and through the end of 2023. This SEP will be available for all beneficiaries who use a covered insulin product and begins on December 8th, 2022 and ends on December 31, 2023. Beneficiaries may use this SEP one time during this period. To utilize this SEP, beneficiaries must call 1-800-MEDICARE so a customer service representative can process the enrollment change. Consistent with current policy, when Part D enrollees change plans mid-year, their True Out-of-Pocket (TrOOP) costs carry over from one plan to the next

 

[Russ]

Before anyone gets SEP happy, it's not for use by agents. Beneficiaries must call 800-Medicare.

From the CMS Memo:
Special Enrollment Period
Since MPF will reflect Part D sponsors’ insulin benefits and cost sharing as they were submitted in their CY 2023 bids, CMS is granting a Special Enrollment Period (SEP) for Exceptional Circumstances to allow beneficiaries to add, drop, or change their Part D coverage if they find a better option after the 2022 Annual Enrollment Period (AEP) and through the end of 2023. This SEP will be available for all beneficiaries who use a covered insulin product and begins on December 8th, 2022 and ends on December 31, 2023. Beneficiaries may use this SEP one time during this period. To utilize this SEP, beneficiaries must call 1-800-MEDICARE so a customer service representative can process the enrollment change. Consistent with current policy, when Part D enrollees change plans mid-year, their True Out-of-Pocket (TrOOP) costs carry over from one plan to the next

So agents can’t help them again