Aetna to Wellcare WTH?

[somarco]

Got email from client earlier. Complaining about @Wellcare. He signed up for Aetna last year. Went to fill his Rx using his new Wellcare card and his copays "increased significantly".

WTH?

This is the first time I can recall where a PDP block was tranferred mid-year. Can they (WellcareWTF) change the terms of his coverage? With higher copay's and presumably different preferred pharmacy's?

 

[vic120]

As far as I know, the coverage and plan is exactly the same, I Just went over copays on Medicare.gov for 2 new plans I am doing today and it all looks the same on .Gov

Unless.Gov has not updated

Is it possible he is. in the donut hole?

Another client of mine complained his copays went up and I found out that instead of going to a preferred pharmacy, as usual, He instead went to a standard pharmacy, Thinking all in-network Pharmacies in the network is the same

That plan, in particular, has much higher copays at standard Pharmacies

 

[Chazm]

Maybe donut hole
Maybe the wrong preferred Pharmacy

 

[WiscBroker]

It's 2019, they can do whatever they want.

 

[somarco]

I don't think he went in the donut hole. Just a few med's, all generic.

He likes to run his own reports. I did see where he was interested in Aetna even though I warned him the Wellcare thing makes it a dicey play. I suggested Cigna Healthspring. He may have bucked my advice and enrolled with Aetna even though they had higher copay's.

Still no idea how he ended up with Wellcare.

 

[LostDollar]

If he did not go to CVS for the prescriptions, my guess would be preferred pharmacy is the issue.