jimmycc's drug advisory thread

[sshafran]

That is real kind and thoughtful of you. That said, let us see the details on this plan that you were able to save the person over $1000 dollars just by switching them within the same carrier. That sounds like a real neat case. Now quit jacking around and give us the details like a good apprentice should. Or are you now for the first time ever in this forum suddenly not interested in learning something? The good news here is I got some syrup for the waffle I expect you will now be serving me.

You're a moron and quite inexperienced if you don't think this is (a) believable and (b) common.

Let's see... I had to go as far back in my database as yesterday to find a case with "such extreme circumstances."

• Zip Code: 43081
• Current Coverage: Original Medicare
• Current Subsidy: No Extra Help
  [?]
• Drug List ID: 5540195456
• Password Date: 05/21/2018

Take a look - SilverScript Choice estimated yearly retail: $2,678
SilverScript Plus estimated yearly: $6,853

This assumes you understand how to do rx lookups....

 

[sshafran]

You're a moron and quite inexperienced if you don't think this is (a) believable and (b) common.

Let's see... I had to go as far back in my database as yesterday to find a case with "such extreme circumstances."

• Zip Code: 43081
• Current Coverage: Original Medicare
• Current Subsidy: No Extra Help
  [?]
• Drug List ID: 5540195456
• Password Date: 05/21/2018

Take a look - SilverScript Choice estimated yearly retail: $2,678
SilverScript Plus estimated yearly: $6,853

This assumes you understand how to do rx lookups....

Sorry, this case has a $4,175 spread between the two plans. You were looking for a smaller spread - closer to $1,000.

 

[kgmom219]

What are you all fighting over? This isn't brain surgery.

Get the zip code. Get the drug list.

Go to the plan finder. Run it with the 3 main players (CVS, Walgreens, Walmart) and the years winner. 2018 is Kroger.

Tell the client the best price based on the triangle of contracts. Let them know if any of their drugs have a QL they are going to hit. PA drugs. Step Therapy. Donut Hole. Best pharmacy for that year. Don't go the first 2 weeks of the year, because nobody is happy then in a pharmacy. They are either meeting a deductible or sick. Get your RX's filled the last week in Dec, if at all possible. Then request the refills (assumes a move) when you have a 2 week supply on hand. "Just in case".

The whole reasoning of there being a flat commish on these plans is so that we put them on the best plan for them for THAT year.

You guys are making this much harder than it is.

NEXT.

SS...I think you should have put them on the highest cost plan. You get more of commish that way, right? That's quite a list, BTW.

 

[sshafran]

SS...I think you should have put them on the highest cost plan. You get more of commish that way, right? That's quite a list, BTW.

What was I thinking!? My mistake.

 

[goillini52]

Get your RX's filled the last week in Dec, if at all possible.

That's a great idea!!! That's probably why I did it. I was on Part D for 7 months last year and refilled like you said to take me to the Donut Hole, but not over. I won't spend less time in the Donut Hole this year as a result of doing it that way.

 

[kgmom219]

That's a great idea!!! That's probably why I did it. I was on Part D for 7 months last year and refilled like you said to take me to the Donut Hole, but not over. I won't spend less time in the Donut Hole this year as a result of doing it that way.

If you aren't going to hit it, you might want a 90 day supply in Dec, too. (How to manipulate the system according to KGMom)

Its also because the first 2 weeks in January at a pharmacy are MISERABLE.

A couple of years ago I got the flu (yes, I had my shot) and had to go on Jan 5. I was in the line from h**l with sick people and people pissy about their deductibles and insurance not working. The pharmacist walked up to me at the end of the line and asked "What are you doing here? You KNOW better than to be here right now!" (They know what I do and my background.) Told her I needed some tamifliu and she said "WHY? I gave you the damn shot!" She went behind the counter, filled it and brought it to me.

Never, ever go to the pharmacy the first 2 weeks in January unless its absolutely necessary.

 

[JimmyCrappedCorn]

You're a moron and quite inexperienced if you don't think this is (a) believable and (b) common.

Let's see... I had to go as far back in my database as yesterday to find a case with "such extreme circumstances."

• Zip Code: 43081
• Current Coverage: Original Medicare
• Current Subsidy: No Extra Help
  [?]
• Drug List ID: 5540195456
• Password Date: 05/21/2018

Take a look - SilverScript Choice estimated yearly retail: $2,678
SilverScript Plus estimated yearly: $6,853

This assumes you understand how to do rx lookups....

First of all I would like to thank you for accepting the challenge. All I wanted to do was show that weasel wannabe insurance agent how tricky these drug plans actually are but hes not here to learn anything hes here to teach us.

This will take some looking into but there is most surely something wrong with those figures Medicare.gov is giving us on your case. I know some may not want to believe this or hear this, but just going to Medicare .gov is not the end all answer. I will look in detail later but for now I would bet that those figures are not correct. My thinking is the whole point of Silverscript's Plus plan is that it pays better then their choice plan. That being said there is no way the Plus plan is going to cost 4000 a year more. I'll get back to you on this.

 

[sshafran]

First of all I would like to thank you for accepting the challenge. All I wanted to do was show that weasel wannabe insurance agent how tricky these drug plans actually are but hes not here to learn anything hes here to teach us.

This will take some looking into but there is most surely something wrong with those figures Medicare.gov is giving us on your case. I know some may not want to believe this or hear this, but just going to Medicare .gov is not the end all answer. I will look in detail later but for now I would bet that those figures are not correct. My thinking is the whole point of Silverscript's Plus plan is that it pays better then their choice plan. That being said there is no way the Plus plan is going to cost 4000 a year more. I'll get back to you on this.

It's possible, but in this situation the primary Rx discrepancy was the Basaglar Kwikpen. Covered on Choice's formulary but not covered on the formulary for the Plus plan. In other words, I don't think it was inaccurate.

 

[goillini52]

It's possible, but in this situation the primary Rx discrepancy was the Basaglar Kwikpen. Covered on Choice's formulary but not covered on the formulary for the Plus plan. In other words, I don't think it was inaccurate.

That is odd, because the Plus plan is supposed to have more drugs on it.

 

[LostDollar]

weasel

I already looked up one avatar special for you. Not doing another.