Know of Anything to Supplement a Part D Plan?

[alldaytuesdays]

Thanks in advance for any knowledge anyone has on a situation like this...

I have a MedSupp client that has a Part D plan that doesn't cover one of his medications (Lantus, diabetes, several hundred/month). There are many other Part D plans that do cover it. Obviously, he didnt look into it enough when he signed up in AEP (on his own). There's no possibility (that I can tell) of an SEP or anything.

The question is - are there any plans that supplement a Part D plan or any alternatives for someone in this situation? Anyone ever tried to help someone with this problem?

 

[insurance0707]

You can have the client call customer service and find out if they'll make an exception and cover the Lanuts. The worst that could happen is they say No. The next option is to get the formulary book and have the client take it into his doctor or fax it into his doctor and ask the doctor if there is a similar drug to lantus, such as humalog, novolin, etc. that is covered under the formulary that he could switch to.

Another option is to go right to the manuafacturer and find out if you can get it for free. Here's a link that will let you know the guidelines......

Program

Is he a veteran? He may qualify for this medication through the VA program.

I hope this helps.

 

[GreenSky]

I moved a number of my clients into the Advantra Value plan, always checking Medicare.gov to confirm the formulary. Never had an issue until now.

Just got a call from a client (also a friend) that can't fill her asthma medication. Sure enough, it's no longer listed on the formulary.

I made her promise to call CMS and file a complaint. It was there in December for the 2009 policy year and now both medications are non-forumulary.

I'm going to call Advantra on Monday but we all know what that will solve.

I tried very hard to not bother with Part D this year. I am definitely out of that part of the business for next year and the future.

Rick

 

[Cenla Agent]

I haven't dealt heavily with Part D since about 2006-2007 other than to answer the occasional question from clients having to do with prior authorization, or to occasionally write a client turning 65.

Like Rick and I'm sure many others, I'm trying to avoid MA altogether right now, and with Humana no longer being competitive this year with their Part D plans, I never even gave it a second look. After a payment snafu last year, I told my FMO that I wasn't writing Humana anymore and so far have stayed true to my word, although some of that has had to do with health problems that have kept me out of the field for several months.

 

[Todd King]

It was because you were selling Humana. Their MA plans are bad for your health!!

 

[Cenla Agent]

It was because you were selling Humana. Their MA plans are bad for your health!!

Compared to what I saw other people in the state doing, they were pretty good at the time. My complaints with payment were them paying me twice for old sales, them swearing it was legit and then turning around and charging it back, not not getting paid to begin with as has happened with other carriers, FMO's, MGA's, etc. Sure, I could make a lengthy list of complaints, but I do think they provided excellent training for breaking into this market, although it did take me a little while to see that MA's weren't for everyone.

But I will look at doing something else if they are uncompetitive on Part D for 2010 next year the way they are now. If you're going to be in the Sr. mkt, (especially marketing to turning 65's) I figure you need a competitive Part D plan to be able to offer.

 

[ronmelton3]

Option One
You could move them to a SNP plan (Special Needs Plan) You have one SEP per year.

Option Two
You could also direct him/her to Blue Sky - Online Drugstore for Prescription Medications - Fully Licensed Canada Pharmacy
One vial of Lantus is $73 + shipping. $14 ?
I buy mine from there... No Prescription needed. Yes, that's right OTC!
And it won't count against the donut hole!!!!!!

Hope this helps...

Ron