Part D - Lose PAP

Jul 4, 2019

  1. TwoCents
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    Good point. OP didn't clarify. I didn't even think about a manufacturer PAP.
     
  2. TwoCents
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    Ask or see if the info is on their site.
     
  3. somarco
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    somarco GA Medicare Expert

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    Yes, I am referring to drug company PAP.

    Many that I have looked at won't pay if your have Part D and the drug is covered by the formulary. Some will pay a portion if your copay is high. Don't recall seeing any that did not have income requirements to qualify.
     
    somarco, Jul 5, 2019
    #13
  4. David Taylor Jr
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    David Taylor Jr Super Genius

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    I never advise going without prescription coverage. For one thing, they can get a penalty if they decide to enroll later. What happens if they get a new script that there is no PAP for and they do not have coverage? PDP is so inexpensive it doesn't make sense to not have it. I have only seen RARE occasions when the PAP is advantageous over actual coverage. But if someone can get coverage, the PAP isn't really intended for those people anyway.
     
  5. LostDollar
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    LostDollar Guru

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    This may not be the plan your prospect is thinking of/dealing with, but you can look up the drug in question here and see, if an assistance plan is listed, what it says for that plan in regard to income, insurance and part D.

    Pharmaceutical Assistance Program
     
  6. joe92275
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    joe92275 Super Genius

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    you are thinking in the right direction. You are correct some Pharmaceutical programs have different guidelines for people with Part D versus "Under 65" private/employer coverage. As odd as this may sound going with a D can potentially harm her where she would lose the PAP or she may need to meet a different out of pocket criteria. For example, with most insulin they require a % of the household income to be spent before any assistance is offered if they have a D...if they don't then they can get insulin for free. So be careful, way too many agents stand on the "you need a PDP or else" blanket advice and in more cases than you would think having a D is more harmful. Especially if they are slightly out of range with the LIS guidelines. Those people get hurt the most with RX costs. It's a tricky situation that requires more research and is a case by case....there is no blanket answer.
     
    joe92275, Jul 14, 2019 at 7:15 PM
    #16
  7. somarco
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    somarco GA Medicare Expert

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    Prospect has gone AWOL. Ready to sign up after the weekend. Not a peep out of her in over a week.

    I pulled the plug on reports emailed to her so she can't access them any more.

    Also sent her my "closing your file" email.

    She may come back around or be gone forever. Either way, I am not wasting any more time on her.

    My money says she found someone who would say ANYTHING just to get her to buy.

    Every once in a while someone comes back and asks forgiveness . . . wants me to take them on as a client. My response is "Sorry, you had your chance. No Mulligans".

    People would rather buy from the person who tells them what they want to hear vs telling them the truth.

    Not my circus. Not my monkeys.
     
    somarco, Jul 14, 2019 at 7:38 PM
    #17
  8. DS4
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    I spent 1 hour in my office with a prospect after a half hour on the telephone the week prior. Complicated Part D. 90% of our time was spent on Part D. Couldn’t close her in my office. Then, she goes AWOL. Calls me last Thurs. She bought Plan G from another agent for $2/ mo less than my Plan G. The other agent doesn’t sell Part D. She says she now ready to buy Part D from me. Click.
     
    DS4, Jul 14, 2019 at 9:09 PM
    #18
  9. somarco
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    Been there. Done that. Got the t-shirt AND hat.
     
    somarco, Jul 14, 2019 at 9:34 PM
    #19
  10. vic120
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    Like Somarco, Been there too

    Amazing how they are not even embarrassed when they ask for help with the part D

    I am not shy to say that is a service I only do for Med Supp Clients Sorry
     
    vic120, Jul 14, 2019 at 10:31 PM
    #20
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