Part D Notes 2025

[straightnochaser]

For BCBSKS PDP I can't tell if the plan finder pricing is for Myrbetriq or Mirabegron.

If I have the right formulary, the formulary says this:

MYRBETRIQ- mirabegron tab er 24 hr
25 mg, 50 mg

on tier 2

but planfinder shows a price of $1500-1700 on tier 3

(and if this messes up thread flow and you want it deleted, tell me.)

That's not gonna be for the generic - you have to specifically choose the generic version

 

[Midlevel]

I found a new record for a member's prescriptions so far. Total drug cost for the year is $41,106.00. Client will pay $510.66 total with the BCBS MAPD.

 

[DS4]

I found a new record for a member's prescriptions so far. Total drug cost for the year is $41,106.00. Client will pay $510.66 total with the BCBS MAPD.

Those clients need WellCare!

 

[Midlevel]

Those clients need WellCare!

 

[Sandman]

When I enter an insulin combo, in this case Novolog generic and Basaglar, it shows one as not covered. If I just enter one of them, it shows it as covered. Any explanation for this?

 

[straightnochaser]

When I enter an insulin combo, in this case Novolog generic and Basaglar, it shows one as not covered. If I just enter one of them, it shows it as covered. Any explanation for this?

One med is covered and one isnt? Also never look up generic insulins they typically aren't covered, you look up the name brands.

 

[Sandman]

Yes, when I enter both meds (name brands), one of them shows as not covered.

 

[straightnochaser]

Yes, when I enter both meds (name brands), one of them shows as not covered.

novolog isnt gonna be covered by every carrier - humalog is an alternative and they are interchangeable

 

[Sandman]

I tried substituting humalog for novolog, but get the same result. Not one carrier will cover basaglar and one of those other insulin drugs. it shows one of them as not covered. Very odd.

 

[straightnochaser]

I tried substituting humalog for novolog, but get the same result. Not one carrier will cover basaglar and one of those other insulin drugs. it shows one of them as not covered. Very odd.

I have noticed that also with a few carriers (zing is one)... they gave the blends like Novolin/Humalin but not Novolog or Humalog