They'll enroll at Medicare dot gov
Pdp $$
- Thread starter hockeyday
- Start date
They'll enroll at Medicare dot gov
- 7,142
Sounds like a Medicare lesson
First Part -- Part A
Second Part -- Part B
Third Part -- Part C
Fourth Part -- Part D
Fifth Part -- Part E
SShafran wrote: How many (specific number) clients do you have on a $16,000 per month Cancer drug getting it covered by their PDP, and what are the names of these specific drugs?
Here are a couple of recent examples.
- Client takes Imbruvica 140 mg tablets; takes 3 tabs 2 x daily. He has leukemia and will take this drug the rest of his life. He takes 4 other drugs including Eliquis. His total estimate costs for 2024 (premiums + deductibles + copays) for all his drugs = $3,342 filled at a local preferred pharmacy with Wellcare Value Script PDP. (This was a major reduction in his out-of-pocket costs vs. 2023 for the same medications when he paid over $11,100.) For 2024 the estimated "retail" cost on all his drugs filled at his local preferred pharmacy = $15,785 per month.
- Client takes Verezenio 1000 mg tablet; takes 2 tabs daily. She has late-stage breast cancer. Will potentially take this drug the through Dec. 2024. Also takes two other high dollar meds....Jardiance and Eliqus. Her total estimated costs for 2024 (premiums + deductibles + copays for all her drugs = $3,285 filled at a local preferred pharmacy with Wellcare Value Script PDP. Estimate "retail" cost on all her drugs = $16,342 per month.
- Also have had several clients in recent year taking Revlimid....retail on that was then $15,872 for 21 capsules....another cancer drug. Fortunately, those costs have dropped.... brand Revlimid actually cheaper than the available generic....brand runs about $1,081 for 21 capsulses vs. $3,890 for 21 caps with generic "Lenalidomide" according to Plan Finder tool at www.medicare.gov.
I hope this is helpful.
Here are a couple of recent examples.
- Client takes Imbruvica 140 mg tablets; takes 3 tabs 2 x daily. He has leukemia and will take this drug the rest of his life. He takes 4 other drugs including Eliquis. His total estimate costs for 2024 (premiums + deductibles + copays) for all his drugs = $3,342 filled at a local preferred pharmacy with Wellcare Value Script PDP. (This was a major reduction in his out-of-pocket costs vs. 2023 for the same medications when he paid over $11,100.) For 2024 the estimated "retail" cost on all his drugs filled at his local preferred pharmacy = $15,785 per month.
- Client takes Verezenio 1000 mg tablet; takes 2 tabs daily. She has late-stage breast cancer. Will potentially take this drug the through Dec. 2024. Also takes two other high dollar meds....Jardiance and Eliqus. Her total estimated costs for 2024 (premiums + deductibles + copays for all her drugs = $3,285 filled at a local preferred pharmacy with Wellcare Value Script PDP. Estimate "retail" cost on all her drugs = $16,342 per month.
- Also have had several clients in recent year taking Revlimid....retail on that was then $15,872 for 21 capsules....another cancer drug. Fortunately, those costs have dropped.... brand Revlimid actually cheaper than the available generic....brand runs about $1,081 for 21 capsulses vs. $3,890 for 21 caps with generic "Lenalidomide" according to Plan Finder tool at www.medicare.gov.
I hope this is helpful.
- Thread starter
- #94
You should be helping them with patience assistance for a number of those meds,
hockeyday wrote:
"You should be helping them with patience assistance for a number of those meds.'
I am very aware of patient assistance. As you know, not everyone qualifies if income exceeds thresholds specific to each drug and program. My clients are mostly affluent and need to rely on Part D. A good place to start search for patient assistance programs I use is www.rxassist.org.
"You should be helping them with patience assistance for a number of those meds.'
I am very aware of patient assistance. As you know, not everyone qualifies if income exceeds thresholds specific to each drug and program. My clients are mostly affluent and need to rely on Part D. A good place to start search for patient assistance programs I use is www.rxassist.org.
Those examples are good. My point was: it's rare. I have a few taking those exact Rx's and they are expensive.
If someone is in IRMAA and they forego PDP and they need one of those, my gut says there will be an alternative (either alternative payment means or an alternative treatment)
Or, they're out of luck. But they're big kids and it's what they decided. Probably penny wise and pound foolish.
Special Agent
Guru
- 662
good article about part D cost in 2025 in Forbes
www.forbes.com
put url here if you can't open article [EXTERNAL LINK] - archive.ph
Biden's Inflation Reduction Act Unravels Medicare Part D
The reality is that the IRA is slowly, but predictably, destroying Medicare's "Part D" drug benefit.
www.forbes.com
put url here if you can't open article [EXTERNAL LINK] - archive.ph
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