What Good Are the M.gov Plan Finder Tools.

[G.Gordon]

This has been a terrible Jan. 2015 so far. We're getting call after call about client's experience not being what the report estimated, not even close.

Just in:

10/28 report, all drugs together cost $85.95 retail, during the deductible phase, $21.94, during initial phase $15.94

01/21 report, all drugs together cost $159.70, ded. phase $75.02, initial $18

Tamsulosin .4 in Oct was $15mo retail, now $54 retail at same pharmacy on same report.

Totally bogus information.

With this new information the call to action for this client would have been to change plans, not stay with Wellcare. A sub $100/year difference turns out to be an estimated difference over $300/year. Enough to make changing worth while.

 

[sman]

This has been a terrible Jan. 2015 so far. We're getting call after call about client's experience not being what the report estimated, not even close.

Just in:

10/28 report, all drugs together cost $85.95 retail, during the deductible phase, $21.94, during initial phase $15.94

01/21 report, all drugs together cost $159.70, ded. phase $75.02, initial $18

Tamsulosin .4 in Oct was $15mo retail, now $54 retail at same pharmacy on same report.

Totally bogus information.

With this new information the call to action for this client would have been to change plans, not stay with Wellcare. A sub $100/year difference turns out to be an estimated difference over $300/year. Enough to make changing worth while.

This is why I save every comparison as I'm sure you do too. I've had a few issues myself. Currently dealing with a network issue on a plan for a particular doctor. Plan showed the doctor was in network at the time of enrollment. In fact, the doctor still shows in network today. However, the practice merged with another practice back in November and the new practice is not in network. My account rep had the same conversation with someone the day before and he told me that he doesn't believe the doctor's office ever notified them they would no longer be participating in the plan.

The biggest challenge I face on an annual basis is a person complaining that "last year I paid XX amount for this medication, now I'm paying more. I wish I wouldn't have changed plans."

I then get to remind them the plan they were on was changing and they are actually saving XX amount of dollars on the new plan. This usually involves emailing them the comparison again so they can see it in black and white. Of course, with med.gov not being accurate, who really knows at this point.

If you and I make a mistake, we're held accountable. But when it's the government who makes the mistake, there are no repercussions. Other than it causing more problems for the broker.

 

[policy doctor]

OK...i'm getting calls from some about meds also. The big issue here is that meds have been repriced higher and we all know that insurance co's can change the formularies in a few months.

However, clients with many prescriptions are realizing that they might hit the donut hole this year...I have on diabetic who orders 90-day supplies and he just hit it....boy is he p'oed!!