Who to trust on RX comparisons

[gregj]

stand-alone PDP's are subsidizing drug coverage with MAPD's.

maybe more like MAPDs subsidizing Rx coverage...?

 

[somarco]

In my state (Alabama), drug coverage with Advantage plans has a much lower deductible and lower copays. It seems the stand-alone PDP's are subsidizing drug coverage with MAPD's.

Margin on the medical claim side is subsidizing the D in MAPD.

 

[Rich Sagall]

Margin on the medical claim side is subsidizing the D in MAPD.

 

[Rich Sagall]

At NeedyMeds we are finding more PAPs are helping people with health insurance if their plan doesn't include coverage for the drug they need. Are drug discount card is also helping many who can't afford their medications.

 

[LostDollar]

At NeedyMeds we are finding more PAPs are helping people with health insurance if their plan doesn't include coverage for the drug they need. Are drug discount card is also helping many who can't afford their medications.

When you say "health insurance", are you including Medicare and Part D coverage in that category?

 

[Rich Sagall]

When you say "health insurance", are you including Medicare and Part D coverage in that category?

Yes. For the drug discount card, people on Medicare can use a drug discount card if they opt to go self-pay outside their Medicare coverage. If this is done, what they spend doesn't count towards getting out of the donut hole or towards their deductible. Same applies for private insurance.

We are also offering 8 free COVID tests per month through the spring to Medicare Part B recipients. You can find more info on our website.

 

[LostDollar]

Yes. For the drug discount card, people on Medicare can use a drug discount card if they opt to go self-pay outside their Medicare coverage. If this is done, what they spend doesn't count towards getting out of the donut hole or towards their deductible. Same applies for private insurance.

We are also offering 8 free COVID tests per month through the spring to Medicare Part B recipients. You can find more info on our website.

My question related to the PAP's.

Those who read regularly here understand that discount cards such as goodrx can be used INSTEAD of Part D, but not with it.

When you say this in a Senior Insurance Forum on Insurance Forums:

At NeedyMeds we are finding more PAPs are helping people with health insurance if their plan doesn't include coverage for the drug they need.

Are you meaning that you are seeing PAP's starting to change their rules and allow people on Medicare Health Insurance to qualify for the PAP plans?

 

[somarco]

SOME PAP's are available for those with Part D but they come with stipulations. May include . . . Januvia, Janumet, Trelegy, Imbruvica, Latuda, etc.

 

[LostDollar]

My question related to the PAP's.

Those who read regularly here understand that discount cards such as goodrx can be used INSTEAD of Part D, but not with it.

When you say this in a Senior Insurance Forum on Insurance Forums:

Are you meaning that you are seeing PAP's starting to change their rules and allow people on Medicare Health Insurance to qualify for the PAP plans?

Yes. For the drug discount card, people on Medicare can use a drug discount card if they opt to go self-pay outside their Medicare coverage. If this is done, what they spend doesn't count towards getting out of the donut hole or towards their deductible. Same applies for private insurance.

We are also offering 8 free COVID tests per month through the spring to Medicare Part B recipients. You can find more info on our website.

SOME PAP's are available for those with Part D but they come with stipulations. May include . . . Januvia, Janumet, Trelegy, Imbruvica, Latuda, etc.

I asked the question because of a similar post you made somewhere recently.

The needymeds person dodged the question and responded with comments about their drug discount card and "free" covid tests they can bill Medicare Part B for.

So far, to me, based on posts here, you (@somarco) are coming across as knowing more about PAP's available to Medicare Beneficiaries than NeedyMeds does.

 

[kgmom219]

They aren't subsidizing the MAPD plans. MAPD plans have to spend X dollars or they get suspended in that area for the upcoming year.

And with the dental amounts increasing, I am not seeing the MAPD vs Part D spread I saw last year