It’s finally over. Midnight, December 7th, midnight. Done and done!

If you did not enroll in a new plan, your current one will roll over to next year. Most will have slightly higher premiums, at least one will have a significant premium increase. 

Drug tiers are changing, higher plan deductibles in most cases, and a higher copay to match. This year's preferred pharmacy may not offer preferred pricing next year.

Make a note to read your ANOC (annual notice of change) when it arrives next September. And . . . read my newsletters! Open enrollment warnings start in August and are repeated in September, October and November.

You can only change your drug plan between October 15th and December 7th of each year. 

We are all adults.

There is no magic.

Deal with it.

Rule number one when you are filling prescriptions. You don’t have to always use your drug plan card. Most generic medications have a lower copay when you use a discount card INSTEAD of your drug plan.

https://www.goodrx.com/

https://www.singlecare.com/

https://www.blinkhealth.com/

(More on Blink Health to follow)

I have had a Part D plan for 7 years, Rachel for 3 years. In that time we have always enrolled in the lowest premium plan and have never used our plan. 

This approach may not work if you use any brand name prescriptions . . . but you can usually save money with GENERIC medications. There is often a work around for brand name drugs . . . just ask.

SOMETIMES you need to enroll in a HIGHER PREMIUM PDP to get a lower copay. General rule of thumb . . . higher premium = a lower brand name copay.

It is relatively easy to change drug plans during open enrollment, but sometimes your doctor prescribes a new, more expensive, medication during the year. You can’t change plans but you can change the way you BUY your medication.

Discount cards rarely work for brand name drugs but here are a few things you can do.

Canadian pharmacies are my default “go to” for many expensive brand name drugs. Some brands may have a generic not offered in the US. 

ASK your doctor before opting for a generic that is not available in the US.

My two current favorite Canadian resources are . . .

https://www.mapleleafmeds.com/

https://www.canadianpharmacyservice.com/

If discount cards or a Canadian pharmacy does not work for you, give me a call. I have other resources that may be a fit.

A new way of doing things . . .

SAME PILLS. LOWER PRICES.

https://www.blinkhealth.com/

Pick up your medication at any of our participating pharmacies nationwide.

https://www.blinkhealth.com/participating-pharmacies

Blink does not need to know the pharmacy you plan to visit. You can use Blink at almost any pharmacy that is convenient for you. The Blink Price is the same at every pharmacy.

When you present your Blink Card to the pharmacist, ask them to process Blink as the primary payor.

Quick Save is available at select pharmacies. Pay online, and pick up the same day at your local pharmacy.

https://www.blinkhealth.com/quicksave

Is Blink Health better than GoodRx?

https://www.blinkhealth.com/better-rx-savings

Prescription drugs make up 90% of all healthcare transactions and account for nearly 50% of profits accrued in healthcare — with another 10% of prescription drug profits being sucked up in the supply chain. With this many exchanges, the money spent on fulfilling them and the markups added by middlemen, the opportunity for impact and savings is enormous.

A major cause of unnecessary price inflation for branded drugs is the consolidated PBMs. Of the three PBMs that represent 80% of transactions, only two PBMs, Express Scripts and CVS Caremark, represent around 80% of the negotiated rebates with pharmaceutical manufacturers. They rent their negotiated rates to all other PBMs, who add their own mark ups.

https://www.blinkhealth.com/blog/solve-the-healthcare-cost-crisis-starting-with-prescription-drugs

Blink Health is not new, nor is it new to me. Originally a discount card only, they have expanded their services to include an online pharmacy that can deliver meds to your door or transmit your prescription to your local pharmacy for pick up.

Will Blink Health work for you?

Only one way to find out. Try it and see. 

Blink Health is an option for possibly saving money. It does not replace Part D.

There is still a lot of discussion and confusion about the consumer cost of insulin when using a PDP in 2023.

The $35 copay that is in all the news reports is PER REFILL, not per month. If you use 3 different kinds of insulin each one MAY have their own $35 copay.

I say MAY because not all insulin meds have a $35 copay. Further confusing the matter, you and your twin may each use insulin “A” but your PDP formulary offers a $35 copay while the plan your twin has does NOT have a $35 copay.

IF your plan formulary allows for a $35 copay that amount should be flat for the year. It is not subject to your plan deductible, nor does your copay change as you move through the plan levels from deductible to initial to gap (donut hole) to catastrophic.

Isn’t it odd how the way the plan actually works is different from the spin politicians put on this “new” benefit . . .

Good resource for diabetic supplies . . .

https://www.northcoastmed.com/

CGM, pumps, test strips, meters, etc.

Most of you know I earn $0 from working on Part D plans, instead I rely on compensation from Medigap plans and referrals. This was a choice I made 12 years ago when I switched from writing individual major medical and group health insurance plans. CMS constraints make it impossible, in my mind, to offer the widest range of options to my clients, so I did it my way  . . .

Anytime you, or your friends, have questions about Medicare call or email. I am more than just a friendly face . . .

2020 has been a difficult year for many but we are about to turn the page on a new year. This is a time of year when people of all faiths reflect on the blessings we have, not material wealth but the joy of friends and family. So now I leave you with this thought . . .

And peace to all, good will towards men.

Merry Christmas,

Bob