2021 drug plans UPDATE

Published: Tue, 10/20/20

The Medicare Plan Finder still has a number of bugs. Specifically, ExpressScripts and Cigna drug plans are not showing ANY drug copay's.

We are told these problems SHOULD BE fixed AFTER October 20, 2020

In the past either of those plans have had very limited application. Their formulary tier pricing + premiums rendered them non-competitive in many situations. But a few clients found these plans to be competitive based on a combination of medications, location and pharmacy preference.

As a reminder, brand name medications usually are NOT covered when there is a generic alternative. A few examples are Armour Thyroid and Vivelle Dot.

Anticoagulants such as Eliquis, Xarelto and Pradaxa seem to have that end of the market locked up. I haven't found much pricing relief for those medications.

You may be able to substitute a Thyroxine / Triiodothyronine Combination for Armour Thyroid.

https://www.goodrx.com/thyroxine-triiodothyronine-combinations

Vivelle Dot is available at a lower price from BlueSky Drugs in Canada

https://www.blueskydrugs.com/Product/Vivelle+Dot

Anticoagulant article @ GoodRx

https://www.goodrx.com/anticoagulants

https://www.blueskydrugs.com/Product/Eliquis

https://www.blueskydrugs.com/Product/Xarelto

https://www.blueskydrugs.com/Product/Pradaxa

If you choose the right drug plan you can catch a pricing break on Eliquis and Xarelto once your deductible is satisfied. I looked at $0 deductible drug plans but the combination of much higher premium and even higher copay made them non-competitive.

Pradaxa stays expensive even after the deductible.

The illustration below can be used as a reference. I ran the report assuming someone took the recommended dosage of ALL THREE drugs (which would never happen). When I run client reports the PLAN DETAILS option button (in Medicare Plan Finder) delivers the kind of granularity that is most helpful.

Elixir RxPlus (PDP)

$14.30

Monthly premium

$445.00

Yearly drug deductible

CVS PHARMACY #04504 - Drug costs during coverage phases

Preferred in-network pharmacy

CVS PHARMACY #04504 - Drug costs during coverage phases
Preferred in-network pharmacy

Estimated total drug + premium cost

You will pay $3,100.95 per year on drug + premium costs.

Based on current drug costs, it's estimated that:

You'll meet your $445.00 deductible in January
You'll enter the coverage gap in March
You'll exit the coverage gap in July

You can see how, in this example, your copay drops considerably once the deductible is satisfied.

WARNING - Given the problems with the Plan Finder I have no way of knowing if the above is accurate or not. If you are taking any of these drug check with your drug plan carrier for 2021 pricing BEFORE enrolling.

Printing the Reports

PDF copies are easy to produce using an add-on such as Print Friendly

https://www.printfriendly.com/

The Print Friendly tool can be used in Chrome and Firefox. I never use Edge or Safari so I can only presume this popular plugin can be used in those browsers.

I Can Help . . .

I will run as many reports as I can for clients but will have very little time once we move into November. I had over 80 requests for review before October 15th and I have managed to run about half of them.

Some folks have had trouble following the "guide" in an earlier email so I am abandoning that idea. Medicare designed the Plan Finder to be "user friendly". Their idea of user friendly seems to run contrary to what the public expects.

If you want me to run reports I will get to them as time permits. Here is what I will need.

Name of your current drug plan carrier
Exact name of each medication and dosage
How often filled and quantity
Preferred pharmacy

The most time consuming part of drug plan reports is entering drug names and dosage. Once that is done the analysis can be completed in less than 5 minutes.

Hope this helps.

Let me know if you have questions.

Take Care,

Referrals are ALWAYS appreciated!

Bob Vineyard, CLU

404 252 5859

Georgia Medigap Rates

Medicare Expert