United HealthCare Part D Prescription Drug Plans NOT!!!

[twinklesweep]

For many years I have enjoyed a Medicare Supplement Plan administered by United HealthCare that, together with original Medicare, has the result of, well, how shall I put it?: I pay for my health care up front (and it is expensive: approximately $280/month for original Medicare and the supplement), and with this combination, my medical costs are zero beyond the premiums. Because I deal with several serious (and in some instances life-threatening) medical issues, what I would pay for medical care if I did not have this combination of insurance plans would exceed (some months even far exceed!) the cost of the premiums. It's also important to remember that EVERY specific Medicare Supplement Plan is identical to every other specific plan; that is, if one wishes the options, say, of Plan F, by law United HealthCare's Plan F offers identical benefits as Mutual of Omaha's Plan F, even if the premiums of the two plans are wildly different!

I foolishly made the assumption that because United HealthCare's Medicare Supplement Plan works so well for me, then their Part D Prescription Plan offerings would do the same. WRONG!!! And you know what they say about people who assume.... I cannot wait till open enrollment next month (sometime in October) so I can choose a new plan to be effective for January 1, 2014.

Some examples:

On and off I am on a medication for a condition that worsens, then improves, and on and on. One medication is particularly effective for it in that it treats the symptoms effectively without any undesirable side effects. And in the interest of economy, in the past I opted for the generic of this drug, which I found just as effective. The last time I filled the prescription (a year ago with a different Part D plan), the copay for the generic was $5 for a three-month supply done through mail order; all generics were considered Tier 1. When I went to use my United HealthCare benefit, I learned that this company placed this generic in Tier 3 and that my cost for the same three-month supply would be $105! I recognize that the costs of everything go up, but why the placement of this generic drug into Tier 3?! My MD's office requested a "tier exception" which the company refused to grant.

Recently I found myself dealing with an infection which required two different antibiotics. Unlike the previous example, with an infection I felt I had no choice. One antibiotic was given free by Publix (bless them!). The other is an old, basic, generic drug that's been used forever—and which United HealthCare moved out of Tier 1, resulting in a cost to me of $25. I've used this antibiotic in the past; again, as a Tier 1 generic, the copay had been $5. The reason I had changed companies to begin with had to do with the costs of non-generic (name brand) medications that I use that are not available in a generic form.

Generally speaking, given the time of its creation, the Part D Prescription Drug Plans, with their arbitrary tier assignments, "donut holes," and so forth, came into existence in support of the insurance and pharmaceutical industries, IMHO, NOT the senior consumer. (I reiterate that this is solely my opinion.) Keep several things in mind: When we select a plan, it is chiseled in stone for a year; there is no changing it. On the other hand, the insurance company sponsoring that plan can change anything it wishes, for example, removing specific prescription drugs from its formulary (which may be the very drugs you need!); the only thing it cannot change in the course of the year is the amount of monthly premium.

So all I am suggesting is to research carefully and choose wisely, while at the same time keeping in mind what this person's experiences have been with United HealthCare's Part D Prescription Drug Plans. I've heard that United HealthCare is making inroads here in our community; just be careful not to be taken in by glossy advertising and glib marketing skills....

[gomoho]

My understanding is you need to research the drugs you are taking to see how they work in the plan you are selecting. Problem is we don't know in advance what meds we might need in the future so it's a gamble. But - think if you had no coverage how that would work.

[ijusluvit]

For many years I have enjoyed a Medicare Supplement Plan administered by United HealthCare that, together with original Medicare, has the result of, well, how shall I put it?: I pay for my health care up front (and it is expensive: approximately $280/month for original Medicare and the supplement), and with this combination, my medical costs are zero beyond the premiums. Because I deal with several serious (and in some instances life-threatening) medical issues, what I would pay for medical care if I did not have this combination of insurance plans would exceed (some months even far exceed!) the cost of the premiums. It's also important to remember that EVERY specific Medicare Supplement Plan is identical to every other specific plan; that is, if one wishes the options, say, of Plan F, by law United HealthCare's Plan F offers identical benefits as Mutual of Omaha's Plan F, even if the premiums of the two plans are wildly different!

I foolishly made the assumption that because United HealthCare's Medicare Supplement Plan works so well for me, then their Part D Prescription Plan offerings would do the same. WRONG!!! And you know what they say about people who assume.... I cannot wait till open enrollment next month (sometime in October) so I can choose a new plan to be effective for January 1, 2014.

Some examples:

On and off I am on a medication for a condition that worsens, then improves, and on and on. One medication is particularly effective for it in that it treats the symptoms effectively without any undesirable side effects. And in the interest of economy, in the past I opted for the generic of this drug, which I found just as effective. The last time I filled the prescription (a year ago with a different Part D plan), the copay for the generic was $5 for a three-month supply done through mail order; all generics were considered Tier 1. When I went to use my United HealthCare benefit, I learned that this company placed this generic in Tier 3 and that my cost for the same three-month supply would be $105! I recognize that the costs of everything go up, but why the placement of this generic drug into Tier 3?! My MD's office requested a "tier exception" which the company refused to grant.

Recently I found myself dealing with an infection which required two different antibiotics. Unlike the previous example, with an infection I felt I had no choice. One antibiotic was given free by Publix (bless them!). The other is an old, basic, generic drug that's been used forever—and which United HealthCare moved out of Tier 1, resulting in a cost to me of $25. I've used this antibiotic in the past; again, as a Tier 1 generic, the copay had been $5. The reason I had changed companies to begin with had to do with the costs of non-generic (name brand) medications that I use that are not available in a generic form.

Generally speaking, given the time of its creation, the Part D Prescription Drug Plans, with their arbitrary tier assignments, "donut holes," and so forth, came into existence in support of the insurance and pharmaceutical industries, IMHO, NOT the senior consumer. (I reiterate that this is solely my opinion.) Keep several things in mind: When we select a plan, it is chiseled in stone for a year; there is no changing it. On the other hand, the insurance company sponsoring that plan can change anything it wishes, for example, removing specific prescription drugs from its formulary (which may be the very drugs you need!); the only thing it cannot change in the course of the year is the amount of monthly premium.

So all I am suggesting is to research carefully and choose wisely, while at the same time keeping in mind what this person's experiences have been with United HealthCare's Part D Prescription Drug Plans. I've heard that United HealthCare is making inroads here in our community; just be careful not to be taken in by glossy advertising and glib marketing skills....

I think I'm in the same boat as you. That is, I am seeking a set premium, Part D prescription plan effective January 1st. I'm tempted to opt for the AARP United Health Care companion to Plan F, which runs about $40 per month, but has no additional copays or other costs. I don't spend that much monthly yet, but am not sure what prescription costs I may encounter in the future.

When you find what you think is best, can you tell us who writes the policy, what the premium is and whether there are additional copays or other costs?

Thanks!

[twinklesweep]

My understanding is you need to research the drugs you are taking to see how they work in the plan you are selecting. Problem is we don't know in advance what meds we might need in the future so it's a gamble. But - think if you had no coverage how that would work.

Yes, of course we must research our ongoing drugs, but look what happened to the one of mine that jumped from $15/3 months to $105/3 months.... They can change anything they want with no regards to the needs of the senior consumer. True that with something one cannot anticipate, like an antibiotic, it can be a "crapshoot."

I have not forgotten what it was like to have no Part D Prescription Drug Plans. My meds cost way less than they do nowadays. Nature hates a vacuum, so as soon as a mega insurance business is created, as it was with Part D, costs rose to fill the vacuum, IMHO.... Remember, with the implementation of Part D, another law made it illegal for Americans to fill their prescriptions in Canada (where obviously they were cheaper, or else why would Americans want to purchase their meds elsewhere.... And why were they cheaper in Canada? Because Canada negotiated with the pharmaceutical companies for bulk purchase; Part D legislation disallowed that, meaning full costs minus whatever the insurance plan came up with served the pharmaceutical industry, not the consumer....

I know someone who was in an accident in a Third World country where there are municipal hospitals for the indigent with no costs involved. He ended up in a private clinic, where the care was superb and the charges were low—I mean even shockingly low! Other expenses of living there were very comparable to here, I was told (for example, food and clothing). Why so reasonable? Simple: no insurance industry.... His approximately ten days stay in clinic there cost slightly less than the cost of one day in a hospital within the U.S.

I think I'm in the same boat as you. That is, I am seeking a set premium, Part D prescription plan effective January 1st. I'm tempted to opt for the AARP United Health Care companion to Plan F, which runs about $40 per month, but has no additional copays or other costs. I don't spend that much monthly yet, but am not sure what prescription costs I may encounter in the future.

When you find what you think is best, can you tell us who writes the policy, what the premium is and whether there are additional copays or other costs?

Thanks!

I believe all the plans have set premiums (the one thing the plan cannot change, whereas they can change anything else). It is hard to figure the best plan for the very reason you mention: not knowing that your needs might be in future. I will do my homework and will be happy to share what I find and what plan I'm going to take. But everyone MUST keep in mind that my experiences and needs might not be the same as anyone else's, that in spite of recommendations, one must do one's own research as well. Good luck!

[StarbuckSammy]

Thanks for sharing this information with us.