Choosing Medicare plans

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vnatale
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Choosing Medicare plans

Post by vnatale » Tue Nov 30, 2021 6:30 pm

I know that we have an older crowd here. Many whom are of Medicare age and who are on Medicare.

Being that I've yet to take any drugs on a regular basis I have always chosen the least expensive plan. Since I've been on Medicare starting April 2016 that has always proven to be the correct choice as my one-time prescriptions for anything have been few.

Having had the chicken pox as a child makes me a candidate for contracting shingles, something I'd prefer not to get.

When I got my flu shot in September I asked the pharmacist what it would cost for the shingles vaccine. He told me it would be two shots - $180 each - $360 total.

I was thinking that he'd used my drug card and that was the price for me having no coverage for it. That was two months ago so I'm not totally remembering all my thinking back then.

Like everyone else I have until a week from tonight - December 7, 2021 - to make choices.

I called my existing drug plan and asked what this would cost:

Shingrix Suspension Reconstituted 50 MCG/0.5ML Intramuscular

I think the representative told me two things. First she said it's be a $1 per shot then she said it'd be $165 for a 30 day supply and 90 days for a 90 day supply.

I told her that did not make sense to me since it's only two shots. Logically you'd get your first shot for the $165 and then second shot would be within the 90 days of the first (how much later do you get the shot?). Therefore, why wasn't the cost just $330? She could not explain.

Then I called the Stop & Shop pharmacy where I'd been in October and asked what my current costs would be to get those shots today. I was told they could not tell me because that depended upon what drug plan I chose.

I'm trying to find a drug plan that will cost less than $360 annually additional from the least expensive plan (going by my October information) and which will fully pay for the two vaccine shots. But when I go to the drug plans they want to know how often you take the drug. This is basically a two-off thing and no kind of regular thing. Has anyone else ever tried to research something like this?

In sum I really do not know how much it would really cost me paying it 100% on my own and I don't know how to navigate each drug plan's questions so to a. find out if the shots are covered or b. if covered, what they will cost me.

So color me quite confused about this whole thing!
Above provided by: Vinny, who always says: "I only regret that I have but one lap to give to my cats." AND "I'm a more-is-more person."
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Xan
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Re: Choosing Medicare plans

Post by Xan » Tue Nov 30, 2021 8:30 pm

Why would you want to buy insurance in order to pay for a one-time thing? Just pay for the shots.
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Re: Choosing Medicare plans

Post by Mountaineer » Wed Dec 01, 2021 6:01 am

Check out GoodRx. They frequently offer a drug price that is less than an insurance price and all you have to do is show your card to the pharmacist. Prices at several stores are usually shown: Walmart, CVS, Walgreen's, etc. Go to one of the stores that offers an injection service. As I recall, I got my Shingrix injections at Acme a few years back. Does not look like great savings on Shingrix though.

https://www.goodrx.com

https://www.goodrx.com/shingrix
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vnatale
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Re: Choosing Medicare plans

Post by vnatale » Wed Dec 01, 2021 8:50 am

Xan wrote:
Tue Nov 30, 2021 8:30 pm

Why would you want to buy insurance in order to pay for a one-time thing? Just pay for the shots.


You are not on Medicare. Once you are on Medicare you need to get on some kind of drug plan. All Medicare is subsidized by the government in some way (via all the Medicare payments we've made from our earnings).

Therefore I have to make some choice of a drug plan. I normally choose the least expensive one.

Assuming the costs of the two shots would be $360....if I can find a plan that costs less than $360 annually more than the least expensive plan and which fully pays for these two shots....then I'd be ahead. Even more ahead if the more expensive plan results in lower costs for the unknown prescriptions I may need in 2022.
Above provided by: Vinny, who always says: "I only regret that I have but one lap to give to my cats." AND "I'm a more-is-more person."
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vnatale
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Re: Choosing Medicare plans

Post by vnatale » Wed Dec 01, 2021 8:51 am

Mountaineer wrote:
Wed Dec 01, 2021 6:01 am

Check out GoodRx. They frequently offer a drug price that is less than an insurance price and all you have to do is show your card to the pharmacist. Prices at several stores are usually shown: Walmart, CVS, Walgreen's, etc. Go to one of the stores that offers an injection service. As I recall, I got my Shingrix injections at Acme a few years back. Does not look like great savings on Shingrix though.

https://www.goodrx.com

https://www.goodrx.com/shingrix


Thanks!

This is quite useful.
Above provided by: Vinny, who always says: "I only regret that I have but one lap to give to my cats." AND "I'm a more-is-more person."
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vnatale
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Re: Choosing Medicare plans

Post by vnatale » Wed Dec 01, 2021 9:54 am

Xan wrote:
Tue Nov 30, 2021 8:30 pm

Why would you want to buy insurance in order to pay for a one-time thing? Just pay for the shots.


The other key issue regarding medical expenses and insurance is taxes.

As a self-employed person I get to deduct from income on page 1 of the1040 any health insurance premiums. That is a big benefit to reduce Adjusted Gross Income (AGI). If I pay for the expenses they do not get deducted there but, instead, go on the Schedule A, which is no benefit if you do not itemize deductions plus medical expenses deductions are severely limited by having to exceed a percentage of your AGI. In my case paying medical expenses offer me no tax benefit.

Also, in my case, I get the same deduction for insurance paid for Massachusetts tax purposes. Massachusetts otherwise has no deduction for medical expenses.
Above provided by: Vinny, who always says: "I only regret that I have but one lap to give to my cats." AND "I'm a more-is-more person."
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