Comparing Medicare Part D Plans
Helping patients in Los Angeles compare prescription drug plans
I know that many times vulnerable seniors will be pushed to plans they don’t want by brokers who make money recommending certain plans. For our comparison, I have an example urology patient living in Los Angeles who has overactive bladder requiring Gemtesa as well as advanced prostate cancer requiring Orgovyx and Erleada. These are some of the most expensive prescription medications we have in urology.
We have already gone over the costs associated with Medicare + Medi-Cal (which should be very low) here and now we will see the drug costs. For those who qualify for Extra Help (or have Medi-Cal) an example Part D plan is below (which would be all you have to pay)
Medicare Part D Plan with Extra Help
Now be careful because there are also Part D plans that not only have higher premiums, but also higher drug costs (no surprise who is behind this plan: United Health Care)
Medicare Part D with Extra Help, expensive from United Health Care
Our next comparison is a Medicare Advantage plan for fairness
Medicare Advantage with Part D
While it may seem that this Medicare drug plan is cheaper by approximately $69 than Medicare + Medi-Cal, consider that you are giving up the freedom of original Medicare. While there may be some patients who cannot afford $5.70/month what you definitely should not do is sign up for the below
Medicare Advantage with Part D
The tricky thing is that the score says that there is a $0 drug deductible. But the fine print shows that Kaiser does not cover a basic medication like Gemtesa and charges $606/month for it (although there is a cap of $2100). While Kaiser may offer other benefits in terms of HMO coverage, that is a discussion for a different day.
Ultimately there are many reasons why a patient may choose one plan over another. What I hope to show in this series is that patients who qualify for Medi-Cal have good options. Settling for Medicare Advantage because of money should not be one of them. I highly recommend that you check these plans out for yourself or your loved ones here.