insuranceguy088
New Member
- 11
Chazm is correct. Xarelto is on Silverscript's formulary for 2018. There is no doubt. I am 100%. Not on Medicare.gov yet.
PDP reports on Medicare.gov
- Thread starter somarco
- Start date
Just for some background, I worked at a PBM. In fact, I worked for the one that has morphed into SS, 20+ years ago.
My point is that this a MASSIVE FAIL. Its not "no big deal". They are #1 nationwide without a deductible. They sent out wrong information to every single 2017 member. They gave bad information to Medicare.gov. They had to resend information to every member. They are going to lose business because they screwed up Xarelto.
80%(?) of seniors do their drug plan themselves. And this is a pretty popular drug. How many of them have access to the forum and know about the error? This stuff HAS to be right. They make a fortune on Part D. Get some more QA people in place. Damnit.
But it is what it is, it's done. Not much else they can do at this point. If 80% of seniors do their drug research themselves, then maybe this will teach them that they should use a broker ;-)
BTW here is the letter that went out
"
Special message for agents of SilverScript members who take Xarelto®
As a result of the late addition of Xarelto back to the SilverScript 2018 formularies, the SilverScript annual cost estimates on Medicare.gov for clients taking Xarelto will be too high. Medicare.gov will show Xarelto as a non-formulary drug instead of displaying the medication at Tier 3 pricing. We know that you need a quick way to get the accurate lower cost estimates, and we know that you want supporting documentation for your clients. We have made it easy for you to update the SilverScript cost with just a click or two using the prepopulated SilverScript Agent Portal pricing tool.
We are here to help.
Our records indicate that you have one or more clients who have filled a Xarelto prescription in the past six months. We have prepopulated the SilverScript Agent Portal’s pricing tool with all of the medications that each of these clients have filled during the past six months.
Simple steps to run an updated analysis.
Please log into the SilverScript Agent Portal, select plan year 2018, then click on the Pricing Tool link. Enter your client’s primary residence state and click on the Continue link. When the Drug Pricing Quote page displays, enter the Medicine Cabinet code displayed in the table below into the Quote Number field in the Drug Pricing Tool. Click the Retrieve Drug Quote button. The Portal will display all of your client’s medications. Edit the pre-populated drug list in the pricing tool based on the information your client has most recently provided to you.
Here is the list of your clients who have filled a Xarelto prescription (Subscriber ID, Medicine Cabinet Code, Member Name):"
BTW here is the letter that went out
"
Special message for agents of SilverScript members who take Xarelto®
As a result of the late addition of Xarelto back to the SilverScript 2018 formularies, the SilverScript annual cost estimates on Medicare.gov for clients taking Xarelto will be too high. Medicare.gov will show Xarelto as a non-formulary drug instead of displaying the medication at Tier 3 pricing. We know that you need a quick way to get the accurate lower cost estimates, and we know that you want supporting documentation for your clients. We have made it easy for you to update the SilverScript cost with just a click or two using the prepopulated SilverScript Agent Portal pricing tool.
We are here to help.
Our records indicate that you have one or more clients who have filled a Xarelto prescription in the past six months. We have prepopulated the SilverScript Agent Portal’s pricing tool with all of the medications that each of these clients have filled during the past six months.
Simple steps to run an updated analysis.
Please log into the SilverScript Agent Portal, select plan year 2018, then click on the Pricing Tool link. Enter your client’s primary residence state and click on the Continue link. When the Drug Pricing Quote page displays, enter the Medicine Cabinet code displayed in the table below into the Quote Number field in the Drug Pricing Tool. Click the Retrieve Drug Quote button. The Portal will display all of your client’s medications. Edit the pre-populated drug list in the pricing tool based on the information your client has most recently provided to you.
Here is the list of your clients who have filled a Xarelto prescription (Subscriber ID, Medicine Cabinet Code, Member Name):"
- Thread starter
- #24
My guess would be 80% keep whatever plan they have had because it was good this year and should be next as well.
I encounter very few people willing to tackle Mcare.gov PDP site. Many that do still don't know how it works . . . they just think they do.
Others will buy a BX PDP because they bought the (overpriced) BX Medigap and "everybody takes BX".
When I suspect a problem with pricing or the price is extra critical to the patient, then I print all details and possibly use companies proprietary engine and again making copies of everything. Don't really have time to stop and analyze.
I don't ever remember worrying much about drug costs before the program started. Sure....a few here and there but someone is really having a hay day with this and someone else is taking it ITB. I wonder who.
I don't ever remember worrying much about drug costs before the program started. Sure....a few here and there but someone is really having a hay day with this and someone else is taking it ITB. I wonder who.
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