Rytary, Gocovi, MAPD

[somarco]

Prospective client T65 in March, currently on the listed meds . . . Rytary #240 per month, Gocovi #30 monthly.

Currently has EGHP with a $25 copay for Rytary, $10 for Gocovi. Those will go away when she retires and goes on Medicare.

Best option found in the PDP choices comes with a projected annual cost of $4700 just for the copay.

Their income precludes PAP or foundation assistance. Search&Save shows $24k Rx cost for the least expensive MAPD. Can that be right? Or am I being confused by all the bragging about how MAPD is so much better for Rx than PDP?

 

[alphawave2k]

Without the specifics on county, I used Cherokee (GA) for a generic search. Found the least expensive MAPD for a tad over $21K annual, and $31K annual for PDP. Again, don't know to trust these numbers. I usually do a triple check...Integrity Mktg's platform, Medicare.gov and then best carrier's price on their website.
So if above is true, at least in this case, MAPD is better option for the meds.

 

[somarco]

30338, Dekalb

Rytary 48.75/195mg, Walgreens
Gocovri 68.5mg, Walgreens

Projected total cost with Cigna Saver =$4,779 drug cost on Mcare.gov for the balance of the year which is close to what S&S showed for April thru Dec.

Thanks for confirming what I saw.

 

[kgmom219]

Assuming it’s an option…what’s the COBRA cost? Use the 8 month window so she’s not a late enrollee?

Assuming next years OOP is $7500, it will help. Then the $2K OOP in 2025.

Is Prescription Hope an option?

 

[somarco]

Assuming it’s an option…what’s the COBRA cost? Use the 8 month window so she’s not a late enrollee?

Assuming next years OOP is $7500, it will help. Then the $2K OOP in 2025.

Is Prescription Hope an option?

She has been working PT now for 2 years on a 90 day review option. She won't know until April if they will allow her to work or not and keep benefits. COBRA is a option but don't want to get sideways with the COBRA/Medicare trap. I will look into this in more detail and pitch it if it seems to be viable.

I don't feel comfortable betting on the come for the $2k OOP in 2025. Too many things can happen between now and then. Looking for a clean option if there is one. Even if it is still around, I worry about what premiums & tiers will look like when/if that happens.

Won't qualify for Hope . . . income is too high.

She may have to bite the bullet if her employer (large local hospital) won't allow her to work PT and keep group insurance.

 

[BibH]

My sisters a Dr at Wellstar and turns 65 this yr . She’s going to p/t soon and Wellstar’s allowing her to keep her full medical benefits.Her and husband top irmaa bracket so she’s differing Part B ,

 

[somarco]

My sisters a Dr at Wellstar and turns 65 this yr . She’s going to p/t soon and Wellstar’s allowing her to keep her full medical benefits.Her and husband top irmaa bracket so she’s differing Part B ,

Is she disabled?

My prospective client is partially disabled and can only work PT due to her medical condition.

 

[BibH]

No she’s not disabled .

 

[BALDELMO]

Amantadine Hcl Coupons & Prices
Amantadine Hcl is a Antiparkinson Dopaminergics class drug which is manufactured by UPSHER-SMITH. The normal out-of-pocket price of Amantadine Hcl is $98.60 per 30, 100MG Tablet, but you can pay just $15.34 for 30, 100mg Tablet when you use your SingleCare prescription drug discount card to get the Amantadine Hcl coupon. Amantadine Hcl is a generic prescription; Gocovri is the branded form of Amantadine Hcl.

 

[Tom in RI]

Gocovri is a time release version of Amantadine and Rytary is a time release version of Carbidopa/Levidopa. I’ve been dealing with these for a client for several years. For the last couple of years Elixir was the only plan covering both, at least here in RI. This year Elixir dropped both meds from their formulary. My client now lives in Florida, the only PDP covering both in Florida is Cigna at the costs show by the OP. Full cost is close to 40k.