46% Increase for 2024 AARP UHC Part D in North Carolina

[javmd]

Have just received the Annual Notice from UHC.  What is the justification except a UHC money grab?  I've been with AARP B and D for many years with minimal usage for D.  This is the largest %age increase I've seen and the well-known competition now is far lower.  Who at AARP is responsible for selecting UHC - is this what's called  "fighting for health care"?

[LindaS108826]

Just saw AARP received 9 BILLION dollars from United Health.   Something stinks!

[GailL1]

@LindaS108826 

Maybe IF you would go to the actual source of the statement it could be cleared up for you and the hundreds that are gonna read this and take your statement at face value.  

This is par for people that don’t know how to use the internet - they take things out of context and then post them without even a source document or an understanding of the actual details.

AARP.org - Grant Thornton LLP - Consolidated Financial Statements and Report of Independent Certifie... 

Now look at page 15 under the heading of “ Royalties “

from the link for those who won’t look it up - [copy / paste]

Royalties are received from AARP-branded third-party providers of member benefit programs in return for the rights to use AARP’s intellectual property (including name, logo, and membership information) in offering programs. For royalty agreements which include fixed fee consideration, revenue is recognized ratably over the term of the agreement. For royalty agreements which include variable consideration, revenue is recognized when the member purchases a good or service from an AARP-branded third-party provider.

In 2024, AARP restructured an existing royalty agreement with one of its group health insurance providers. As part of this restructuring, the frequency of the royalty payments was changed with AARP receiving a one-time royalty payment of $9.062 billion in exchange for the group health insurance provider receiving an exclusive license for the right to use AARP’s trade name and other intellectual property in marketing efforts for a particular health insurance program directly related to this agreement.

This one-time advance payment was recorded in investments and deferred revenue and other liabilities in the accompanying consolidated statements of financial position. In determining the useful life of this license,

AARP considered several factors, including the expected useful life of similar assets, AARP’s own experience with this particular health insurance program and the overall health insurance marketplace.  Management determined that the estimated useful life of this license is 12 years and will amortize it on a

straight-line basis over that period. The unamortized balance of the deferred revenue relating to this restructured agreement at December 31, 2024 is $8.727 billion.

NOTE THIS SPECIFICALLY  ➡️      In connection with this royalty agreement, the Plan historically collected insurance premiums from participating members and remitted the insurance premiums to the group health insurance provider within contractually specified periods of time. The collection of premiums and submission of amounts due has historically been classified as agency transactions. During the holding period, these amounts were maintained by AARP in depository accounts which were included as part of the cash and investment balances, respectively. The corresponding liability for these agency transactions were included in the insurance premiums payable balance (Note 6). As a part of this restructured agreement, the Plan now remits all collections to the group health insurance provider daily. Thus, insurance premiums payable within the accompanying consolidated statements of financial position decreased significantly from December 31, 2023 on account of the group health insurance provider’s daily receipt of premiums.

===============

[from ME]  In layman’s terms - they are now just doing it in a different way under this 2024 restructuring agreement.

I will continue this in my next reply to you since there is a character maximum.

[GailL1]

@LindaS108826 

Continuing from my reply to you on your statement - same link just from page 16 - from the link [copy paste]

Payments received for royalty agreements in advance of AARP satisfying its performance obligation are recorded within deferred revenue and other liabilities in the accompanying consolidated statements of financial position and recognized as revenue in future periods as performance obligations are satisfied. The changes in deferred revenue were caused by either the receipt of the one-time royalty payment from the group health insurance provider or normal timing differences between the satisfaction of performance obligations and customer payments.

As of December 31, 2024 and 2023, royalties included within deferred revenue and other liabilities totaled $8,727,047,000 and $17,000, respectively. AARP recognized $17,000 in royalty revenue in each of the years ended December 31, 2024 and 2023 from amounts that were included in deferred revenue and other liabilities at December 31, 2023 and 2022.

For royalty agreements, which include variable consideration, management has elected the practical expedient permitted under Accounting Standards Codification (“ASC”) 606 not to disclose information about remaining performance obligations.

[ME]  Then from page 21 of the same link - Grantor Trust

NOTE 6 - GRANTOR TRUST

AARP established a grantor trust for the purpose of making group health insurance and other health-related products and services available to AARP, Inc. members or for the general benefit, good and welfare of AARP. Agreements between AARP, Inc., AARP Services, United Healthcare Corporation (“United”), Metropolitan Life Insurance Company (“MetLife”) and Genworth Life Insurance Company (“Genworth”) make certain types of insurance available to AARP, Inc. members.

The Plan, a grantor trust, holds group policies, and maintains depository accounts to initially collect insurance premiums received from participating members. In accordance with the agreements referred to above, collections are remitted to third-party insurance carriers within contractually specified periods of time, net of the contractual royalty payments that are due to AARP, Inc., which are reported as royalties in the accompanying consolidated statements of activities. AARP derived 34% and 63% of total royalties from the Plan for the years ended December 31, 2024 and 2023, respectively.

Billing of insurance premiums and issuance of certificates of insurance to insured members are the responsibility of the third-party insurance carrier. The collection of premiums and submission of amounts due to the insurance carrier are classified as agency transactions and, as such, are not recorded as either revenue or expenses in the accompanying consolidated statements of activities. For the years ended December 31,2024 and 2023, the Plan processed $13.1 billion and $12.1 billion of premium payments from member participants, respectively.

Premiums collected from insured members are subsequently remitted to the third-party insurance carriers and are recorded as a liability, insurance premiums payable, in the accompanying consolidated statements of financial position. For the years ended December 31, 2024 and 2023, the Plan invested certain funds that generated net investment income of $69,892,000 and $106,817,000, respectively, which are included in investment gain in the accompanying consolidated statements of activities.

end [copy / paste]

Now - please tell us where you got this snippet of a statement that you posted without any explanation - which you “just saw”.  

[CBtoo]

The other problem with United Health Care (I am bout 75 hours into fighting this right now) is that in my state starting June 1, 2023 (they are rolling it in) they now have supplements without the "no extra cost to us benefits". In my state at my age that G is $69.99 cheaper than the no extra cost to us version of G we had. Which tells me earlier it was no extra cost because they had already included the cost. They claim (which Medicare disagrees with) that my plan hasn't ended because they still offer the benefits. Um yeah but clearly not at no extra cost to me. It is now essentially $70 more. Their current claim since they offered the new versions without the "benefits" under a different legal entity that means all of us trapped in the more expensive G can't change without passing medical underwriting (well unless we live in one of the states that has the birthday rule and you can change once a year then without having to deal with medical underwriting). I don't pass medical underwriting so I am trapped.  

Frankly United Health Care seems to collect class action suits which speaks to their ethics - or lack there of more appropriately  (and they lose them as far as I can tell). This is a class action suit waiting to happen as the no extra cost to us was fraud and the plan was effectively ended as these extras are not at no extra cost to us. They say but we still have a plan with extras. I said but it is at an pretty big extra cost to us. G without them is cheaper so that tells us exactly what the cost is. 

Locally the dental discount extra is useless as no board licensed dentist locally accepts it. The vision discount is only at a place that doesn't sell the higher end lenses for classes. I found out the hard way there is a huge difference in the width of clear vision with progressive lenses between the cheap lenses and the expensive ones. When they dumped silver sneakers and went to renew a number of fitness centers including those with pools mostly didn't sign back up. I sure can't afford a gallon and a third of gas every time I'd go to the fitness center with the pool to use the pool. It would be cheaper to pay to join the one right down the street that I can walk to.

I need to temporarily move just to be able to take advantage of the birthday rule with respect to changing out of G with extras into the one without.

The other thing that cracked me up was I was told the new G was to atract more healthy seniors. Now how will that happen when you can sign up for whatever one you want with you first sign up. They can't screen you out then. G with extras has a 2 year look back for failing medical underwriting G without has a 5 year. So yes that will prevent more people from changing. And certainly as you age you are less likely to use fitness centers, etc. so that is a profit line. That is the problem with for profit medicine in the USA. 

I'd guess over time United Health Care will offer more versions of each alphabet letter supplement so they can lure people in with lower premiums and then trap them. As a result the "older" supplements will likely have much higher premiums over time. Just look at what happened with F. That was only 4 years ago you no longer could sign up for it if you were 65 then. Now those premiums are more than the premiums for G + the deductible because no younger people in them. I went with community rated as that keeps premiums lower when you are older. But not if UHC is going to pull these stunts and we are trapped due to failure to pass medical underwriting.

[CBtoo]

In 2025 medicare D plans will have a cap on the premium price increase they can charge. As a result AARP United Health Care (and a number of others, but certainly not all) decided to jack the prices up now (mine more than doubled. Bye bye AARP for that) so that when they are limited by the percent increase they are starting from a higher premium thus dollar wise the increase is more.

[JimCossitt]

That is consistent with what I have read in other sources.   Regardless, the willingness of AARP to endorse the UHC outfit without some kind of an explanation or justification is very problematic.

[GailL1]

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@JimCossitt wrote:

That is consistent with what I have read in other sources.   Regardless, the willingness of AARP to endorse the UHC outfit without some kind of an explanation or justification is very problematic.

---

Because UHC is THE BIGGEST MA insurer in the country and is available nationwide.

KFF.org 08/09/2023- Medicare Advantage in 2023: Enrollment Update and Key Trends

Same thing with MediGAP - AARP/UHC Medigap is one of the biggest in the country - if not THE biggest and is highly rated in financial stability - which is paramount for any insurance company and for those who make royalties off of their endorsement of such a product.

Investopedia.org- 11/27/2023 - Best Medicare Supplement (Medigap) Companies

[CliffL424699]

Money grab.

[GailL1]

But look at all the NEW stuff that is being added as a result of the Inflation Reduction Act passed back in 2022 -

Key prescription drug affordability highlights include:

• 2023 — Insulin will be limited to $35 for a month’s supply. This takes effect January 1 for insulin covered under Part D and July 1 for insulin covered as durable medical equipment under Part B.
• 2024 — Low-income assistance will be expanded to people with income at or below 150% of the federal poverty level.
• 2025 — Part D enrollees will have their out-of-pocket drug costs capped at $2,000. They will also have the option to pay these costs in monthly amounts rather than all at once.

Then there is the  IRA’s Part D structural changes:

• 2024 — People who reach the Part D catastrophic phase will no longer have to pay cost-sharing.
• 2025 — The Manufacturer Discount Program in Medicare Part D will replace the Medicare coverage gap discount program. In general, it will require drug manufacturers to pay a 10% discount on certain drugs in the initial coverage phase and a 20% discount in the catastrophic phase. Government reinsurance in the catastrophic phase will decrease from 80% to 20% for most brand-name drugs and from 80% to 40% for generics.

Then there is the part of the IRA that stabilizes Part D premiums beginning in 2025 to no more than a 6% increase.

Look at all you are getting for a few dollars more - did you think that the government was gonna pick up the cost of these changes and benefits?

AARP.org - 10/09/2023 - How New Medicare Law Affects Your Health

KFF.org 10/17/2023 - An Overview of the Medicare Part D Prescription Drug Benefit

Medicare Rights.org - Inflation Reduction Act Fact Sheet Outlines Important Changes for 2023 and Bey...

AND you have the option to change plans during this annual enrollment period - just like every year - to the one that is best for you.

[javmd]

NONE of this NEW stuff applies to me.  It's still 46% increase that AARP did not fight for me.

[JohnP933815]

Agree.  none of this applies to me either.  My premium will increase 82% in Michigan.  Nothing in the news about this!!!!

[steve960]

Not sure it's only a few dollars more, but I otherwise agree with the explanations suggested based upon my own research including the link below. Compared to my projected increase for 2024 AARP UHC Part D in MI of 82% you're ahead. As suggested by others I am changing to a cheaper (only slightly) alternative. The increases appear to be across the board.

Part D Premium Increases, Market Disruption Expected in 2024

[GailL1]

Wonder why it is affecting stand-alone plans a LOT more than those within a MAPD?  Do those insurers just manage their MA + PDP benefits better than they do for the stand-alone variety.

[steve960]

Since their birth in 2003, MA plans have evolved into cash cows for insurers, commonly their most profitable product. The MA juggernauts with their unmatched lobbies now cost Uncle Sam more than trad Medicare. Through a combination of aggressive aggregate risk scoring, narrow networks, more prior authorization/first pass denials and lower hospital negotiated rates (helping push some critical access hospitals under), MA’s indeed “better manage their benefits” but not on behalf of their member IMO. As previously suggested, some of the extra cash can be used to “buy down Part D premiums leading to oppositional premium trends in 2024.”

[javmd]

Interesting article from Avalere

[GailL1]

---

@javmd wrote:

NONE of this NEW stuff applies to me.  It's still 46% increase that AARP did not fight for me.

---

But it is insurance so the benefits apply across the board regardless of whether these new changes actually affect you 

You have the option of changing plans that fits your needs better - including pocketbook and you can do this every year if you want or your needs change.

[javmd]

So today I changed D plans for my wife and myself.  Cost savings for premiums alone will be $1400 next year.  Drug costs have similar savings compared to AARP United. As a physcian, I was able to interpret going through the entire formularies for both AARP United and Siverscript, and there did not appear significant differences in availability for most common prescribed meds for different medical conditions.  Appears United is getting its bucks prior to 2025 cap, and Aetna is going for market share to potentially capture Advantage prospects, as a number of plans did 8 years ago when I first joined AARP plans.  Shame on AARP for continuing to promote United.  Appears to be self-serving rather than serving the best interests of AARP members.  I think this should be an issue for periodic review, rather than blindly continuing a longterm relationship purely for the endorsement revenues.

[CBtoo]

javmd - Thanks for going through the formularies. I had Silverscript before but had to change as I got financially wiped out with 3 cancers close together and live in hud. Silverscript mostly ignores requests for proof of premium payments in a timely manner. Now that it is being administered by another company they bought or whom bought them - no idea which way it went - that may have changed. I'll have to see. Fighting that once I ended up about 3 or 4 levels and they admitted to me that over half of the people with D never use it. Big money maker that must be for companies. 

[sktn77a]

Don't feel locked into the AARP UHC part D.  Go to the Medicare website and choose the part D provider that is the cheapest for your meds.  AARP/UHCs Part B and D supplements are pretty expensive.  You might be able to justify the Part B supplement being a community rated policy (as opposed to issue age-rated/attained age-rated policies) but I've seen no advantage to this based upon historic annual premium increases.  Their part D policy may be advantageous one year and (as you have found out) really poor in other years.

AARP gets a commission for associating its name with UHC - nothing more, nothing less.

[javmd]

So I've reviewed all the D plans available in my zipcode for NC.  With minimal medications I've never met the deductible.  I priced total premium+drug costs and one well-known plan from a large insurance company has monthly premium 1/12 of AARP-UHC, and the total premium-drug annual cost is 1/6 of AARP-UHC.  Pharmacist said that with capping of premium rules due to go into effect 2025, many plans have a money grab for 2024.  Also of interest, plans have a contracted price in effect prior to the deductible, and pharmacies can give you an even lower "retail" price than the contracted price, so a med cost can actually go UP during the year prior to reaching deductible.  One specialty drug priced separately would be $1000 cheaper than AARP, but throwing in GoodRx for that will save me $1000s during 2024 alone.  It pays to do your homework.

[CBtoo]

Javmd - also, while not advertised anywhere you can find easily, if you turn proof of payment (eg when you use GoodRx, another coupon or otherwise pay cash for a covered drug not using your D) into your D they are supposed to count it against your deductible. 

Also the formularies can change during our D "year". They are only required to keep them unchanged for one month. I'd suspect they likely will "get" a few people taking expensive meds that way. 

[GailL1]

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@CBtoo wrote:

.. . . . while not advertised anywhere you can find easily, if you turn proof of payment (eg when you use GoodRx, another coupon or otherwise pay cash for a covered drug not using your D) into your D they are supposed to count it against your deductible. 

---

I have talked to several Med PDP agents that write for several different insurers and they seem to all agree that it sounds like you are describing is the (old) Medicare Coverage Gap Discount Program (CGDP).  Because no other discount (coupon) program would intermix with the Medicare PDP deductible.  It was discontinued at the beginning of 2025 when the Medicare PDP changed as a result of the Inflation Reduction Act.  

Healthline.com - Can You Use Drug Coupons If You Have Medicare Part D? 

As required under the Inflation Reduction Act of 2022, the Coverage Gap Discount Program ended on December 31, 2024, and was replaced by the Manufacturer Discount Program. 

Effective January 1, 2025, Part D coverage is available only for applicable drugs covered by a Manufacturer Discount Program agreement with CMS. Under the Manufacturer Discount Program, participating manufacturers are required to provide discounts on their applicable drugs in the Initial Coverage and Catastrophic Coverage phases of the Part D benefit.

Note: they do not have to do it until you have met the Part D deductible.

You do not have to sign up for it or submit anything - if CMS has a signed agreement with the drug manufacturer then you get the discounted price once you have met your deductible. 

If this is not what you are talking about, me and my agent contacts don’t know but maybe the pharmacist would know the name of what program they were using with the PDP insurer to get this discounted cash price into your deductible.  

[CBtoo]

This has nothing to do with what I was talking about. 

I am not using the PCP provider to get the discount. I wasn't using my PCP provider AT ALL to fill my Rx at the in network pharmacy (I could have filled it at any pharmacy but went to the one where the coupon cost the least which happened to be an in network one).

As I have said repeatedly I was using a GoodRx or SingleCare coupon and initially not using my Medicare D at all. Then I contacted my PCP provider and asked what to do to get what I paid cash for, not using my insurance, to count against my deductible. 

[GailL1]

@CBtoo 

And then the Pharmacist (PCP) gave you a claim to complete?

Then perhaps they were just doing this for you because it is not a practice that is used for others.  

VeryWellHealth.com 07/17/2025 - Why You Can't Use Drug Coupons With Medicare Part D 

[CBtoo]

No. As I stated before my D did.

And as your article states you can't both use a coupon and have the pharmacy charge your D at the same time. In the pharmacy you have to choose one or the other. As I stated before I choose the coupon in the pharmacy and then I contacted my D. Read my previous post for what I did. 

[GailL1]

@CBtoo wrote And as your article states you can't both use a coupon and have the pharmacy charge your D at the same time. In the pharmacy you have to choose one or the other. As I stated before I choose the coupon in the pharmacy and then I contacted my D

==================

But you cannot use the coupon to get the better price and then file for what you did pay to go on your Part D deductible - To use the discount coupon, you are choosing to NOT use your Part D plan.  To use the Part D plan, you are choosing to use the plan and not the discount coupon.

CommonwealthFund.org - 10/01/2024- Are Online Discount

Websites Helping Medicare Beneficiaries? 

from the link ~

Beneficiaries have options and make trade-offs to lower their costs and afford their prescriptions. One recent option is companies that offer prescription discounts. An increasing number of private, for-profit companies, including GoodRx, Amazon, BlinkRx, and Cost Plus Drugs, offer medication discounts via physical cards or online promotions. But there is one important limitation: beneficiaries cannot use these onlinediscounts with Part D drug coverage.

AmazonPrime is another drug discounter and even in their terms of service it says . . . . . The Amazon PrimeRx prescription savings benefit is not insurance and cannot be combined with any insurance benefit, copay assistance program, or other third-party financial benefits. When you use the Amazon Prime prescription savings benefit, you are responsible for the discounted cost of your prescription(s), and you agree not to seek reimbursement for any cost incurred using this Product from any commercial or employer sponsored insurance, or any federal or state-funded health care program (for instance by submitting a manual claim).

from this link:

Amazon Prime Rx Terms 

more:

The Amazon Prime prescription savings benefit and INSIDE RX ARE NOT INSURANCE. Cannot be used with any insurance benefit, copay assistance programs, or by persons covered by state-funded or federal-funded programs such as Medicare, Medicaid, or Tricare for purchases of certain medications, even if processed outside the benefit as an uninsured (cash-paying) patient.

More:  Nerdwallet.com - 06/21/2024- Cost Plus Drugs Might Save Medicare Members Money — With a Catch 

from the link:  Cost Plus Drugs offers inexpensive generic prescription drugs, but it’s not a replacement for Medicare Part D coverage.  Medicare prescription drug plans won’t pay for Cost Plus Drugs medications, so you’d have to pay out of pocket.

Does Cost Plus Drugs work with Medicare?

“We are cheaper than Medicare copays, so we are a great place for Medicare recipients to buy medications,” Mark Cuban wrote in a Twitter direct message.

If you want to buy those lower-cost medications from Cost Plus Drugs, your Medicare plan won’t be involved. Cost Plus Drugs doesn’t bill Medicare, whether you have a stand-alone Medicare Part D plan or a Medicare Advantage plan with prescription drug coverage. You’d have to pay for medications from Cost Plus Drugs out of your own pocket, but it may be well worth doing.

How Cost Plus Drugs affects your Medicare Part D coverage

You don’t get any credit toward your Part D deductible when you fill a prescription through Cost Plus Drugs. You only meet the Part D deductible by paying for drugs your plan is covering, and Cost Plus Drugs doesn’t bill Medicare Part D plans.

more info at the links ~

Singlecare says this:  

Can you use SingleCare with Medicare?

It’s important to note: When you use your SingleCare card, the pharmacy processes it instead of your Medicare card, not in conjunction with your Medicare card. Let’s say you have a $100 copay for a medication with Medicare, and the SingleCare price is only $5. The pharmacist can use the SingleCare card to give you the lower price. But, when you do this, it won’t count toward your out-of-pocket maximum. 

Why can’t Medicare patients use coupons?

The Anti-Kickback Statute (AKS) “prohibits the exchange (or offer to exchange) of anything of value in an effort to induce (or reward) the referral of the business reimbursable by federal healthcare programs.” This includes drug manufacturer coupons and rebates. The AKS was intended to prevent pharmaceutical companies from making money or persuading the purchase of prescriptions that the federal government would reimburse through the Medicare program.

However, it is 100% legal to still use drug coupons if you have Medicare. As mentioned above, Medicare beneficiaries will just have to choose to use the drug coupon or their Medicare card. You just can’t use both.

Singlecare and Medicare PDP - ONE OR THE OTHER ; NOT BOTH 

That is the reason why you nor I nor anybody can do as you said you did - Everybody I talked to and all the reading - says the same thing.  You have to use one or the other - and never the two shall meet- No discount coupon use of a drug - GoodRx, Singlecare or Prime Rx or any other -  on the Part D formulary medication will be used to increase a Part D plan deductible.nor will it br applied to any other Part D plan cost.  

Somebody just messed you up here.  

[GailL1]

@CBtoo  Still looking - I’m a diehard.  

Question - I think I know the answer but will ask to make sure.  I have found several insurers reimbursement claim forms - Is that the type form that you completed?  

Similar to this:  https://www.caresource.com/documents/part-d-direct-member-reimbursement-form/ 

You had to send them a special type receipt showing 

Prescription Receipt – This receipt shows the pharmacy

information, date of service, physician, Rx number,

drug name, eleven-digit NDC, quantity, days supply

and amount you paid. This is usually the receipt

attached to the outside of the prescription envelope. As

an alternative, you may request a prescription history

report from your pharmacy for a given time period. As

long as it shows all of the information noted in this

paragraph and is signed by the pharmacist, this can

serve as your pharmacy prescription receipt.

When your specific PDP insurer gave you credit for what you paid on your deductible.   Did you have to pay anymore to bring what you paid up to their level of tier reimbursement?.  

Because I assume the price you paid with the discount coupon was lower than your price on the PDP plan.  So there was no reimbursement amount in question.

[TRL1111]

. 

---

@CBtoo wrote:

also, while not advertised anywhere you can find easily, if you turn proof of payment (eg when you use GoodRx, another coupon or otherwise pay cash for a covered drug not using your D) into your D they are supposed to count it against your deductible. 

---

What's your source for that?  Savvy people know to check their insurance price against discount out-of-pocket options, and will often choose the out-of-pocket even though it doesn't count toward the deductible.  If it can count toward the deductible, that would be a win-win.  But this is the first I've heard of that being possible.

[CBtoo]

TO: TRL1111 - Savvy people know to ask their Medicare D provider like I did. I give myself 10 stars for being savvy. Hmm since I am savvy maybe I can get 20 stars or even more? LOL  

Sheesh being polite and not name calling/puttin people down on these forums doesn't take much work. So you hadn't heard of something. So what? Most people still learn new things regardless of their age. Your better approach would have been to ask me how this works rather than attack me.

But since more than you read this forum (so you can ignore what I will post next if you don't want to know and be savvy like me since you didn't ask) here is how I have done it (last did it in 2024 so don't know if the rules have changed in 2025).

1) This only works with a drug on their formulary so check that first - or at least that is what I have found. 

2) Call your medicare D (I have original medicare so no idea if this works with an advantage plan that includes drugs - you will need to call them to ask) and find out their process. Be prepared for the first customer service rep you talk to have no idea. Sometimes I have had to talk with a supervisor or call back and ask again.

3) I have had 4 D's in 6 years and I have found what they want me to do overlaps substantially (but you need to ask what they want). What I have had to do is to file a manual claim with my Medicare D (since you didn't have your pharmacy submit the bill to insurance - and of course you can't use a coupon at the same time you use your insurance; it is one or the other; they need a claim form) in order for it to count.

4) I have found some Medicare D's have an easier process than others (I have had 4 different ones in 6 years). Although their manual submission process varies you likely will need the pharmacy receipt, the paper that they attach to your Rx that tells about the drug that has your name and drug on it, etc. and sometimes I have had to submit a copy of the Rx from my physician, along with the diagnosis code relevant to the Rx.

5) I don't bother to go through the hassle if only a small amount of money is involved, but in some cases I have saved a fair bit using GoodRx, SingleCare, etc. Then I think that is worth it to me for the PITA factor to submit this. Once I had to appeal but I won.

6) Again call your Medicare D to see how they want you to proceed.

So now you too (eg the original poster who attacked me) can be savvy and save some money if you feel like jumping through the flaming hoops.