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"?

[GailL1]

@CBtoo 

A question - so you get credit for what amount towards your deductible for the med that is on the formulary but you buy some other place?

What you actually paid for it OR what your PDP plan would have applied? 

⬇️

Edited to add:  I have searched and searched and cannot find anyplace where this would be possible because you cannot use or even count in the deductible a formulary drug purchased outside of the plan design like from a discounter like GoodRx or similar.

Edited to add:  

In fact, this is what GoodRx says

”Prescription medications purchased using a GoodRx coupon won't count toward your Medicare deductible or out-of-pocket maximum. So compare both options carefully to decide what works best for your situation.”

GoodRx.com 12/09/2024 - Medicare Part 😧 7 Ways to Save on Your Prescription Medications 

Look under the heading of:  

How does GoodRx work with Medicare?

By all means post a link to someplace that can verify your claim - from Medicare.gov or even a PDP or MAPD that says it.  Cause I don’t see it and do not believe that what you claim is possible.

[CBtoo]

So far (last did this in 2024) I have gotten credit for what i have paid (eg on my receipt from the pharmacy after using ONLY the coupon and not my D, and it is correct you can't use both at the same time but what I am doing is not that; also the drug has to be on your D's formulary). First I buy the med with the coupon and then I contact my D so the amount I paid for the drug with the coupon can be credited against my deductible, Doing this requires jumping through all the hoops my D tells me to jump through. Then and only then did they credit what I paid to my deductible. I am also presuming it would count against the max out of pocket if you submitted it after the deductible was met but I have not been in a situation to do so thus can't state this from first hand experience. 

[GailL1]

@CBtoo 

Nope - no cigar - only drugs on the plans formulary count against your OOP limit with the said insurer.  Same with the deductible - 

If the price is cheaper at a drug discounter then by all means - use the drug discounter but the price you pay does NOT count against your plans OOP or deductible.  That is a financial decision that one has to make on their own cause some people never meet their deductible or their OOP on their plan but could save money by using the drug discounter price.  

[SummerOnTheWay1]

[10/12/25] Carolyn @CBtoo , thank you for this information. Nicole!

➡️[*** CAROLYN. 

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@CBtoo wrote:

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.

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.

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. 

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[GailL1]

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@SummerOnTheWay1 wrote:

[10/12/25] Carolyn @CBtoo , thank you for this information. Nicole!

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I wouldn’t try this until we get a link from her validating how this works - cause I just don’t see how it would word.

In fact, this is what GoodRx says

”Prescription medications purchased using a GoodRx coupon won't count toward your Medicare deductible or out-of-pocket maximum. So compare both options carefully to decide what works best for your situation.”

GoodRx.com 12/09/2024 - Medicare Part 😧 7 Ways to Save on Your Prescription Medications 

Look under the heading of:  

How does GoodRx work with Medicare?

[CBtoo]

Telephone calls don't have internet links. In my message I stated I called. Believe what I was able to do or not. No skin off of my teeth nor money out of my pocket if you don't. 

My Medicare D's (more than one of them over the last 6 years) are the ones who told me this and when I followed exactly what they told me to do it worked.

I haven't tried it this year as I haven't needed to. Perhaps this has changed under the new D rules with the changes in the max out of pocket. That I wouldn't know. I am not sure I'd trust Good Rx though since they aren't a medicare D provider. I'd trust what my D provider told me over a for profit coupon program.

I'd suggest you call your Medicare D provider and ask them rather than demanding a link from phone calls. Your medicare D would be the most reliable source of information to find out what the current situation is - not what I say, not what you say, not what others say, not what random sites on the internet say, etc. ALSO I don't know if it works with advantage plans as I don't have one. 

Of course you can't use a coupon and your medicare at the same time. But obviously paying out of pocket and then getting what you paid credited against your deductible is not the same thing. Whether or not this can be done in 2025 I can't say as I haven't had to do that this year. I now, this year, have a grant for my expensive med where SingleCare was cheaper than my copay for Medicare D (and cheaper than GoodRx) so I haven't had to do this in 2025. And my D provider in 2025 is a new to me one so I don't have any past experience with them with respect to that. Since I haven't had to do this in 2025 I haven't called them in 2025. 

Of course the most reliable source of information is the horse's mouth. Call your medicare D and find out although sometimes the people who answer the phone don't know all the rules so and I have found that that sometimes I have to call more than once to get to someone who actually knows the rules or a supervisor. 

[GailL1]

Wonder if more beneficiaries will pay attention this year (2024 benefit year) than they normally do?

[JohnM222300]

 I was shocked at the increase in cost (CA). My premium was going to TRIPLE and my drug cost was going to DOUBLE and they call that a simple rollover. "If you're happy with your current plan, do nothing and it will roll over." It's downright dishonest, and it feels wrong to me that AARP is putting its name on this. There are other plans out there that cost the same as my current one, and only 1/3 of the cost of AARP. Do your homework and pick a cheaper plan for next year, don't just go with the "rollover"!