I just met with our BC/BS agent.  I finally feel some peace with this Medicare Drug Plan stuff.
 
I guess there are 7 regions in the US, and all have different government criteria.  Then, within the regions there are many Insurance companies offering different options.  I guess our region, which includes Iowa, South Dakota, North Dakota, Minnesota, Montana, Nebraska, and Wyoming, is being blessed by the government because we do not get subsidized much compared to the coastal regions.  Right now my husband is on a study using Gleevec, so the drug does not cost him anything.  This could change at any time.  The agent recommended Option 2 for him.  This would cost him 53.90/month with no deductible, but Gleevec is not on the formulary.  He goes to Houston Thursday & Friday, and hopefully they will assure him that he will be on the study for the next year.  Otherwise he would have to go to Option 3 which would cost him $99.90 per month (no deductible).  Gleevec is on the formulary.  He would pay 30% coinsurance for all drugs, but they WILL pick up costs after the $3600 max out of pocket. So, we'll wait until he has been to MD Anderson and decide which option to use.
 
Wow...what a nightmare.
 
My sister is living in Texas, which he says is a whole different thing!
 
Debby
 
 


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