medco, united health care questions/confusions. Please help

[icekitsune]

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Hi There,
I'm was assigned to look up information regarding insurance for a patient, i guess to help the patient choose a decent insurance plan under medicare part D. I was told to look up tiered levels, something like fixed copay and percentage of cost for just abilify (only drug that he is taking). I am really confused on what i'm supposed to look up. Can someone explain to me what these insurance/pharmacy program means?

I was told medco was an mail order pharmacy and is not insurance.. Is he asking me to find how much the drug will cost the patient? What is percentage of cost. I have absolutely no experience in insurances at all. Much help is greatly appreciated

 

[All4MyDaughter]

This is the easiest way to compare Medicare Part D plans: https://www.medicare.gov/find-a-plan/questions/home.aspx

United Healthcare is an insurance company. Medco is a pharmacy benefit manager. Most plans have both, but sometimes a company serves as their own PBM. My United Healthcare plan is switching from Medco PBM to CVS/Caremark at the beginning of 2013.

 

[genesis09]

All of United Healthcare plans will be dropping Medco as their PBM at the end of the year. They will switch to Catalyst.

 

[All4MyDaughter]

All of United Healthcare plans will be dropping Medco as their PBM at the end of the year. They will switch to Catalyst.

Our UHC plan is switching to CVS/Caremark. We just got all the info in the mail.

 

[icekitsune]

thanks for the reply. but what does that mean? Does that affect their medicare insurance? Someone explained to me that medco and united health care has insurance plans under medicare part d. So i guess, what i need to do is look up the best premium, deductable and copays for this patient. Sorry..i'm still very confused

 

[All4MyDaughter]

thanks for the reply. but what does that mean? Does that affect their medicare insurance? Someone explained to me that medco and united health care has insurance plans under medicare part d. So i guess, what i need to do is look up the best premium, deductable and copays for this patient. Sorry..i'm still very confused

Health insurance - pays for doctor visits, xrays, hospitalization, etc
Part of health insurance is pharmacy coverage, and health insurance plans often hire pharmacy benefit managers (PBMs) to manage that.

United Healthcare is health insurance
Medco is a PBM

If you need to look up plans, use the link I provided. Did you look at that site?

 

[icekitsune]

Health insurance - pays for doctor visits, xrays, hospitalization, etc
Part of health insurance is pharmacy coverage, and health insurance plans often hire pharmacy benefit managers (PBMs) to manage that.

United Healthcare is health insurance
Medco is a PBM

If you need to look up plans, use the link I provided. Did you look at that site?

I did, thank you. I saw the medco and unitedhealth both have prescription drug plans but only unitedhealth (out of the two) have medicare health plan with drug coverage. Thanks so much for helping me with this.😍
Also, if the plan has a deductible. the patient would have to pay upto the deductible and then the ins will help cover and the patient will pay copays (after the deductible's been reached??)

 

[All4MyDaughter]

I did, thank you. I saw the medco and unitedhealth both have prescription drug plans but only unitedhealth (out of the two) have medicare health plan with drug coverage. Thanks so much for helping me with this.😍
Also, if the plan has a deductible. the patient would have to pay upto the deductible and then the ins will help cover and the patient will pay copays (after the deductible's been reached??)

Yes

 

[farmadiazepine]

It is confusing as hell to pick any medicare part d plan. It's the most disorganized, confusing thing ever. It's also very stupid. The entire system could be made easier, but hey, this is America and I'll leave it at that..

 

[MountainPharmD]

It is confusing as hell to pick any medicare part d plan. It's the most disorganized, confusing thing ever. It's also very stupid. The entire system could be made easier, but hey, this is America and I'll leave it at that..

Isn't it great our government just dumped it on the seniors without any plan for explaining it or helping them? Oh wait your local retail pharmacist gets to do that for free! Maybe the government isn't so stupid!

 

[icekitsune]

do you guys know what direct medicare A and B means? I have a pt which has direct medicare A and B but is on wellcare C and D