Wisconsin Medicare Recepients

[Nikki J]

Formulary is the list a drug plan covers. It also will tell you what tier they are so you can calculate copays. If the advantage plan has an attached formulary it might still have a separate deductible / out of pocket max.

Re the deductible For an advantage plan it is likely after you meet it you will still have copays. I didn’t realize you were referring to that. My comment was about a supplement. You need to check this and also see what the copays might be. The hmo I had prior to medicare had fairly high copays for dme and therapies ( pt, ot and st). Do you see another higher number anywhere? There is often a deductible and then an oop max. In that scenario it is only when you reach the oopmax that you stop paying copays

 

[KimT]

Did you look at Plan G supplementals? The deductible is less than $300 per year. Remember, Trilogy and similar bipaps are paid for on a rental basis, so you would have a deductible each year. PWCs are purchased outright so you actually own it. My cough assist machine was monthly until the cost was paid in full, then I owned it.

 

[Nikki J]

Wisconsin doesn’t have the standard medigap plans. Massachusetts doesn’t either. Nor does Minnesota.

 

[lgelb]

A formulary is a drug list that shows the conditions, if any, under which a drug will be reimbursed and then you look at the tiers listed in your plan certificate to see how much you will pay vs. how much the plan will.

To make it more simple, if you use the medicare.gov site to enter your drugs first, and you can select a pharmacy also, it will show you a list of Part D or Medicare Advantage plans in your zip and how much you would pay for the drugs that you enter on the page.

 

[raw40]

I am in Wisconsin. My mom really shopped around with insurance. She chose, in my opinion, a great plan. From paying her bills for her, I can attest that there was minimal out of pocket, even with her wheelchair, BiPAP, and cough assist. She was 62, though, when she had the following: Medicare primary, AARP Medicare supplement, and SilverScript for prescriptions.
Hope you get what you need!