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(Medicare Part D Insurance Plans for those over 65)

Medicare Part D Insurance Plans for those over 65

Comments are grouped chronologically, with newest first.

(Contributed by John Church, 12/12/2013)
Last year I selected a plan (Coventry First Health) for my wife based on her drug list.  After enrolling, I tried to get one of the prescriptions filled, and the claim was denied.  Although the medication was in their formulary, it required Prior Authorization (PA), but upon checking, they said medicare had not approved the drug for this use, and that it was only approved for three specific cases. We appealed, they denied. (Note that our SRS BC/BS plan had paid for the prescription.)

Simply selecting a plan based on submitting a drug list does not tell you whether they will actually pay for a drug or not. Further checking is required before selecting a plan.

It also turns out that Coventry First Health is changing their formulary next year and excluding another of my wife's meds while increasing the premium. So don't count on anything being the same even if you stay with the same plans.
Re: CIGNA Insurance (Contributed by John Church, 12/12/2013)
Recently, I noticed the following statement posted in a local medicap practice office:

Effective 1/1/2014, ("this practice") will no longer be contracted with CIGNA insurance. Please make arrangements to either switch insurance or physician. In the event you do not switch insurance or physician your claims with CIGNA will be considered "out of network".

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Aiken SC

Revised: January 2, 2015

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