Thursday, July 16, 2026

Thousands of Medicare beneficiaries thought their drug plan was free. Then they lost it.

 

Thousands of Medicare beneficiaries thought their drug plan was free. Then they lost it.

https://www.dailykos.com/stories/2026/7/16/800067959/health/thousands-of-medicare-beneficiaries-thought-their-drug-plan-was-free-then-they-lost-it/ 

Thousands of Medicare beneficiaries thought their drug plan was free. Then they lost it.

by KFF
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This Aug. 29, 2018 photo shows an arrangement of prescription Oxycodone pills in New York. Figures from a 2017 survey released on Friday, Sept. 14, 2018, show fewer people used heroin for the first time compared to the previous year, and fewer Americans misusing or addicted to prescription opioid painkillers. (AP Photo/Mark Lennihan)
Next year, thousands of people in 32 states and Washington, D.C., may see their premiums go up and not realize it.AP

By Susan Jaffe for KFF

Jude Pare and his partner, Diane Tix, live in rural Minnesota until temperatures dip below freezing, when they take refuge in Arizona for the winter. While away, their mail is forwarded. But Pare, 77, said he didn’t receive any warning from his Medicare prescription drug plan that his $0 monthly premium was about to increase.

So he didn’t know he had a bill to pay. After he and Tix returned home to Minnesota in April, they got a letter from Wellcare, the insurer that provided his drug plan, saying his coverage had been terminated after three months of unpaid premiums totaling $28.80. Under Medicare’s rules, he can’t enroll in a plan again until the fall, for coverage beginning in 2027.

Pare takes Xarelto, a blood thinner that reduces his risk of strokes, blood clots, and pulmonary embolism. “He could bleed to death without it,” Tix said. A 90-day supply of the drug costs about $1,800 using a coupon from GoodRx, a discount drug website, she said.

Pare is among tens of thousands of Medicare beneficiaries who were on Wellcare’s Value Script drug plan who will likely go without prescription drug coverage for the rest of the year because they didn’t pay premiums for three months.

Related | Democrats propose bill capping out-of-pocket Medicare costs for enrollees

Next year, thousands more people in 32 states and Washington, D.C., who are enrolled in zero-premium drug plans from Wellcare and other insurance companies may find themselves in the same situation if their premiums go up and they don’t realize it, according to a KFF Health News analysis of drug plan data. Premiums and other changes for 2027 will be unveiled in September.

Going without medication can be life-threatening, especially for Medicare beneficiaries. Nearly 90% take one or more prescription drugs, according to the Centers for Disease Control and Prevention. Almost half live with four or more chronic health conditions that can cause functional or cognitive impairments.

By the time Jude Pare and his partner, Diane Tix, found out he owed $28.80 for three months of drug plan premiums, his coverage had been canceled. He is among tens of thousands of Medicare beneficiaries who will likely go without prescription drug coverage for the rest of the year after their drug plans were canceled. (Diane Tix)
By the time Jude Pare and his partner, Diane Tix, found out he owed $28.80 for three months of drug plan premiums, his coverage had been canceled. He is among tens of thousands of Medicare beneficiaries who will likely go without prescription drug coverage for the rest of the year after their drug plans were canceled.KFF/Diane Tix

Congress added prescription drug coverage to Medicare in 2003. But the coverage is administered by commercial insurance companies, which compete fiercely with one another for the business of about 56 million Medicare beneficiaries enrolled in drug plans.

Zero-dollar or very low monthly premiums have helped make Wellcare’s Value Script the bestselling stand-alone prescription drug plan in Medicare, with nearly 6 million customers across the U.S., according to government data. But in 26 states and Washington, D.C., some Value Script members who didn’t have to pay a premium last year were caught off guard by increases in 2026.

After a two-month grace period — which Wellcare extended to three — Medicare drug plans can drop customers who don’t pay their premiums, no matter how small the amount. Some members who lost their coverage in Nevada, for example, owed as little as $8.10 for three months, according to a KFF Health News analysis of Medicare drug plan data.

Wellcare terminated coverage for about 140,000 Value Script beneficiaries in April, according to a person with knowledge of the matter who was not authorized to speak publicly about it and feared reprisals at work for doing so. About 40,000 of the people who were dropped may be able to enroll in new coverage immediately because they have low incomes and receive financial assistance through a program Medicare calls “Extra Help.”

Multiple state officials said they had heard the same disenrollment figures, including Nevada’s insurance commissioner, Ned Gaines, who chairs the National Association of Insurance Commissioners’ senior issues task force; Rebecca Gouty, director of the State Health Insurance Assistance Program in West Virginia; and Tim Smolen, director of Washington state’s Statewide Health Insurance Benefits Advisors. The West Virginia and Washington initiatives are part of the federally funded State Health Insurance Assistance Program, or SHIP, which provides free, unbiased help navigating Medicare.

Surprise Bills

The Centers for Medicare & Medicaid Services, which oversees Medicare drug plans, declined to provide the number of Value Script members who lost coverage due to unpaid premiums. “The agency does not publicly provide plan-specific disenrollment figures or state-level breakdowns related to the non-payment of premiums,” Christopher Krepich, a spokesperson, said in a written statement to KFF Health News.

Centene Corp., Wellcare’s parent company, also declined to provide disenrollment numbers.

“We recognize how disruptive a loss of coverage can be and are committed to helping members understand their options,” said Sarah Baiocchi, senior vice president for specialty and prescription drug plans at Centene. She acknowledged that “some members in our Value Script plan experienced a premium for the first time, or for the first time in several years.”

Baiocchi said all Value Script members received a CMS-required annual notice of changes in September, before the premium increases took effect.

A version of the booklet sent to members in two states and Washington, D.C., is 21 pages long. The new premium is mentioned on pages 3 and 8, along with changes to out-of-pocket costs and how to find updates on covered drugs and network pharmacies.

The company also informed members about 2026 premium changes through phone calls, text messages, regular mail, or email, Baiocchi said.

People who are dropped are not able to reenroll or join another drug plan until the start of the open enrollment period this fall for coverage beginning Jan. 1, unless they qualify for an exception, Krepich said. And because they will have gone without coverage for at least 63 days, they could be hit with a permanent late-enrollment penalty that increases every year for the rest of their lives.

“Medicare should be doing something about this so that we can go ahead and get coverage now,” said Wayne Bennett, 74, who lives in Durham, North Carolina.

Wayne Bennett lost his Medicare drug coverage because he didn’t pay the premium, which was free last year but — without his knowing — went up this year. “Medicare should be doing something about this so that we can go ahead and get coverage now,” he says. (Wayne Bennett)
Wayne Bennett lost his Medicare drug coverage because he didn’t pay the premium, which was free last year but — without his knowing — went up this year. “Medicare should be doing something about this so that we can go ahead and get coverage now,” he says.Wayne Bennett/KFF

In May, he found out that Wellcare had canceled his Value Script plan because he hadn’t paid his $3.60 monthly premiums. He takes nine prescription drugs to treat his blood pressure, glaucoma, chronic obstructive pulmonary disease, and other health problems. He filled most of his prescriptions — including several at no cost — before he lost coverage. He doesn’t know what he’ll have to pay when his supply runs out.

Gouty, the West Virginia program head, said many Medicare beneficiaries arrange for their monthly drug plan premium to be automatically deducted from their Social Security benefits, and that many likely thought that choice remained in place until they changed it.

“They didn’t realize that when the plan was a zero premium in 2025, that stopped the Social Security premium deduction and they would have had to reelect it for 2026,” Gouty said.

In other words, even if they mistakenly thought the premium was still zero, Medicare beneficiaries would have needed to somehow allow Social Security to make deductions — something the agency doesn’t do — or set up a payment plan through their bank or credit card in case payment was necessary.

“That sounds goofy,” Tix said.

Centene’s Baiocchi blamed the Social Security Administration for the problem: “We believe this was a key driver of non-payment disenrollments and subsequent complaints.”

Spokespeople for the agency referred questions about the matter to CMS.

Krepich said legal requirements for drug plan enrollment and disenrollment limit what CMS can do to help beneficiaries who lose coverage for not paying their premiums.

‘Pretty Upset’

Now that Pare has no prescription drug coverage, his doctor replaced his blood thinner medication with a much less expensive drug that should be just as effective. Pare paid $111 for four other medications that used to be free under his Value Script plan. He hasn’t had to refill four more prescriptions yet and doesn’t know what they will cost, Tix said.

If Wellcare members knew about the premium increases, they could have set up direct billing or an automatic payment plan early this year before the payment grace period ended April 1. But they would have been able to fill prescriptions during the grace period, so if they didn’t see Wellcare’s notices, they likely assumed there was no problem with their coverage.

Bennett, the North Carolina man, said Wellcare used to send him text messages with health tips and reminders when it was time to pick up a prescription. He didn’t know his premium had increased from $0 to $3.60 until it was too late.

“I was pretty upset,” he said, when he called the company. “The premium wasn’t that much, and I was ready to pay it right off the bat. I had my credit card out ready to make the payment.”

The customer service representative wouldn’t let him pay because his coverage had been canceled, Bennett said.

Hoping to restore it, Bennett called Senior PharmAssist, a Durham nonprofit that advises Medicare beneficiaries and is one of more than 2,200 SHIP sites across the country. He was told he must wait until January to restart his drug coverage, said the group’s executive director, Gina Upchurch.

He doesn’t qualify for the “Extra Help” low-income subsidy or meet other CMS criteria for a special enrollment period, which would allow him to change drug plans during the year. CMS typically allows midyear switches for beneficiaries who, for example, move out of their plan’s service area, experience a natural disaster, or get help paying for drugs from a state program.

Related | They’re uninsured after Obamacare became too costly. And they’re far from alone.

Senior PharmAssist was able to help one of its participants join another drug plan after she lost Value Script coverage because she is in North Carolina’s pharmacy assistance program for people with HIV/AIDS and has limited income, Upchurch said.

A further exception allows any Medicare beneficiary to enroll at any time in a drug plan that has earned five stars, the top grade in Medicare’s performance ratings. However, there are no five-star Medicare drug plans available to the general public. Only two insurers offer five-star plans, and only for retirees from certain employers. Their combined enrollment is about 8,700 as of June 1, according to the insurers.

But Upchurch, with more than two decades of Medicare expertise, doesn’t blame beneficiaries for not paying attention or for assuming Wellcare’s messages were bogus. Older adults are particularly vulnerable to identity theft and other scams and are often advised to ignore junk mail and calls from telemarketers.

Since Value Script members such as Bennett continued to get their prescriptions filled during the payment grace period, “why wouldn’t they think this was a scam?” Upchurch asked. “They are constantly bombarded by people selling them something that’s illegitimate or trying to scam them.”

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  1. Comment by Things Come Undone.

    "The Centers for Medicare & Medicaid Services, which oversees Medicare drug plans, declined to provide the number of Value Script members who lost coverage due to unpaid premiums. “The agency does not publicly provide plan-specific disenrollment figures or state-level breakdowns related to the non-payment of premiums,” Christopher Krepich, a spokesperson, said in a written statement to KFF Health News."

    Why not ?

  2. Comment by first last.

    Having qualified for that Extra Help meant the generic EpiPen only cost me $1.80. The pharmacy called because they thought it was a mistake, too, lol. I had a backup credit card all ready in place. Also qualified for the Medicare Savings Plan which covers the Part B through NYS Medicaid as a QI. I’ve lost the QMB qualification that covered Part A deductibles because I did some selling on EBay but Social Services said I can get that back. Glad I live where I do.

  3. Comment by AdamSelene.

    Remind me again why we hated "Hillarycare" so intensely ... and why the "single payer option " never even made to the [metaphorical] negotiating table

  4. Comment by ComradeAnon.

    Exact same thing happened to me. I MIGHT have received a piece of mail announcing this, but I seriously doubt it. I definitely didn't an email or a text. I'm on only a few relatively inexpensive drugs and the G**RX card helps. But my agent told me I might have a penalty applied this October since it lapsed. Definitely watching this closely. Thanks for great article.

  5. Comment by Leslie in KY.

    So I have had the WellCare plan. In the fall when enrollment opened, I did the thing I do every year which is search using the Medicare drug plan tool for the best plan with my meds. It was still WellCare but I noticed it went up to $8 from $0 last year. I elected to take the plan and then followed instructions to have the premium taken out of my Social Security check (I think, if not it was our bank). It did involve some notices from them where they asked how I wanted to pay the premium and I remember making sure my husband took care of his because he is not always attentive to such things. I can imagine him forgetting to set up the autopay. There have been other years where our plan, including WellCare, had a fee so I expect there to be one. I think it was only $0 on two of the years we have been on Medicare.

    I have had a lot of new diagnoses with new drugs added since I took the plan including expensive blood thinner Eliquis, which it is only paying part of, which for some reason was $515 the first 90 days but $186 the next refill. I probably need to ask why that happened, now that I am looking this up to write this comment. Retail price says $1,214. Could be something about the donut hole, I don’t know.

    That said, I still have original Medicare and a Mutual of Omaha plan G supplement and have only paid the $285 deductible this year while having multiple tests, procedures etc. including an ablation for the a-fib last Friday, at Vanderbilt where the quality of care is top-notch. We are lucky to be within driving distance 2.5 hrs since we are in a medical desert here (Paducah). The old doctors are retiring, new ones don’t want to move here, and if someone didn’t grow up here and become a doctor, they are having trouble getting quality physicians here now.

    • Reply by GrumpyOldGeek.

      Your WellCare Part D plan has a deductible which is why the first Rx's of the year have higher co-pays. It's capped at $2100 out of pocket annually. My research doesn't show a donut hole this year, but who knows? My Zarelto is about $2400 retail for a 90-day supply but my co-pay is actually slightly less than yours and this is with a 0$ Part D WellCare plan. I think this has to do with Biden's action to reduce costs for commonly-used expensive drugs. Eliquis and Xarelto were both among the first 10 drugs on Biden's list.

  6. Comment by zenpaddler.

    I learned that my drug coverage was cancelled by reading this article. So for the rest of the year I am at risk of needing an extremely overpriced drug. I will also have to pay a premium added to my payment for the rest of my life because I didnt pay a insurance company every month. They can drop me for 10. and then cost me 100s. Nice system. By the way the company sent me survey question via email in April yet they could not send a payment notice. Thank you Susan.

  7. Comment by thanxamillion.

    Open enrolment? “…helping members understand their options”? Late enrolment penalty?

    WTF? I’m a US citizen expat living in Europe. As a resident I have health insurance. There are no “options”. There is no “open enrolment”. There are no “late enrolment penalties”. I have the exact coverage as every other legal resident. If I need medical care I get it. If I need prescription drugs they are subsidised.

    When I listen to my 84 year old sister, in the US, talk about the convoluted crap she goes through to keep body and soul together and not go bankrupt, my eyes cross.

    WTF is wrong with American voters that they don’t rise up and demand a sane healthcare system? It’s real simple. A single payer health insurance run by the government. If you want some private specialty insurance it can be bought. But you really don’t need it. The single payer system pays your healthcare bills.

    And if the problem is “not enough money”… that’s simple too. Elon Musk has plenty!

  8. Comment by Angela Marx.

    When I started on Medicare in 2020, I elected for my Social Security benefit to pay my premiums, including my Part D, directly - BEFORE they sent my benefit check. So there is never any chance that my premiums will go unpaid.

    Can't every Medicare patient opt to do this?

    • Reply by tmseattle.

      It's not clear to me that those people would have been covered since they had a free plan. I don't think there's a way to set up automatic payments of $0.

    • Reply by JakeBoom.

      From the story, it sounds like when the premium went to ZERO, that triggered the automatic withdrawal from SS to go away and then when the premium increased, they would have had to reenroll in the automatic withdrawal. And many didn't notice.

    • Reply by zenpaddler.

      That was not an option for 0$ plans. It is like a bait and switch. We will cover you for 0 payment. Then we wont send you a clear email saying their is a charge now so we can cancel you. Just honest straight forward business.

    • Reply by GrumpyOldGeek.

      Yes, everyone can opt to do this as long as the option is available. It's possible to enroll in Medicare and delay your enrollment in Social Security (to get a higher monthly SS benefit, for example), so premiums must be paid another way (direct billing or bank auto-pay) for the interim. I think the problem with WellCare Part D was that people weren't signed up for SS premium payments and assumed it was 0$ but that changed. People got notice but assumed it wasn't real and didn't pay the small premium. If they had elected the SS payment option when they signed up, it would have been paid automatically. Thus, only a few thousand people fell through the cracks rather that the millions who chose the most popular WellCare Part D plan. I pay premiums through SS, I have that WellCare plan and it's still in force.

    • Reply by oslyn7.

      We thought that was the deal for us, too. Somehow, somewhere along the way, things changed...discovered to our horror that there was an unexpected additional charge and WellCare dumped us.

    • Reply by Leslie in KY.

      If you had a year with 0 premium you have to set up the auto deduction again if that changes. See my comment.

  9. Comment by juliabliss.

    Not just M4A but actual universal healthcare. Paid with tax dollars which will be lower than the monthly premiums, copays, deductibles and noncovered expenses charged to "normies" under the current capitalistic for-profit plans. If you want better insurance and can afford it, you can have the privilege of paying for it like they do in the UK and Canada.

    This is not just for seniors btw. My husband has taken meds since his 30s whose (generic) cost raises eyebrows every time I fill it before we use the GoodRx app. I have required meds every day since junior high, and at one time those cost me $800/mo under employer insurance with monthly employee premiums of $900/mo.

    This should be embarrassing for anyone paying attention ... which unfortunately doesn't involve most of our lawmakers because they receive affordable insurance, decent pay, paid sick leave, plus onsite concierge doctors at work. M4A would help tremendously.

  10. Comment by WireBender73.

    Years ago I got switched to one of the (then new) expensive blood thinners which I couldn't afford. First, I went back to Warfarin, very inexpensive but requiring me to get blood tested (INR) regularly, a fairly inexpensive lab test, finger stab. Minor annoyance. Any different thing in my weekly diet could put the values off, and I was at risk of large bruises after a small bump, or worse in a major accident. One small bump years ago still shows a shadow under my skin all down my calf.

    Today I'm not on any blood thinners because I signed up to get a Watchman put in my heart in a little pocket that doesn't do much functionally, but any cardiac rhythm change can allow blood to pool inside it. When regular rhythm returns the clot which formed when it wasn't pumping can now get pushed out to any art of the body where it can do damage, including major strokes.

    I got to see the watchman before surgery and it looks like a fingertip sized metal mesh umbrella. It closes to go in, opens inside, and won't come out. The body says it doesn't belong there and works to wall it off completely. No opening left in a few weeks, no clots form, no blood thinners needed again but only once closed off. As far as I know the surgery is covered by insurance like all necessary surgeries per your plan. Insurance companies know it saves them a lot of money in your medical bills. No more weekly blood tests, at least for that. No fear of bankruptcy from needed meds I couldn't afford.

    I have a relative who had several bad strokes for a different reason where her blood thinners weren't under control. She feared the Watchman when it was new tech, but several years later and hearing my story, she got one. No new strokes, though damage from earlier still lingers and she remains in a wheelchair and has problems with speech.

    This is not a one-thing-fixes-everybody, but I recommend talking to a trusted doc to see if it can work for you.

  11. Comment by Isny.

    This article talks about the blood thinner Xralto and quotes the wife as saying her husband would bleed to death without it. It's a blood THINNER -- he could bleed to death with it (unlikely). A blood thinner is to prevent strokes, etc.

    Also, if you're in dire straits, take a low- dose baby aspirin every day. Not as efficient as the prescription blood thinners, per my cardiologist, but still works well and everyone can afford it.

    • Reply by WireBender73.

      I was already on the aspirin regimen and still needed blood thinners. (See my comment above.)

    • Reply by juliabliss.

      I realize you're trying to be helpful, but this was just one example. There are plenty of meds that treat conditions that cannot be helped with a device or lifestyle changes. Let patients and doctors handle health, the way they do in every other country on the planet. Thanks.

    • Reply by jhecht.

      Everyone I know who was prescribed Xarelto, including myself, are now on Eliquis. I don't know if it's any cheaper, but it doesn't have the side effects that Xarelto has.

    • Reply by Isny.

      I understand. Just saying that it would have at least helped the person in the article. Better than nothing, I mean.

    • Reply by Isny.

      Absolutely!

    • Reply by Isny.

      Good to know. I talked with my cardiologist about Eliquis versus aspirin. She told me Eliquis was the gold standard of blood thinners. She did leave it up to me whether to start it now or not, since I'm not yet at great risk of strokes. YET being the operative word.

    • Reply by thanxamillion.

      Exactly. Healthcare ain’t for amateurs. The “do your own research” crowd, like JFKjr, can get you dead.

      I let my doctor do the research.

  12. Comment by Notpaidtopost.

    I had Well-Care Medicare Advantage coverage last year, after Aetna discontinued the wonderful plan I had with them.

    I did not like Well-Care at all. First, they called, texted and emailed me constantly. Ever feel like your insurance company was invading your life, perhaps looking for an excuse to deny coverage for something? That's what it felt like. Also, their dentalcare provider was HORRIBLE. And unprofessional. I'd even use the words 'fraud' and 'misrepresented'.

    Dealing with WellCare systems was like dealing with a computer program that was 10 years old and had never been updated.

    I've been healthy. I got Med Advantage for the dental, because I think dental health is super important. I'll hope to switch to regular Medicare in a few years.

    I dumped WellCare for a better option. I'm super happy with my new provider.

    Despite all the crap WellCare sent me last year, I didn't get notice of this change. It may not have been part of my coverage, not sure, but my prescriptions were free.

    Dr. Oz sends out emails monthly, which I read. This kind of thing should have been noted.

    In my opinion, three months warning is not acceptable when dealing with slow moving ginormous government programs.

    • Reply by Isny.

      You read the shit Dr. Oz sends out? His face turns my stomach (because of the despicable person he is), so I delete his emails as soon as I see his photo.

    • Reply by Leslie in KY.

      It is funny because when I was a speech therapist, we had managed care plans instated by Kentucky for the Medicaid patients I was serving. Coventry Cares (which I called Coventry doesn’t care) became Aetna, and we had WellCare and later Anthem BC/BS to deal with for prior authorizations. Aetna was EVIL and the doctors I dealt with for appeals horrible and I could tell you stories. I talked with the state Medicaid directors and they told me to just have parents ask to have their child changed to another provider, which at first was just WellCare, later the Anthem was an option. WellCare was fantastic, no problems, they approved everything, never made us fight to get visits etc.

    • Reply by MilesNorth.

      Insurance companies collect a lot of data. In the first month after raising premiums, the insurance companies knew that many people did not get the message. Their lack of a proper response is criminal fraud. This should investigated and remedied.

  13. Comment by richthetraveler.

    Medicare prescription plans are a joke. I have one, but soley because someday I may need the cap on out-of-pocket expenses. But for the rest, usually the prices on GoodRx are superior to the co-pays for my Wellcare program. I have trained my pharmacy people to compare the prices for each before filling a prescription. Usually the prices at GoodRx or with store coupons are better.

    • Reply by zenpaddler.

      Medicare doesnt cover my only script. It is something my mother and grandmother used. My doc goes through the procedure to get it covered yet it never actually does cover it. Yet if one goes to the hospital under stress they use drugs. Lots of drugs priced as high as a drug can be priced. No choices except to argue price after words.

    • Reply by Leslie in KY.

      Most of mine are free because they are routine things like bp meds, thyroid meds. It is true for some of the other drugs that have come up now that I am a professional patient this year, I go the other route, although the last one was only $1 difference so who cares.

  14. Comment by Hopeful.

    When I first signed up for Medicare, I did not know that paying for the drug coverage was required. I knew you got Part A, Part B is paid by SSA (If you have it), but then you also have to get Part B gap insurance. I did the math for Part D and figured that with my medications, it was more cost effect to not get the coverage. Turns out, you have to sign up for it. I had to pay penalties for a year (essentially doubling my cost of prescription insurance-which was not large, maybe $7 per month to $14 per month).

    Then to get dental and vision coverage, you also pay extra.

    Oh, how much I pray for a sane system.

    • Reply by BlueStar99.

      Right. We design an incredibly complex, multi-layered system, with predatory for-profit companies running large parts of it, and we expect our seniors, who may be facing cognitive decline to navigate it. It is cruel.

    • Reply by Rexxmama.

      Original Medicare does not offer dental and vision coverage, so if your plan does (even if you decide to forego it) then you're in a Medicare Advantage plan instead...ie, a regular insurance company that offers medical insurance plans that likely restrict which doctors or hospitals you can visit, or won't cover you if you travel to a part of the country that is "out of their covered region/territory." It does pay to go to a certified Medicare insurance agency to review what you currently have vs what you currently need, and they can also help you find a prescription provider (Plan D for actual Medicare) that will provide what you need at the lowest cost.

    • Reply by Seriously Now.

      Are you sure the penalties are only for a year?

      My first year in Medicare was 2024. It happens I take no medication regularly. Very occasionally I may get a script for an illness and by occasionally it may be once every five years.

      Drug plans were just not on my radar so naturally I forgot to get one. I now pay a penalty every year because of a brain fart that happened once. Every year for the rest of my life. The punishment does not fit the crime.

    • Reply by MartyM.

      Yes Medicare Adv plans & Medicare don’t tell us buying a prescription drug plan is the Law!

      So those with only 1-2 prescriptions may think they don’t need it - but will be charged. ugh

    • Reply by GrumpyOldGeek.

      Part D late enrollment penalty is monthly for the rest of your life.

    • Reply by Seriously Now.

      I don’t understand your point. I stated it was for the rest of my life.

  15. Comment by Simnsays.

    "Going without medication can be life-threatening, especially for Medicare beneficiaries."

    Things are not going to change or improve until we accept the fact that the Trump administration doesn't give a shit if we die.

    • Reply by juliabliss.

      Frankly, while the Trumplicans are far worse in this regard, the D party has not exactly shown itself to be interested in allowing people to access care that they can afford to pay for. Yes it's great to have access to something called insurance at exhorbitant rates with very little coverage. It is better than the nothing that was an option in the pre-ACA days.

      But it should be a national embarrassment that that is all we're able to scrounge up, and label a success.

    • Reply by Simnsays.

      You will get no argument from me. Sigh.

  16. Comment by Milwrob.

    Ah, thanks to those who have been buying GQP lies and racist marketing since 1980 along with the seventy seven million stupid people who fell for it again, people are suffering. Don't fret America it is about to get worse ~ the Trump Epstein class need their tax cuts and Orange Caligula needs his war to try to look tough. What do you get from the bargain? You get to pay more, get less and die early! To paraphrase Lincoln, the GQP works to ensure that: "Government of the Stupid, by the Stupid, for the Rich shall not perish."

  17. Comment by Isny.

    I'm on Wellness zero premium. I switched this year because my Aetna plan, which started out at $10/month, had gone up to $90/month. They obviously didn't want me anymore.

    My Medicare account online has a great tool for finding drug plans. You put in every single drug you take, and it will list all the available plans starting with the cheapest. I am under no illusions that my $0 plan will increase, and I will read all mail from Wellness PLUS check the Medicare website at Open Enrollment.

    Having said that, we definitely need Bernie's Medicare for All plan, which includes drugs, dental, vision, and hearing, all at $0 monthly premium.

    • Reply by MarvinMartian.

      I concur about the Medicare(dot)gov tool for checking drug plan prices.

      Just used it this week. Sweetie coming home from hospital with 2 super-duper antibiotics. I entered the name and dosage (when I knew it) and one came up completely covered ($0) and the other came up with about $90 co-pay. Still more than I want to pay, but my middle name is Ebenezer.

      I went to the pharmacy realizing the info could be off, but was plesantly surprised to find it was just about perfectly correct, in fact, a few dollars less.

      So, I am one of those on WellCare Value Script but I still have a Zero monthly.

      So I am wondering who were the people who lost their free coverage and why? Only two things came to my mind:

      A) The state and/or county you live in. I'm in Florida and even though Ruled by the Red, we have a massive health industry here, and it's possible they didn't mess with Florida because ... reasons.

      B) We haven't used the coverage for much beyond a couple of cheap blood pressure medications. Maybe we got to keep the $0/mo coverage because we don't have any expensive drugs. That is a cynical explanation, and if true, a stain on our system, but then, that is hardly a novel or controversial statement.

  18. Comment by Sidney.

    Doesn't Wellcare notify their customers about bills, etc.? This is ridiculous.

    • Reply by Rexxmama.

      They notified me -- I had their Value Plan as my Part D with Original Medicare...zero premiums for the first year, then I think it was around $4 per month for the renewal, then prior to the most recent renewal term they notified me the cost would be close to $7 per month, and they did a drug tier switcheroo so that my most expensive prescription was bumped to a higher-deductible and cost. I went to my Medicare insurance agent, and they found another provider -- Humana -- with a comparable monthly premium, but a bit lower deductible. I am not yet saddled with needing lots of drugs or expensive brand-name drugs, so I can easily pay the entire annual drug plan premium from the get-go; that way they have no means to drop me due to nonpayment before the renewal date.

      If you can afford to do so, I recommend paying the entire annual premium of any insurance plan up front, in full. Then there are no "lost mailings" to worry about. I do that for both my Plan D and Plan F policies; original Medicare deducts the Plan B (hospital) part from my monthly Social Security payment. Something else I do is keep a credit card to use only for paying medical expenses -- plan premiums, uncovered prescription co-pays, elective surgeries (cataracts, anyone?); the only bill I have to watch for comes from the credit card issuer, and I can keep tabs online for how much I owe at any point on that credit card account.

  19. Comment by RepublicanAirPollution.

    "A 90-day supply of the drug costs about $1,800"

    That's $20 per pill, one per day. My insurance pays $19 and I copay $1 (Xarelto)

    This is a life-saving drug. Without it, I am at high risk of stroke, even AFTER my heart operation.

    Of course, Elon Musk needs his tax cut, doesn't he. Not to mention bombs for Gaza and Iran. These bombs are expensive... gotta make those cuts to ill and frail Americans!

    • Reply by Isny.

      Let me add:

      Biden got Eliquis (a better version of Xralto, per my cardiologist) to reduce its price for Medicare. I'm supposed to start it, so I checked the cost: $200/month. That's the special, reduced cost. Snort. I'm sticking to low dose aspirin for now, which is cheap. I'll think about Eliquis as I get older.

    • Reply by jhecht.

      I'm only paying $50 a month for Eliquis with Medicare. Maybe I have better secondary insurance but you should check with your pharmacy.

    • Reply by Isny.

      I'm sure you have a better drug plan. I'm currently on the zero premium plan, which works for me. On this same plan, Eliquis would cost me $200/month. Not only that, but my other medication, which costs me $0, would jump to $30/month.

      These plants are tricky, and you have to be on your toes at all times. Cause they just want to make money.

    • Reply by Leslie in KY.

      I started Eliquis the end of March and the first 90 days cost $515 but the next time I went in to refill that it was only $186. Retail says $1,214. CVS lets you know if they can do it cheaper off your insurance with one of those programs, but for this there was nothing. I just had an ablation at Vanderbilt last Friday but understand I will still need to be on the Eliquis awhile, I think they said a year. Since I got the ablation right after the a fib started I am thinking it will be successful.

    • Reply by Leslie in KY.

      Oh and my plan is WellCare $8 a month plan.

  20. Comment by CTLiberal.

    My blood is boiling over in anger for these people. My mother receives on some days up to a dozen scam calls a day, and dozens of spam phishy emails and texts. This is just cruel.

    • Reply by WireBender73.

      I used to get bombarded by those "according to your records I see you have (fill in the blank with anything common, like back pain.)" I ask who they are, where they got their information ("It's in your records") It's all a scam. My docs deal with what I or actual tests tell them needs attention. Nobody ever needs to call me suggesting a med or procedure I should take. It's always a scam unless they can cite a referral I'm aware of from my doc and they have my doc's name.

    • Reply by Puddytat.

      Same here. It seems your contact data gets released when you're eligible for Medicare. I thought it would stop in between Medicare enrollment dates, but it's never-ending! You just start disregarding stuff you get sent (except in the US postal mail because that is high security and the USPS has investigators and penalties for fraud and scams).

      There's also a point in your life where your attention gets short and things seem more complex so a whole lot no longer makes sense so you disregard even more. My heart goes out to those people. I could see the same thing happening here.

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