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I have had federal BC/BS drug coverage for roughly 52 years of my life. Open seasons came along every year and the only change I ever considered was whether to go with the Standard Option or the Basic Option. We changed to Basic Option a few years ago. We both have Medicare Part A and B. Drug benefits never seemed to change much.
In the past two weeks both my spouse and I received a slick brochure titled 2024 FEP MEDICARE PRESCRIPTION DRUG PROGRAM (“MPDP”) Basic Option Member Kit. I have read it and didn’t see many changes other than higher drug co-pays and the addition of a Pharmacy Out-of Pocket Maximum.
The only thing bothering me is a statement that “What happens if I don’t want MPDP anymore?” followed by “Once you leave, we will place you back in the traditional FEP pharmacy program.”
I am certain that there are many fellow retired federal employees on this forum who can parse out the exact impacts hinted at in the preceding paragraph. Why would one want MPDP instead of the traditional FEP pharmacy and vice versa?
I can't answer your question, but I got a letter from Medicare stating that I was already approved to be in the MPDP Prescription program. Since all my prescriptions are already at an in-program pharmacy and I have a Standard Option BC/BS plan, I expect that it will save me even more money than it does now. Maybe the fact that you have the Basic Option Plan is the difference? Check to see if your pharmacy will be an in-house one under the MPDP Plan.
I have had federal BC/BS drug coverage for roughly 52 years of my life. Open seasons came along every year and the only change I ever considered was whether to go with the Standard Option or the Basic Option. We changed to Basic Option a few years ago. We both have Medicare Part A and B. Drug benefits never seemed to change much.
In the past two weeks both my spouse and I received a slick brochure titled 2024 FEP MEDICARE PRESCRIPTION DRUG PROGRAM (“MPDP”) Basic Option Member Kit. I have read it and didn’t see many changes other than higher drug co-pays and the addition of a Pharmacy Out-of Pocket Maximum.
The only thing bothering me is a statement that “What happens if I don’t want MPDP anymore?” followed by “Once you leave, we will place you back in the traditional FEP pharmacy program.”
I am certain that there are many fellow retired federal employees on this forum who can parse out the exact impacts hinted at in the preceding paragraph. Why would one want MPDP instead of the traditional FEP pharmacy and vice versa?
This program requires pre-approval for some medicine and step rules apply. Cut and paste from the pdf document provided
"Are there any restrictions on my coverage?
Some covered drugs may have additional requirements or limits on coverage. These requirements and
limits may include:
· Prior Authorization: FEP Medicare Prescription Drug Program FEP Blue Focus Option
requires you or your physician to get prior authorization for certain drugs. This means that you
will need to get approval from FEP Medicare Prescription Drug Program FEP Blue Focus
Option before you fill your prescriptions. If you don’t get approval, FEP Medicare Prescription
Drug Program FEP Blue Focus Option may not cover the drug.
· Quantity Limits: For certain drugs, FEP Medicare Prescription Drug Program FEP Blue Focus
Option limits the amount of the drug that FEP Medicare Prescription Drug Program FEP Blue
Focus Option will cover. For example, FEP Medicare Prescription Drug Program FEP Blue
Focus Option provides 30 tablets per prescription for atorvastatin 80 mg tablet. This may be in
addition to a standard one-month or three-month supply.
· Step Therapy: In some cases, FEP Medicare Prescription Drug Program FEP Blue Focus
Option requires you to first try certain drugs to treat your medical condition before we will
cover another drug for that condition. For example, if Drug A and Drug B both treat your
medical condition, FEP Medicare Prescription Drug Program FEP Blue Focus Option may not
cover Drug B unless you try Drug A first. If Drug A does not work for you, FEP Medicare
Prescription Drug Program FEP Blue Focus Option will then cover Drug B.
This program requires pre-approval for some medicine and step rules apply. Cut and paste from the pdf document provided
"Are there any restrictions on my coverage?
Some covered drugs may have additional requirements or limits on coverage. These requirements and
limits may include:
· Prior Authorization: FEP Medicare Prescription Drug Program FEP Blue Focus Option
requires you or your physician to get prior authorization for certain drugs. This means that you
will need to get approval from FEP Medicare Prescription Drug Program FEP Blue Focus
Option before you fill your prescriptions. If you don’t get approval, FEP Medicare Prescription
Drug Program FEP Blue Focus Option may not cover the drug.
· Quantity Limits: For certain drugs, FEP Medicare Prescription Drug Program FEP Blue Focus
Option limits the amount of the drug that FEP Medicare Prescription Drug Program FEP Blue
Focus Option will cover. For example, FEP Medicare Prescription Drug Program FEP Blue
Focus Option provides 30 tablets per prescription for atorvastatin 80 mg tablet. This may be in
addition to a standard one-month or three-month supply.
· Step Therapy: In some cases, FEP Medicare Prescription Drug Program FEP Blue Focus
Option requires you to first try certain drugs to treat your medical condition before we will
cover another drug for that condition. For example, if Drug A and Drug B both treat your
medical condition, FEP Medicare Prescription Drug Program FEP Blue Focus Option may not
cover Drug B unless you try Drug A first. If Drug A does not work for you, FEP Medicare
Prescription Drug Program FEP Blue Focus Option will then cover Drug B.
"
so do most plans from most insurers for most people.
I have had federal BC/BS drug coverage for roughly 52 years of my life. Open seasons came along every year and the only change I ever considered was whether to go with the Standard Option or the Basic Option. We changed to Basic Option a few years ago. We both have Medicare Part A and B. Drug benefits never seemed to change much.
In the past two weeks both my spouse and I received a slick brochure titled 2024 FEP MEDICARE PRESCRIPTION DRUG PROGRAM (“MPDP”) Basic Option Member Kit. I have read it and didn’t see many changes other than higher drug co-pays and the addition of a Pharmacy Out-of Pocket Maximum.
The only thing bothering me is a statement that “What happens if I don’t want MPDP anymore?” followed by “Once you leave, we will place you back in the traditional FEP pharmacy program.”
I am certain that there are many fellow retired federal employees on this forum who can parse out the exact impacts hinted at in the preceding paragraph. Why would one want MPDP instead of the traditional FEP pharmacy and vice versa?
My husband and I are insured with Medicare A/B and FEHB as a secondary and as such have also been faced with the autoenrollment into the new FEHBMedicare prescription drug plan. We got information ( letters, emails) several months ago, but didn't pay the notices the attention we should have, other than just the cursory looksee to see if our drugs, pharmacies would be in the new plan, and what the costs of our meds would be. It was all pretty much comparable, the drugs and pharmacies were included, so we let it go and got notices several days ago that we had been enrolled in the new plan, with new cards to boot.
I should have realized that this new plan was a Medicare Part D plan, at least with the notices that enrollees with higher incomes may pay more for the plan ( though we are not in that category,)but it hit me square between the eyes when I got a letter informing me that I might have to pay additional costs for the plan in the form of penalties because it looked to them as though I had not had credible drug coverage at some or perhaps all time between 2012 ( when I first signed up for Medicare) and 2023. There was a form to fill out ( that didn't show any place to document such coverage that I could see), and I had to wonder how the he!! they got my information for enrollment in this new program if not from the FEHB insurance plan ( of which hubby and I have been members since its inception in 1984) which includes drug coverage. Well, typical federal government SNAFU, as I saw it, and we determined right there and then to OPT-OUT of this new program. We want no part of any Part D Medicare drug plan, the FEHB drug plan has been more than adequate for our needs, and I even discovered that the one expensive drug I take ( Eliquis) would actually cost MORE on the MDPD plan than on the original FEHB plan for 2024.
I followed the instructions on the letter, and the robo-directions to opt out for both of us, after about two hours on hold, dumped off a couple of numbers I called, spoke to a very nice, professional individual who went through the process of unenrolling us from the MDPD, assured us we would remain on the old plan, answered a number of our questions and informed us there were many, many federal retirees who felt as we did and were also opting out. He even gave me the transaction numbers for our opt outs so we could check later and make sure it happened.
Old fed, I appreciate your link to the my federal retirement site article, reading the pros and cons of switching to the new program lets me know we were right in opting out.
My husband and I are insured with Medicare A/B and FEHB as a secondary and as such have also been faced with the autoenrollment into the new FEHBMedicare prescription drug plan. We got information ( letters, emails) several months ago, but didn't pay the notices the attention we should have, other than just the cursory looksee to see if our drugs, pharmacies would be in the new plan, and what the costs of our meds would be. It was all pretty much comparable, the drugs and pharmacies were included, so we let it go and got notices several days ago that we had been enrolled in the new plan, with new cards to boot.
I should have realized that this new plan was a Medicare Part D plan, at least with the notices that enrollees with higher incomes may pay more for the plan ( though we are not in that category,)but it hit me square between the eyes when I got a letter informing me that I might have to pay additional costs for the plan in the form of penalties because it looked to them as though I had not had credible drug coverage at some or perhaps all time between 2012 ( when I first signed up for Medicare) and 2023. There was a form to fill out ( that didn't show any place to document such coverage that I could see), and I had to wonder how the he!! they got my information for enrollment in this new program if not from the FEHB insurance plan ( of which hubby and I have been members since its inception in 1984) which includes drug coverage. Well, typical federal government SNAFU, as I saw it, and we determined right there and then to OPT-OUT of this new program. We want no part of any Part D Medicare drug plan, the FEHB drug plan has been more than adequate for our needs, and I even discovered that the one expensive drug I take ( Eliquis) would actually cost MORE on the MDPD plan than on the original FEHB plan for 2024.
I followed the instructions on the letter, and the robo-directions to opt out for both of us, after about two hours on hold, dumped off a couple of numbers I called, spoke to a very nice, professional individual who went through the process of unenrolling us from the MDPD, assured us we would remain on the old plan, answered a number of our questions and informed us there were many, many federal retirees who felt as we did and were also opting out. He even gave me the transaction numbers for our opt outs so we could check later and make sure it happened.
Old fed, I appreciate your link to the my federal retirement site article, reading the pros and cons of switching to the new program lets me know we were right in opting out.
you're welcome.
I don't understand why folks were auto enrolled. are there ANY FEHB plans that don't have drug coverage? I don't think so but someone may come here and surprise me.
seems like a cost shifting measure to me. it didn't impact me because I don't have part b so I never got auto enrolled.
I don't understand why folks were auto enrolled. are there ANY FEHB plans that don't have drug coverage? I don't think so but someone may come here and surprise me.
seems like a cost shifting measure to me. it didn't impact me because I don't have part b so I never got auto enrolled.
Well, my husband and I are figuring the auto-enrollment is because they really want FEHB members enrolled in the new FEHB Medicare Part D plan,( MDPD) and it's more likely to get new enrollees if they don't have to do anything to get there, they don't weigh the pros and cons of each plan, compared to having to "opt-in", enroll via forms or online if they want the MDPD. Lord knows, they are touting all the alleged benefits of this plan on every piece of information they send or that show on the FEHB
website, though for us I don't see any advantages at all in enrolling in the MDPD, but I do see some downsides. That is why we opted to remain with the FEHB plan which includes a great drug plan, we've been in this plan since its inception in 1984, with it becoming secondary for us with Medicare enrollment ( 2011 for hubby, 2012 for me)
So I can't see for the life of me how they can inform me ( via letter), that they don't see that I have had credible drug coverage since 2012! Makes no sense, where in hell did they get my information as a FEHB participant to "autoenroll" me in the MDPD then, they have to know I didn't chuck the drug plan that's automatically included with that enrollment.
We figure that this new plan will infuse more cash into the federal guv'mint- Medicare program, with Blue Cross paying the premiums for its Medicare enrollees. I'm sure it must benefit Blue Cross too, the only entities IMO not benefitting would be us, and many other FEHB enrollees. Which of course, is why they rolled out the program the way they did.
I just got a letter informing me I have to switch pharmacies because my pharmacy doesn’t participate in the new mdpd program. I hadn’t known about this - I’m happy with my basic bcbs and Medicare parts an and b and never change anything, so my first thought was how could they switch me without my authorization? Did a lot of reading on the internet and found out basically what others are saying here. I’m probably going to opt out next week, just want to see if my doc office or my old pharmacy have any input I’m not realizing from my own reading. My old pharmacy is a small local pharmacy and they’ve been great to work with all these years.
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