Fluticasone alternatives? PDP not covering in 2023

[yorkriver1]

My client needs to find a plan that's OK with this Rx or an alternative.
DIdn't specify if they mean the inhaler or the puff Advair generic fluticasone salmeterol
I think that one also is out at least for Humana.

 

[somarco]

HUMANA PREMIER

Fluticasone Propionate/sa 3 1 Inhaler :: 1 EA Per Inhaler 1 Month 105.80 105.80 45.00 26.45 5.29

FLUTICASONE PROPIONATE/SA 3 1 Blister Pack :: 60 EA Per Blister Pack 1 Month 135.50 135.50 45.00 33.88 6.78

Same ballpark, AARP Medicare Rx Preferred

Tier 3 for Humana Premier and AARP

 

[goillini52]

My client needs to find a plan that's OK with this Rx or an alternative.
DIdn't specify if they mean the inhaler or the puff Advair generic fluticasone salmeterol
I think that one also is out at least for Humana.

You really need to find out which one she takes. There are half a dozen. You can find plans that cover it.

I seems to remember that Medicare stopped covering it a few years ago because you could buy it over the counter.......I think I took it for a while. I've seen them do that a few times. Looks like they're covering it again.

 

[Midlevel]

Wellcare Value Script covers advair as a Tier 3. Ded and then 44.00 copay. Doesn't cover generic though.

 

[yorkriver1]

Wellcare Value Script covers advair as a Tier 3. Ded and then 44.00 copay. Doesn't cover generic though.

I believe I saw that on some other plans, too.
The tier isn't a thing with the client, who is a lovely elder with not good hearing, has extra help, it's just maybe finding a plan where the extra help will pay most of the premium, also. The other client still needs to get back to me with the specifics of their fluticasone Rx.

 

[adjusterjack]

Have your client consult with her doctor about using Budesonide instead. I think it's Rx only and that might solve the coverage problem.

When Fluticasone didn't help me, my doctor put me on Budesonide.

 

[somarco]

I believe I saw that on some other plans, too.
The tier isn't a thing with the client, who is a lovely elder with not good hearing, has extra help, it's just maybe finding a plan where the extra help will pay most of the premium, also. The other client still needs to get back to me with the specifics of their fluticasone Rx.

Use medicare plan finder . . . click qualifies for help . . . click through to plans.

 

[vic120]

do check name brand on this one some only cover the name brand

 

[goillini52]

Use medicare plan finder . . . click qualifies for help . . . click through to plans.

One of my clients just started taking a drug that that according to Search & Save and MedicareCENTER isn't covered on the Humana Walmart plan she has. I decided to check on Medicare.gov and it showed it covered. I called Humana and they say it's not covered, so hello SilverScript.

 

[somarco]

One of my clients just started taking a drug that that according to Search & Save and MedicareCENTER isn't covered on the Humana Walmart plan she has. I decided to check on Medicare.gov and it showed it covered. I called Humana and they say it's not covered, so hello SilverScript.

Medicare updates their formulary 3x per year . . . the last update is usually in August.

Carriers are required by CMS to update their formulary every 2 weeks . . . however there may be a lag between updating internally and when it actually shows up on the consumer/agent facing pages.

S&S and many of the other third party drug plan finders rely on Connecture, which updates monthly, if not more regularly.

A drug formulary formulary is just a snapshot of how things are today . . . tomorrow it may be different. Always a moving target . . .