Silver Script SmartRX PDP

[kgmom219]

I lost my book of SilverScript so this AEP every client will be moved. I too am done with SilverScript.

WTH happened?

 

[somarco]

That's not an SS issue. That's a pharmacy issue but they aren't going to throw the pharmacy under the bus, either

Thank you for the detailed explanation and pointing a finger at who possibly "committed the crime"

There are enough villains in the food chain, and I am not a PBM fan (with exception of the mom & pop stores that need a middle man).

 

[Slade]

The contract with SS may have changed.

I too would like to thank you for that explanation kgmom219. I know these small independent pharmacies have a 3rd party who does the behind the scenes contracting with drug plans and other things. I just wanted to get an official explanation like this from SS or the pharmacy so I have something to tell my dozens of pissed off clients.

Their run around explanation is that the SS drug pricing tool and the Medicare plan finder are just estimates. Imagine if that's what I tell my clients. "I know your drug prices are 1000% higher now but those original prices you experienced the past 9 months were just estimates."

I wonder who else could pull this off? Question, "You said it was only going to cost $30 to change my oil, so why are you charging me $300?" Answer, "$30 was just an estimate and the price of oil went up since you brought your car in."

I am right across the street from the pharmacy and guess where they're sending their unhappy customers? I am the one being thrown under the bus because I enrolled them in their plan and I can't seem to get any kind of official reason for what is happening.

To make matters even worse, the 2022 Medicare Drug Plan Finder still shows the extremely low discounted drug pricing making this plan rank number one quite often when it should be at the bottom. The drug pricing tool on the SS agent portal also shows the lower prices currently as well as 2022. No one to blame for this except SS. This year, consumers with this SS Smart plan got to enjoy these low prices for 9 months before their rude awakening. Next year they will realize they got screwed right away with their first fill in January.

 

[somarco]

@Slade the issues with the Plan Finder, PBM's, formulary's, etc are out of your control. My best advice is to document (in writing) anything and everything having to do with Rx information.

My preferred method of communicating with clients is email. We both have a record of correspondence so nothing relies on memory.

ALL information from me to them regarding Rx is accompanied by a PDF and/or embedded in the email. My clients see the PF info with Medicare.gov "letterhead", not mine.

Clients don't like it when they go to the pharmacy and their copay is higher than promised, but I have the backup proof of what was said.

 

[Slade]

That's not an SS issue. That's a pharmacy issue but they aren't going to throw the pharmacy under the bus, either

They throw the standard retail pharmacies under the bus every day by reaching out to their PDP members promoting mail order and preferred pharmacies. They also throw agents under the bus by direct marketing of their Medicare Advantage plans.

 

[somarco]

They throw the standard retail pharmacies under the bus every day by reaching out to their PDP members promoting mail order and preferred pharmacies. They also throw agents under the bus by direct marketing of their Medicare Advantage plans.

There are challenges and barriers in every industry. If this was easy everyone would be here.

There is always something to gripe about but the rewards are worth it if you can adapt to change.

 

[goillini52]

There are challenges and barriers in every industry. If this was easy everyone would be here.

There is always something to gripe about but the rewards are worth it if you can adapt to change.

Some people aren't happy unless they're bitching about something.

My dad was like that.

 

[sshafran]

Not sure how long ago it was but I recently stopped sending "illustrations," etc., from Medicare dot gov unless specifically requested (it never is).

I do send the summary of benefits.

This is what we actually are supposed to send, but it's rarely provided in lieu of a confusing, inaccurate "illustration" from Medicare.

I think it's helping. It might be little more vague as to "why this plan but not *that* plan" bit I no longer care to really back up the recommendation ad nauseum -- i.e. I'll say based on these Rx's, plan __ looks like a good fit.... but I've moved away from trying to predict the future or have them try.

I don't want the mechanic to explain to me why he is recommending xyz for my car. I don't want a diagram. If I trust him I trust him. Just ring me up.

 

[sshafran]

What I'm getting at is simplicity, simplicity, simplicity.

The summary of benefits for a PDP plan is actually quite simple.

Let then figure out what 23% of Spiriva will be. I'm tired of Medicare predicting $24.36 for Buproprion XL then Jane calling me mad that it was $37.34.

If I just send the summary of benefits... then Jane knows it's 23% (or whatever).

YMMV.

 

[sshafran]

I do use the tools to pick the plan to send.. I just don't share the illustration or spend too much time convincing them that my recommendation is sound. If they want to shop their pdp on me, by all means, shop your pdp...