Monday, November 7, 2011

IBM Prescription drug coverage for 2012

I just took a quick look at the IBM medical coverage selections for 2012 so my observations are going to be brief. I will try to provide better insight later in the week.

I was surprised to see that Medco will no longer be the prescription drug plan provider. It is changing to CVS Caremark. It is really important to determine if CVS will cover your drugs if you decide to use IBM for your drug coverage. It was similarly important to do that if Medco continued to be the provider but at least Medco would have notified you about the change if they would no longer cover your drugs. Also, some of the issues with the donut hole are continuing to ease because of the Health Care Reform act so it is worth the analysis to decide if it is time to get a separate drug plan and not use IBM's offerings. has a spectacular plan finder.

I also wanted to reiterate that if you decide to use a Medicare Advantage PPO or HMO be sure you really understand ALL the potential costs of that plan. The literature mostly describes coverage for hospital and doctor visits. All these plans are required to cover whatever original Medicare covers but they sometimes pay less than original medicare for a give procedure such as an ambulance. Do the detailed comparison!

Finally, there is an aspect to Medicare for Durable Medical Equipment (DME) that is important to understand. Medicare does not set limits for what a DME provider can charge for, say, a wheel chair. It only sets limits for what the reimbursement level will be. So, make sure to understand how DME works with your HMO or PPO should you decide to go that way. If the PPO makes you go specific suppliers you will be stuck with what they charge and cannot shop around.

More to come as I study the options for 2012


  1. I've been following your blog and look forward to hearing your thoughts on the 2012 options...considering a switch to the Aetna Integration Plan A. Of course, that will also entail selecting a Part D Drug plan.Currently have the IBM Medical/Prescription Drug Supp Plus.

  2. The Aetna Medicare PPO plan looks pretty good to me. I have been on the IBM Medical/Prescription Drug Supplement plan for years. The switch to CVS is interesting. In comparing prescription cost 90 mail order of the Aetna plan vs the Medco plan. My costs would go from around $15 every three months to $72. This may be incorrect, but if it is correct, it just about wipes out the advantage of $0 premium vs $29 per month.

    Thanks for putting up this blog. There is much to consider this time around.


  3. I just found out that the CVS option will be around $10 for a 90 day supply of three medications. Aetna says that they are competitive.