Don’t you hate how confusing Medicare is?
To make matters worse, Part D was added in 2006.
A whopping 72% of seniors are enrolled in Medicare Part D, now in it’s tenth year.
After all, if you don’t enroll, you are facing a penalty.
If the confusion of Medicare isn’t enough, you must contend with the yearly changes to your drug plan.
It’s true: you can save Hundreds on Your Part D Plan
Year after year as I review client’s plan changes, the reality becomes clear. You really can save hundreds by comparing the next year’s changes to your current drug plan benefits.
Often a Drug Plan will drop a drug off their list (formulary), or significantly raise the copays.
Or, add a huge deductible where before there was none.
Or, raise the premium $20 or more per month.
You and I both know the importance of keeping up with your insurance, but how do you cut through the chaos and find the information that matters?
Here’s a quick guide to the answers you need.
Open Enrollment
The Medicare open enrollment period is known to seasoned agents as AEP (Annual Election Period), and runs from October 15th-December 7th.
A common misconception is that changes on all medicare plan types are made during this time. The annual open enrollment is for Part D drug plans (stand-alone) and Medicare Advantage Plans, with or without drug coverage. (Medigap plans may be switched any time of year).
The deadline to make changes is December 7th for 2015.
Just Do It
1.) First, my general advice – take 10 minutes to review your drug plan.
According to a U.S. News and World Report article on how Medicare beneficiaries can save on prescription drugs, the number one piece of advice is to use a tool to compare your drug plan for the new plan year.
Your Search Tool Matters
Two of the three search tools mentioned in the article are independent and not affiliated with Medicare. U.S. News and World Report cited a disclaimer of financial interest with one of the companies’ search tools for prescription plans. The other tool did not include a complete listing of drug plans according to the fine print.
The lesson here is to stick with the Medicare.gov tool to avoid unsolicited contact from agents or search results that may be skewed due to company interests.
Medicare.gov allows a comparison of every drug plan available in your zip code.
If you have an agent that you trust, and enrolled you in your current medicare plan, call your agent now!
An agent can do this plan review for you in 10 minutes or less.
Most good agents will do this for existing clients, or have a dedicated assistant to do this task.
Bottom line – The best place to do a quick comparison is Medicare.com. You can do this yourself (instructions further down in this article), or use your agent. Agents are typically good at it because they have spent hours using the search tool.
Your agent will collect your drug information and will likely save a drug list ID# to refer back to in the future.
2.) No agent? Call 1-800-MEDICARE.
(*TIP Medicare is open 24 hours a day! The best times to call are late at night or very early in the morning)
The representatives at 1-800-MEDICARE are trained to collect your prescription drug details and guide you through the process of choosing a plan.
I have not experienced this process first hand, so I do not know the quality of service you will receive there.
There are some very important points that should be considered when doing a drug plan search or comparison.
Make sure the following points are covered when talking to the Medicare representative:
- Make sure the drugs are entered accurately, including any variations like ER (extended release), whether or not they are generic (commonly overlooked), and proper dosing and quantity.
- Check pricing at more than one pharmacy, as there can sometimes be wide variations! (example with Costco!)
- Decide whether or not you want a deductible! Sometimes the lowest monthly premium plans have a $360 deductible.
- Look for the most affordable plan with a $0 deductible.
- If possible, print the drug plan comparison and copays in case there is an error (errors on the Medicare.gov site last year allowed certain members a special enrollment period, due to misleading information).
- Ask if you are going to reach the coverage gap (donut hole), and if so, ask for tips to avoid it.
3.) For do-it-yourselfers:
Have your prescriptions handy, or a list of your medications, including dosages.
Go to Medicare.gov.
About 1/3 down the page, click the green button that says “find health and drug plans.”
Enter your zip code.
Two questions pop up next. To get through the process more quickly, click “I don’t know” (this doesn’t affect search results).
Enter each drug, including dosage and monthly quantity and frequency.
Above and to the right of your drug list, you’ll see a drug list ID number.
(* TIP Save this drug list ID. If you are entering an especially long list of drugs, save this ID right away, in case your computer freezes. You can go back and it recover everything you entered).
Important! You must also save the today’s date and the zip code you are searching for. (It should be your home zip code unless you plan on moving and are searching the zip code of your new residence).
Next, click “my drug list is complete“.
Then, choose up to 2 pharmacies. (You may need to broaden the mile radius of the pharmacy search above the available pharmacies listing).
The next step : click “Refine Your Plan Results.” Here, you click the circle for Prescription drug plans, then click “continue to plan results.”
As of the writing of this article, it is October 2015.
After Oct 1st, until the end of the year, the 1016 plan data is showing on your search. You must click “view 2015 plan data” in order to check any details of your current benefits. This may be necessary if you don’t have your current drug plan information handy, and don’t have the Annual notice of changes letter handy.
Set the filter to “lowest estimated annual retail drug cost.” This is a drop down menu above the plan listing.
The amount of information on this page may be overwhelming. To simplify, ONLY look at the following three things:
- Estimated annual drug costs (left hand column)
- Monthly premium, second column from the left
- Monthly deductible, third column from the left.
Pick the top three plans based on the above.
Example – if you prefer $0 deductible, choose three plans with $0 deductible that have the lowest premium and lowest estimated annual cost.
Click the check box next to each of the three plans, then click “compare plans”
This will bring you to a side-by-side comparison of three plans.
To keep things simple, immediately scroll down to “Monthly drug costs at retail pharmacies”, months 1st-12th listed.
This chart will show you, based on your drug list, your estimated monthly out of pocket (includes plan premium), and whether you will hit the coverage gap (donut hole) during the year.
These numbers include the monthly plan premium. To see a breakdown of the individual drug copays for each plan, click on view drug cost summary, right above this monthly drug cost table.
Conclusion
You can’t afford NOT to take the above advice.
Find a way to review your drug plan, a process that can be as quick as 10 minutes.
Your options include to do it yourself, enlist your agent for help, or call 1-800-MEDICARE.
References –
U.S. News and World Report
Forbes – http://www.forbes.com/sites/nextavenue/2013/10/14/tips-for-medicares-tricky-open-enrollment-season/
Medicare.gov publication updated Sept 2015, about the annual open enrollment
tip sheet updated Aug 2015 https://www.medicare.gov/Pubs/pdf/11219.pdf