Thursday September 21, 2017
How to Find a Better Medicare Prescription Drug Plan
I think I'm paying too much for the medications I take. I have a Medicare Part D prescription drug plan and my out-of-pocket spending is over $4,000 thus far in 2017. When and how can I change my Medicare drug plan?
You can change your Part D prescription drug plan during Medicare's open enrollment period, which runs from October 15 through December 7. During this time, you can switch drug plans or join a drug plan if you did not have one before. You can also switch from Original Medicare to a Medicare Advantage plan, or vice versa if they wish. Any changes to coverage will take effect January 1, 2018.
In September, you should receive your "annual notice of change" from your prescription drug plan. It will outline any changes in coverage, costs or service that will take effect in January.
If you take no action during open enrollment, your current coverage will continue next year. It is recommended that even those who are happy with their coverage review their plan for any changes.
Change Medicare Plans
If you have internet access and are comfortable using a computer, you can easily shop for and compare all Medicare drug plans in your area. You may also enroll in a new plan online.
To find a plan, go to Medicare's Plan Finder tool at Medicare.gov/find-a-plan and type in your ZIP code. You will need to provide your personal information, your current Medicare coverage, select your prescribed medications and their dosages and the pharmacies you use. You will get a cost breakdown for every plan available in your area so you can compare it to your current plan.
This tool also provides a five-star rating system that evaluates each plan based on past customer service records and suggests generic prescriptions or older brand name drugs that can reduce your costs.
When you're comparing drug plans, look at the "estimated annual drug costs." This will show you how much you can expect to pay over a year in total out-of-pocket costs, including premiums, deductibles and co-pays.
Be sure the plan you are considering covers all of the drugs you take with no restrictions. Most drug plans today place the drugs they cover into price tiers. A drug placed in a higher tier may require you to get prior authorization or try another medication first before you can use it.
If you need some help choosing a new plan, you can call 1-800-MEDICARE and they can help you over the phone. Alternatively, contact your State Health Insurance Assistance Program (SHIP), which provides free one-on-one Medicare counseling. SHIP also conducts seminars during the open enrollment period at various locations throughout each state. To find the contact information for your local SHIP visit Shiptacenter.org or call the eldercare locator at 800-677-1116.
If you find yourself struggling to pay your medication costs, check out Medicare's "Extra Help" program. This is a federal low-income subsidy that helps pay Part D premiums, deductibles and copayments. To be eligible, your income must be under $18,090, or $24,360, for married couples living together, and your assets must be below $13,820 or $27,600 for married couples. For more information or to apply, call Social Security at 800-772-1213 or visit SSA.gov/medicare/prescriptionhelp.
Other resources that can help include RxAssist.org, which maintains a comprehensive database of patient assistance programs set up by drug companies for those who have trouble affording their medications and NeedyMeds.org, a national nonprofit organization that maintains a website of free information on programs that help people who cannot afford their medications or other healthcare costs.
Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.
Published September 8, 2017
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