Should you change Medicare Prescription Drug Plans?
Did you or the broker you work with use the Plan Finder Tool to find a lower cost drug plan for 2020?
If the results of the plan finder tool do not match up with your medication fill/refill costs you should have a 2nd chance to change plans for 2020. CMS should be making an announcement on this soon.
What is the issue? The tool produced inaccurate results that beneficiaries, brokers and others that help Medicare beneficiaries make sound decisions to changing prescription drug plans.
It is imperative you read the articles found here and here and here to learn your options for 2020. You may have a ‘special enrollment period’ to change plans.
Should you Change Medicare Prescription Drug plans?
If you are spending more than a few hundred dollars on your annual out of pocket cost for prescription medications (this means your actual refill cost added to your plan’s premium), we recommend you evaluate your alternatives between October 15 and December 7th each year. These plans can change noticeably every year and is an easy way for insurance companies to raise revenue. We can help you get this done.
We feel Idaho residents should change Medicare prescription drug plans when they can get better value by doing so. Plans change annually; if you don’t pay attention to these changes and compare your options annually , we feel you may be setting yourself up for higher costs and frustration.
We have noticed the annual cost for the same set of medications can vary by over 300% between Medicare prescription drug plans available in Idaho.
This is true for people with Original Medicare (with or without a Medigap plan) and Medicare Part C (Medicare Advantage).
We feel Idaho residents should be paying close attention to the prescription drug cost side of their Medicare Advantage plans, especially if they are paying more than a few hundred dollars per year on medications. If you have a Medicare Advantage Prescription Drug plan and find a different plan with lower drug cost and can continue to use the same doctors and other providers (and maybe include more choices) and health cost copays/coinsurance are similar, consider changing plans to save the money.
There are over 20 plans available to people that stay with Original Medicare with or without a Medigap plan. Take the time to understand the differences between your choices. You will be surprised to see the differences between your annual out of pocket costs between these plans.
Should you change Medicare Prescription Drug Plans? This is how they differ from each other
Insurance companies offering Medicare Prescription drug plans differentiate their plans by adjusting a number of variables. They can do this annually. What can change?
Monthly premium.
The number and specific medications included in the plan’s formulary.
Fill/refill pricing differences between preferred and regular plan pharmacies.
How they allocate the medications they cover to the different drug tiers (this can be a big differentiator…the higher the drug tier, the higher the cost).
The copays/coinsurance they charge plan members for drugs in the different tiers.
How they implement Medicare’s standard deductible ($310 in 2014…$320 in 2015 …$360 in 2016…$400 in 2017…$405 in 2018…$415 in 2019 and $435 in 2020)). The plan does not start providing savings until the plan’s requirements on meeting the deductible is met. For example, some plans are exempting tier 1 and 2 medications from the deductible; some plans eliminate the deductible (or a portion of it) entirely.
If medications have reduced copays in the ‘coverage gap’.
Remember, some insurance companies offering Medicare prescription drug plans want your business more than others. How they do this shows up in how they change their plans each year. We see some plans that appear to be targeted to Medicare beneficiaries with specific characteristics; for example, people taking few or mostly generic medications. Some plans appear to specialize in carrying more higher cost (tier 3,4, and 5) medications at a lower cost than others.
When plans change these variables, your share of the cost of the medication you take can change too.
Compare next years version of your Medicare Prescription Drug Plan to your current plan between October 1 and December 7th and do it every year
Medicare Prescription Drug plans can change every year. These changes can affect your out of pocket cost and well as which drugs are covered by their plan. It is not unusual for us to see a 300%+/- variance between annual out of pocket cost for the same set of prescription medications. It is also not unusual for us to see some plans drop key medications while other plans continue to offer the same medication. Remember, you can change plans during Medicare’s annual election period. We encourage you to make an informed choice between prescription drug plans each year. It is your retirement income at stake.
The Kaiser Family Foundation reported results from a 2014 market research study that noted some 70% of Medicare beneficiaries just stay with their current plan AND do not check to see if they can save money by changing plans. Read the summary of this report here.
We encourage you to be part of the growing 30% that want to save money on their medications. If you are not comfortable doing this yourself, call us and will do this work for you. We explain the plan differences and how they affect your out of pocket cost and pharmacy selection. We help Medicare eligible Idaho residents and it doesn’t cost them anything to use this free service.
Change Medicare Prescription Drug plans if it will save you money
If you are not sure there is really a cost savings difference between plans, read this article.
You can change Medicare prescription drug plans between October 15th and December 7th annually; your new plan will be effective on January 1 of the following year. It doesn’t matter if you have a Medicare Advantage Prescription Drug plan (MAPD), a standalone Medicare Prescription Drug Plan (PDP) or PFFS policy, you can very easily change plans if your current plan will cost you more next year. If you have an MAPD plan now, finding a different plan that has as good as or better coverage with the doctors/hospitals you presently prefer AND a has a lower cost of the medications you take is a worthwhile investment in time. You owe it to yourself to find out by working with an independent agent specializing in Medicare. If you are a resident of Idaho, contact us; we will do the research and present you with the results. We will be glad to help and add you to our list of satisfied customers (you become a customer when you enroll in a new plan through us). When you are a customer, we perform this service annually.
How to Change Medicare Prescription Drug plans
Provide your agent with a list of the medications you take and the dosage and frequency you take them. If you have any planned surgeries coming up, contact your physician and learn how your med list will change. If you are presently taking any brand named medications, contact your physician to see if there is a generic available.
Remember, agents working with Medicare beneficiaries must, under penalty of law, protect your HIPAA information. Also, these same agents must pass tests annually for all plans they represent. Be sure and ask the agent if the recommendations they make provide you the lowest annual cost of all plans available to you for the medications you take.
Ask them to show you the results of their analysis.
If you have to change pharmacies to get lower costs, be sure and notify your physicians that your future refills will be filled at the new pharmacy(s). Ask them to send your current and future prescriptions to these pharmacy(s). Your new plan will be effective the 1st of January.
You can change Medicare Prescription Drug Plans annually during the Annual Enrollment Period (October 15th through December 7th).