Shopping For A Medicare Drug Plan
Dear Savvy Senior,
Can you offer some tips for finding a new Medicare prescription drug plan? I have been using the same Medicare "Part D" plan for three years now but my pharmacist recently told me I needed to shop around for a different plan that fits my needs better.
Because Medicare's prescription drug plans can change dramatically from year to year, comparison shopping every year is a smart idea. Here's what you should know.
Nearly everything about Medicare's "Part D" prescription drug plans, from the drugs covered to the premiums to the deductible and size of co-pays, can change from year to year. So each year during the open enrollment period, November 15 to December 31, you need to shop around to ensure you get the best coverage at the lowest cost.
To help compare the dozens of different Medicare drug plans that are available, your first step is to get organized. Start by making a list of the drugs you currently take along with their dosages. Then go to Medicare's Prescription Drug Plan Finder tool, www.medicare.gov/mpdpf, and click on "Find and Compare Plans." From there, simply plug in your personal information and ZIP Code, along with the prescription drugs and dosages you currently take, and you'll get a cost comparison breakdown for each plan available in your area. This tool also provides a five-star rating system that evaluates each plan based on past customer service records.
If you find a better deal, before switching plans, here are some other areas you need to double-check to ensure good coverage:
Total costs. Don't judge a plan strictly by its monthly premium cost. Low-premium plans are often associated with higher prescription co-payments and may prove to be the costliest plans. So take a look at the whole pricing package, including premiums, deductibles, co-pays and coverage gaps, that may apply.
Pharmacy network. Check to see if the pharmacies you regularly use are in the plans' network.
Drug restrictions. Some plans may require you to get permission or try a number of cheaper drugs before they will cover particular prescriptions. Find out!
Coverage gap. Find out if your plan will cover any drugs in the coverage gap known as the doughnut hole, especially if you have a costly drug regimen. Fewer plans are offering such protection, though some offset the costs of generic drugs.
If you're feeling confused or overwhelmed, or if you don't have access to the Internet to compare drug plans, or don't feel confident in working through the information on your own, ask one of your kids or a close friend to help you. You can also call Medicare at 800-633- 4227 and they will do the drug plan comparing for you over the phone. Some other helpful resources include the Medicare Rights Center, which staffs a toll-free number with counselors ready to help at 800-333-4114, and your State Health Insurance Assistance Program (SHIP), which provides one-on-one free Medicare counseling. To find a local SHIP counselor, visit www.shiptalk.org or call your Area Agency on Aging (call 800-677-1116 to get your local number). The National Pharmaceutical Council (a nonprofit research association) also offers a very helpful resource at www.yourpharmacybenefit.org.
Savvy Tip: If your annual income is less than $15,600 for an individual ($21,000 for a married couple living together), you may be eligible for some extra help in paying for your Medicare drug coverage. Call Social Security at 800-772-1213 to see if you qualify.
Instead of paying separately for Medicare Part B, plus a Medigap supplemental policy and a stand-alone Part D drug plan you could sign up for a Medicare Advantage plan that provides all-in-one coverage and it may be cheaper. These plans, which are sold by insurance companies, are generally available through HMOs, PPOs, and private fee-forservice plans. To find the best deals in your area, visit the Medicare Options Compare tool at www.medicare.gov/mppf.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior.org. Jim Miller is a contributor to "The NBC Today Show" and author of The Savvy Senior books.
The Gazette does not endorse the contents of The Savvy Senior. Check with professionals about the contents of this column.