As a Medicare beneficiary, you have many choices to make. One of the most important, though, is choosing the right prescription drug plan (also known as Medicare Part D). If you make the right choices, you can save money and headaches while ensuring you have the medications you need. Here are some tips we’ve gathered to help you find the right coverage.
Know Your Shopping Window
To shop the right Medicare Part D coverage for you, you need to know when do to it!
If you aren’t already enrolled in Medicare, you’ll have your Initial Enrollment Period to enroll in Original Medicare as well as a Part D prescription drug plan. This period begins three months before the month you turn 65, through your birthday month, and three months after the month you turn 65. If you miss this period or are already enrolled in Medicare, you can change or enroll in a Part D plan during the Annual Enrollment period. This is a period from October 15 through December 7, and making changes during this period will change your coverage starting January 1.
If you’re signed up for Medicare and have a Part D plan, don’t think that none of this information applies to you. For many Medicare beneficiaries, shopping around for new and better options during the Annual Enrollment period each year will save you money and ensure you’re benefitting from a plan that suits you the best.
Check the Formularies
Before you go picking a plan, you want to make sure any prescription drugs you currently take will be covered.
Providers of both Medicare Part D and Medicare Advantage plans must disclose the specific drugs they cover. So, make a list of all the medications you take. And then compare it to the formularies provided by the Part D plans you’re interested in.
If you take multiple medications, you might find some medications are covered by some plans, but none of the plans cover all your meds. In this case, pay attention to how much each drug costs without insurance and consider enrolling in the plan that best covers the most expensive drugs you take.
Don’t Just Look at Premiums
When shopping around for plans, premiums are a big part of your choice, but they aren’t the whole story. Benefits under Part D change from year to year. So, it pays to closely examine all the costs under each plan available. Some Part D plans may have low premiums but higher copayments, so they may not actually help to reduce the overall costs you pay for prescriptions. To help your costs stay consistent throughout the year, look for low-deductible plans or plans with additional coverage in the coverage gap.
Don’t Forget the Star Ratings
Another thing to consider? The star ratings. While your primary focus should be whether your medications will be covered, the star ratings system can further help you choose the right plan for you.
The star ratings system measures the performance of each Part D plan. Five stars being the highest and one star the lowest. The ratings are based on factors such as:
- Customer service
- Member complaints, service problems, and dropping the plan
- Members’ experience with the plan
- Drug pricing and patient safety
By checking out each plan’s star rating, you can weed out some of the less ideal plans. Just remember, it’s not the most important consideration. A four-star plan that checks all your boxes at a lower cost could be better for you than a five-star plan that doesn’t.
See if You Qualify for Additional Benefits
If you are a low-income member and/or have both Medicare and Medicaid, you may be eligible for additional benefits. The Extra Help program is designed to help Medicare beneficiaries cover costs associated with prescription drugs, including Part D premiums, deductibles, and other out-of-pocket drug costs. It’s important to also note that, in addition to having assistance with costs, Part D members with Extra Help also have the ability to change plans up to once per month, even outside of Annual Enrollment. This doesn’t mean you shouldn’t be proactive about choosing the right plan for you during Annual Enrollment, but it does mean you have some flexibility if something comes up mid-year.
To apply for the Extra Help program, head to the Social Security Administration website. You can apply for Extra Help any time before or after you enroll in Part D.
Jeffery Insurance is Also Here to Help
Choosing the right Medicare Part D plan for you is often not without some challenges. If you find yourself with questions, the Jeffery Insurance team is here to help. We will guide you through your options and assist you in signing up for coverage that is affordable and meets your needs. Even after you sign up for a plan, we will be available every time you need us. We are based in Scottsdale but are happy to assist you no matter where you are in Arizona. Jeffery Insurance is Arizona’s health care resource!