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Are You Paying Too Much for Your Medicare Part D Prescription Plan?

Paying too muchMost of us, including myself, tend to get comfortable with the status quo. It’s easier to continue with the way things are than to look outside the box and see how we might be able to change something — hopefully in a positive way! This also applies when it comes to health insurance – especially prescription plans. But what if you’re leaving money on the table? Are you willing to think about change?

A recent study by the Kaiser Foundation showed that most Medicare beneficiaries only consider the costs associated with their prescription plan when they initially become eligible for Medicare and select their Part D plan. Most don’t take advantage of comparing plans each year during Medicare’s annual enrollment period, which runs from October 15 to December 7.

Dare to Compare — Plans and Premiums Change Annually

There are numerous Medicare Part D plans to choose from, which are offered by a number of different insurance carriers. You might notice some carriers have left the Part D market and are no longer available, but you might also notice some game changers — new carriers that have come along offering better plans and lower premiums.

But how do you know if you don’t look?! That’s why MediGap Advisors offers an Annual Comprehensive Policy Review to all of our clients (to ensure you remain in the best plain at the best value from year to year).

Part D premiums as well as formularies (list of covered medications) change each year. Most individuals don’t consider changing plans unless they see a particularly large increase in their premium in any given year, but most don’t notice the slow, steady increase they’re experiencing. By comparing Part D plans each year during annual enrollment, you just might be able to keep a little more money in your pocket — rather than those of the pharmacies or drug companies!

What to Look for When Choosing a Part D Prescription Plan

There are several factors to consider when choosing a prescription plan:

> Premium

> Deductible

> Coinsurance/Copay

> Plan Formulary (list of covered medications)

Of course, premium is one of the main factors most Medicare beneficiaries consider when choosing a plan, but what may be even more important (and cost effective) is ensuring the medications you take are on your plan’s formulary. If you take a medication that is not on your plan’s formulary, or results in a higher coinsurance or copay, you may be paying more in the long run.

When your doctor prescribes a new medication, check your plan’s formulary to ensure it’s included on the list. (Your pharmacist can also assist you with this.) If it’s a brand name or non-formulary medication, speak with your doctor and request a more cost-effective medication from your plan’s formulary. Most physicians are happy to comply with your request, especially if they agree that an alternate medication can provide the same results at a reduced cost to you.

Remember that formularies can change each year. So if you take numerous medications on a regular basis, you’ll want to be sure your current medications are covered before you continue with the same Part D plan for another year; otherwise you could be looking at huge, unexpected out-of-pocket prescription costs.

Do you compare Part D plans each year? What has your experience been? I would love to share your story with other readers!

Wiley Long is founder and president of Medigap Advisors, and is passionate about helping people navigate the confusing waters of Medicare. He is the author of The Medicare Playbook: Designing Your Successful Health Coverage Strategy, a clear and simple explanation so you can make the most of your Medicare coverage. For more information visit www.MediGapAdvisors.com.

 

 
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