If you are already a Medicare beneficiary, each year you have the right to shop the Part D Prescription Drug Plans to make sure you have the best one for you. The Open Season is Oct. 15 to Dec. 7. Jana McKinney at the McPherson County K-State Research and Extension office is happy to help you review your plan (it’s a free service), or you can do it yourself at http://medicare.gov
Please call 620-241-1523 to make an appointment to review your Part D Prescription Drug Plan and would like assistance. It is always a good idea to double-check your current plan.
Last year, 543 people with Medicare shopped their Part D plan with McKinney at the extension office and saved collectively $327,000. It’s a great idea to shop Part D, doesn’t take much time and, could save you money. An appointment is required during the Open Season.
All people with Medicare Part D should have received an “Annual Notice of Change” letter. Be sure to open it to see what your premium is going to do, if the deductible increased and what your co-pay will be.
Perhaps you will turn 65 this year, and not sure where to start when considering a Part D plan. Here are some questions to consider before signing up.
Choosing a Part D plan can seem daunting because there are many points to think about.
Depending on your needs, the financial situation, and preferences, some of the following questions and guidelines may be more important than others.
One question to ask is: does this plan cover your drugs? If you take a lot of prescription drugs, then choosing a plan that has the drugs on its formulary is an important first step.
A formulary is a list of drugs that a plan covers. If a plan’s formulary does not include your drug or drugs, then you may end up paying out of pocket for the entire cost of the drug. Create a list of the names of the prescriptions you take, their dosages, and whether they are brand-name or generic. This can help you sort through plans and choose the ones that cover the drugs.
You should also ask about the costs associated with the plan. If you choose a plan with a deductible, know that you will have to pay that amount out of pocket before the plan begins to cover prescription drugs. Also think about the most you can and want to spend on the drug plan’s monthly premium.
The Medicare Plan Finder tool and the plan you consider should provide information about the expected copays or coinsurances for the medications you anticipate taking over the next year. It is, however, difficult to estimate the exact cost of pharmacy copays and coinsurance amounts because these may change over the course of the year.
Another question to consider is: is my pharmacy preferred and in-network? Many drug plans include both preferred and non-preferred pharmacies in their networks. You may pay less for the drugs at preferred pharmacies than at non-preferred pharmacies. If you go to a pharmacy that’s close to home or easy to get to, it may be beneficial to look for a plan that categorizes that pharmacy as a preferred and in-network.
Also note that some plans have a mail-order option that may have cheaper prices than the pharmacy. If you are interested in mail-order, look for a plan that includes that option.
Lastly, you will want to see, what is the plan’s star rating? Medicare uses a star rating system to measure how well Part D plans perform in different categories, including quality of care and customer service. Ratings range from one to five stars, with one being the lowest and five being the highest rating. Medicare reviews plan performances each year and releases new star ratings each fall. You can find a plan’s star rating by using the Plan Finder tool on http://medicare.gov.
Star ratings are not the only factor you should consider when looking for a plan. Even if a plan has a high star rating, it may not be right for you if it does not cover the drugs needed.
However, star ratings can be a factor to consider once you find the plans that will provide the best coverage for you.
Knowing the right questions to ask can help you choose a Part D plan that works with your needs.