With Medicare open enrollment upon us (beginning this weekend on October 15), the search for Part D drug coverage plans can often appear to take a back seat. For millions, the big focus of open enrollment isn’t on part D drug coverage. Instead, the attention seems to be on the marketing battle between the Medicare Advantage insurance companies and the firms offering so-called Medigap supplement plans. That’s where all the noise and attention are.
But overlooking a review of your Part D coverage could be a costly mistake.
If you’re already on a Medicare Advantage plan, which now cover almost half of Medicare beneficiaries, you don’t have to concern yourself with choosing a Part D drug coverage plan – it’s already part of your policy, for better or for worse. But if you’re among the one in five seniors with no supplemental coverage, or the one-third covered by a Medigap plan, shopping for the best part D drug coverage plan is an essential part of open enrollment.
Make the right choice and you could save hundreds of dollars, according to this recent NextAvenue article written by Jennie Phipps, who writes about Medicare and other issues related to seniors. Let’s take a look at the points she makes.
The Search for Part D Drug Coverage Takes Work
“Open enrollment for Medicare Part D prescription drug coverage runs from October 15 through December 7,” Phipps begins. “The average monthly cost for a plan is declining to $55.50 next year from $56.49 in 2023. Now is when the 49 million Part D participants search for better deals and save as much as $700, according to a survey of Medicare insurance agents.”
Unfortunately, while the savings are available, the search takes work. “Figuring out the savings may not be easy. Teresa Mears, the founder and CEO of Living on the Cheap, a group of 40 bargain-hunting websites nationwide, knows how to pinch pennies. But last year, she stumbled when she switched Part D plans.
“Hah! I changed and didn’t save money,” she recalls. “I only take one drug. I changed plans thinking this drug was covered, based on the info online. But it was not. I fear for people who are trying to manipulate this system when they need a lot of drugs.”
The Search for Part D Drug Coverage Even Confuses the Experts
Just because you know the system doesn’t mean choosing a plan is simple. “Even a Medicare expert says it can be tough to make the right decisions,” says Phipps. “Like most people, Jesse Slome learned about changes in his Part D plan via a postal mail notification. Slome, who is the executive director of a trade organization for insurance agents, the American Association for Medicare Supplement Insurance, noticed that the cost of his personal plan was tripling.”
On the surface, that size rate hike should make comparison easy, but as Slome told NextAvenue, it’s seldom that clear. “They offset that [increase] by making generic drugs free. So, it’s not simple. Multiple pieces of the puzzle are changing,” he said, “and those differences can be really expensive.”
Slome told Phipps that it is possible for a layperson to figure all this out yourself, but it requires some time and effort. “Here’s what you need to know,” Phipps writes.
Search for Part D Drug Coverage with a DIY Cost Analysis
By now, says Phipps, if you have a Part D plan, you should have received an annual “notice of change” in the mail from your current Part D insurer. For the open enrollment between October 15 and December 7, any policy or premium changes take effect January 1, 2024.
Phipps proposes a 5-step cost-analysis plan.
- Visit this Medicare site to start comparing plans. (Note that any info you may have retrieved that was posted before October 1 was probably for 2023. You need to start fresh with 2024 data.)  “If you already have a Medicare account, log in,” Phipps says. “If you don’t, you can create one or continue without an account by just entering your zip code.”
- The system will ask, “Do you want to see drug costs when you compare plans?” Make sure you answer “yes.” You’ll also need to gather all of your prescription medications, including the exact medication names and dosages. “You’ll also be asked whether or not you get help paying for your Part D plan,” says the article.
- “Select your preferred pharmacies,” says Phipps. “You can pick up to five from which you want to see drug costs.”
- That should be the final step, says NextAvenue. Click “Done” and you’ll see a list of the Part D drug plans available to you, ranked by the lowest drug costs plus the monthly premium costs for all 12 months. “If you have lots of pharmacy options in your area, it can pay to clear and enter more potential pharmacies,” Phipps advises. “The price differences can be surprising.”
- Once you have made your selection and chosen the least-costly plan, click on the Enroll button and sign up for your 2024 plan on Medicare’s secure website. That’s it.
Remember, as with other Medicare-related policies, if you decide to keep the plan you have, do nothing. You’ll be re-enrolled in your current plan. What’s more, Phipps adds ironically, “If you ignore this whole process, you also will also be re-enrolled.”
Where to Get Help Finding Part D Drug Coverage
“If this sounds confusing and more difficult than you think you can manage,” Phipps suggests, “find a Medicare insurance agent willing to help.” Sounds simple on paper, she acknowledges, but in reality it might be a challenge. According to Phipps, “Medicare pays agents only about $20 for helping someone find a Part D plan. This may not be enough to coax a busy agent to help you, Slome points out.”
The best suggestion might be to contact the agent you used to help you choose a Medicare Supplement or Medicare Advantage plan, if you had one. Phipps suggests, if you do contact an agent, to do it early in open enrollment, not during the busy days at the end. “Make it easy by emailing your required information, including your current medications with exact medication names and dosages and your preferred pharmacies,” she advises.
There’s also an online directory of insurance agents offered by the American Association for Medicare Supplement Insurance. These agents handle Medicare supplements and may be willing to help you with your Part D plan.
Part D Drug Coverage: Bad Timing Leads to the Wrong Choice
As the NextAvenue article point out, there are situations where bad timing on the part of your physician leaves you stuck with the wrong plan. Slome, the trade association director, had this happen to him.
“[H]is doctors last year changed his prescriptions shortly after open enrollment closed, making his new plan choice the wrong one even before it took effect,” the article relates. “Slome called the pharmacy and Medicare. He asked if he could switch plans — whether there were any exceptions to the end of open enrollment.” The answer was no.
“Based on that costly lesson,” Phipps continues, “Slome suggests that, if possible, people schedule medical care that might result in different prescriptions before the end of Medicare open enrollment.” That means you need to act before December 7th!
There are also prescription help plans worth a look, says Slome, no matter what your income. “A good place to start is the National Council on Aging’s Benefits Checkup to find what health and prescription help is available in your zip code,” says the article. “[Y]ou may find that it is cheaper to pay directly rather than use Medicare.” You can also look into discount drug plans including GoodRX and CostPlus.
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(originally reported at www.nextavenue.org)