The ABCs of Medicare Part D

It’s that time of year again. Leaves are falling, the air is cooler and you get to re-evaluate the Medicare prescription drug plans! A virtual cornucopia of fun!

For current Original Medicare recipients, open enrollment of prescription drug plans and Medicare supplement plans (Medigap) that work with Original Medicare runs now until December 7, 2016. This is the time to evaluate plans that are available in your elder’s area and compare to their current plan. They can switch plans during this period only.

Prescription drug plans (Rx plans) are called Medicare Prescription Drug Plans (Part D). Just so you’ve got the right buzz words – you know how important that is!

Some things to consider when evaluating the Rx plans:

A – Always have the complete list of medications beside you before you start, along with their dosage amounts and how often they are taken. Having this information close at hand and in detail can avoid getting costs that are not correct. For example, if your parent takes Metoprolol ER, but you enter just Metoprolol, the plan might read Metoprolol Tartrate, a Tier 1 drug with very different pricing from Metoprolol ER, a Tier 3 drug. Got it? Get all their medication details and have them at hand.

B – Be detail-oriented. Go to Medicare.gov and select the tab for SIGN UP/CHANGE PLANS. Go to FIND HEALTH & DRUG PLANS. Enter your elder’s zip code. After you answer a couple of questions on current coverage, you’ll have an option to enter the drugs your elder takes or not. Best choice – enter the entire medication list. You can select two retail pharmacies in the area to compare. Check the box for PRESCRIPTION DRUG PLANS. Once entered, you will see a list of plans that are offered in that zip code. Each plan listing will have the estimated annual medication costs for the drugs you entered along with a monthly premium amount. You have the option to compare two plans. Do this – it’s helpful.

C – Compare plans thoroughly. If you click on the Plan Provider highlighted in blue at the top of each plan, it will reveal the Plan Details. Plan Details show the comparisons of how much the medication will cost at the two retail pharmacies that you selected and a mail-order option, if it is available. At the top, you can also see the phone numbers to call for more information. The Non-member phone number is the one to call if your parent is not currently in that plan. I suggest calling them. The sales reps that answer the Non-member lines are very helpful (they want you to get their plan). The actual plan pricing can be complicated and it is best to speak to someone directly about your elder’s specific needs and choices.

You can ask them if a mail order pharmacy is available in that plan and compare the mail order pricing to retail pharmacy pricing. Mail order pharmacies often have much better pricing than retail pharmacies, especially for maintenance-type medications (things they take all the time). Mail order pharmacies send out 90-day supplies while retail pharmacies dispense 30-day supplies. On a per day price, the mail order usually has the best.  Read my earlier blog on the Plusses and Minuses of Retail & Mail Order Pharmacies.

D – Discounts and/or coverage for hearing, vision and dental services are sometimes offered by Rx plans. Since Original Medicare doesn’t cover hearing, vision or dental services, some coverage or a discount of any sort is helpful (hey, it’s a discount!). While you’ve got the Non-member sales rep on the phone, ask about this coverage or any discounts available through the plan.

E –  Everything to do with Medicare is complicated, in my opinion; however, it pays to compare what is available from other plans to what your parent has now, at least every couple of years during open enrollment season.

Now are you singing the ABCs song yet?

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