How to Compare Your Prescription Drug Plan During Annual Enrollment on Medicare.gov

www.nuMedicareAdvisors.com
Suzanne McClain of National United Medicare Advisors explains how to use Medicare.gov to review your prescription drug plan.
If you have any questions, please contact our office at [phone]
Navigating Medicare prescription drug plans requires attention to detail to avoid potential financial pitfalls. Here's a guide to ensure you make informed decisions:
Adding Prescriptions: It's vital to ensure that the exact medication you're taking is correctly listed. For instance, when adding drugs like inhalers, ensure the package size and frequency matches your usage. When choosing medications such as metformin, note that there are multiple options like Glipizide and combinations. Always match the drug and its form (like extended-release vs. regular) to your prescription, as different versions can have varying costs.
Comparing Plans: Websites like medicare.gov offer platforms for comparing drug plans. While these tools provide a list of plans available, the trick is in understanding the details. Ensure you're viewing plans for the correct year. These tools often rank plans based on total drug and premium costs. However, a $0 monthly premium plan might end up being more expensive when considering overall costs.
Understanding Plan Details: Each plan has a unique ID number. Mistakenly comparing the wrong plan, even within the same insurance company, can lead to misguided decisions. It's essential to review the "Annual Notice of Change" sent by your current drug company around September, which shows any changes in premiums, deductibles, or formularies.
Formulary Changes: It's crucial to verify that your current medications remain on the formulary for the upcoming year. A drug being removed can lead to significant out-of-pocket costs. For instance, if a drug like Symbicort is removed from the plan's formulary, the overall cost could shoot up.
Deductibles: Deductibles reset at the start of each year. While some might be tempted to enroll in a $0 deductible plan, considering the total out-of-pocket costs might reveal that paying a deductible upfront could be more economical in the long run.
Preferred Pharmacies: Many insurance providers designate certain pharmacies as "preferred." These pharmacies offer medications at a lower out-of-pocket cost compared to "non-preferred" pharmacies. Each year, insurance companies can renegotiate with pharmacies, changing their preferred status. Ensure your regular pharmacy remains preferred for the upcoming year, or consider switching to one that is, to maximize savings. For instance, just switching from a non-preferred to a preferred pharmacy could result in substantial savings.
***In Summary***: When considering Medicare prescription drug plans, it's paramount to ensure your exact medications are on the plan, review formulary changes, understand deductibles, and stick with preferred pharmacies. Conducting an annual review, even if satisfied with your current plan, can lead to significant savings and optimized coverage.
***National United Medicare Advisors is NOT a Government Entity****
For Medicare Advantage - We do not offer every Medicare Advantage plan available in your are. Currently we represent 5 organizations which offer 41 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
For Medicare Part D - We do not offer every Medicare Part D plan available in your area. Currently we represent 7 organizations which offer 17 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

[@utuber1000]

I thought this video was going to be duplicative of others I have watched, I was wrong - much better and more comprehensive attention to important gotchas! Many thanks.

[@suzannemcclain]

awww... thanks!

[@robertmercer9117]

Excellent detailed explanation of Plan D choices.

[@suzannemcclain]

Glad you liked it

[@DuvAngel1]

I just turned 65 last July ~ was on disability and MA~ I guess they had me on some kind of advantage plan. That ended last month. But I still get “extra help. “
That’s all going to end in January . So I’m looking for a new plan for the part D I already have the other parts figured out.
I don’t have much in the way of meds, but I want to make sure that I am covered just in case I get cancer or some other catastrophic illness ~ I am not prescribed anything currently and I don’t have any diagnoses, but what kind of plan would give great coverage for the unforeseen needs?

[@suzannemcclain]

Hey there!
Great question!
It is hard to pick a Part D plan that will cover unforeseen drugs. The good news is that getting "extra help" creates a quarterly enrollment opportunity that allows you to switch Part D plans through the first 3 quarters of the year.
Please call our office if you would like us to help you review the available plans. [phone]

[@x.y.7385]

Can you answer this question for me?
I have one Tier 2 and one Tier 3 drug.
According to the Tier Chart:
The Tier 2 drug says $5 copay - Generic
The Tier 3 drug says 25% - Preferred Brand
Where it displays the cost of drugs per each month, I am paying
full retail price until I hit my deductible and then I am paying a
reduced price.

>>> Where/when does this $5 copay and 25% co-insurance come in to play ?

[@suzannemcclain]

Great question!
It depends on the plan you are looking.
In general, the deductible applies to specific tiers.
Please call our office if you would like us to dig into the plans with you. :)

[@jleechadwick]

I would have no trouble having the doctor change it to a generic that I can pay less for.

[@suzannemcclain]

Yes, as long as it works as well for you.

[@cathyneu7783]

Advantage plans are crap