Are You Paying Too Much for Your Prescriptions?
Updated: Oct 29, 2021
In my work with Medicare, people often ask me which prescription drug plan is the best one. It's an important question and one you should be asking if you are a Medicare beneficiary.
Choosing a Medicare drug plan is an important and personal decision. If you're already enrolled in Medicare, Annual Open Enrollment (Oct. 15 - Dec. 7 each year) is a good time to review your current coverage and decide if it's still the best deal for you. Medicare beneficiaries with traditional Medicare can compare and switch Medicare Part D stand-alone drug plans or join a Medicare Advantage plan, while enrollees in Medicare Advantage can compare and switch Medicare Advantage plans or elect coverage under traditional Medicare with or without a stand-alone drug plan.
If you're on Medicare, you have no shortage of plans to choose from: in 2021, the average Medicare beneficiaries can choose among 33 Medicare Advantage plans and 30 Part D stand-alone prescription drug plans. It can be overwhelming. That's why so many people opt to do nothing.
If you decide to skip the review and stay with the plan you currently have, chances are good that you'll end up paying far too much for your drug coverage. Coverage and costs vary widely among both Medicare Advantage plans and Part D prescription drug plans. Plans can change from one year to the next, which could lead to unexpected and avoidable costs, and disruptions in care for beneficiaries who do not review their options annually.
For example, provider network changes could mean you lose access to your preferred doctors, while changes in the list of covered drugs and cost-sharing requirements could result in higher out-of-pocket drug costs. Further, your health care needs can change from one year to the next, making it even more important to compare coverage options annually. Even without a change made by their plan or a change in health status, you may be able to find a plan that better meets your individual needs.
If the thought of comparing plans is intimidating, you'll be glad to know that help is available. Each year, I guide many clients through this process by looking at your plan through four different lenses.
I will help you review your current health care costs to find coverage that works with your financial situation. How much are your premiums and deductibles? How much do you pay for hospital stays and doctor visits? Just like with everything else, the lowest-premium health plan option might not be the best choice for you.
Are the services you need covered? We know future health care needs can be hard to predict, but changes happen. Maybe your doctor changed your prescriptions this year or you have different health concerns. I will make sure you understand what services and benefits you’re likely to use in the coming year and find coverage that meets your needs.
Your time is valuable. When comparing plans, I will help make sure which doctors and hospitals you’ll be able to use. Where are they located and what are their hours? I will check which pharmacies you can use. Can you get prescriptions by mail? Remember that even if you’re happy with your current plan, these answers might change from year to year.
Quality of Care
Ask yourself whether you’re truly satisfied with your medical care. Not all health care is created equal, and the doctors, hospitals and facilities you choose can impact your health. I can look for plans with a 5‑star performance rating. The right expertise and care may help speed your recovery and improve your outcomes.
It’s worth your time to take a look and compare coverage between now and when Open Enrollment ends on Dec. 7. Only you know what’s most important to you and your family. That’s why I want to make sure you have all the information you need to make the best decision.
To schedule your Medicare Part D Review with Janice Fitchhorn, please call Truhlsen Elder Care Law of Nebraska at 402.426.8877,