If you weren’t already aware by all of the commercials and ads, Medicare’s open enrollment period for 2019 runs from October 15-December 7, 2018. You can also switch providers for your comprehensive health and drug coverage during this same time frame to better suit your needs and maybe even save yourself some money. Medicare health and drug plans make changes on a yearly basis as well – so keep in mind that even if you stay in the same plan, there could very well be changes to cost, coverage and in-network providers.

Coming off the heels of the recent Medicare workshop that Richmond Brothers hosted, we wanted to share some important information that was covered by Clay Carroll, a very knowledgeable volunteer at the Jackson County Department on Aging. While most of the information provided was for “beginners,” there was a great deal of valuable information for even the “most seasoned” Medicare participants.

Today we decided to focus on what could be argued as one of the most complex pieces of Medicare, according to Clay: Part D (the prescription drug plans). To give you an idea of why, just think about this example:

In Jackson County there are 29 prescription drug plans. Each plan can have different attributes including:

• Premiums
• Deductibles
• Co pays
• Covered drugs
• Tier Levels  1-2-3-4-5

When all of those factors are considered, that’s a minimum of over 230 possible options to look at for each drug taken!

So, to help you through this yearly process of reviewing your prescription drug plan (and yes you heard that right – Clay recommends you review on a yearly basis to ensure your plan is still the best option for you) here are Clay’s “insider” tips to navigate your way through the Medicare website :

1. Go to Medicare.gov
2. Click on Find Health and Drug Plans
3. Enter your data in the personalized search area
4. Enter your prescription drugs (Record your drug list ID and Password Date) for future searches (Usually best to enter one month supply of your drugs initially)
5. Add Pharmacies – can expand mileage for more pharmacies
   Use CVS and Kroger for initial pharmacies to bring up most of the enhanced plans
          You can come back and change pharmacies later if needed – When you use CVS and Kroger in the  search you get most of the special plans but they do work with other pharmacies too. You have to look in the pharmacy section of the plan you select to see what other pharmacies are preferred in that plan. Sometimes there are a dozen and sometimes there is only one.
6. Click on prescription drug plans with original Medicare
           Plans are listed in order of annual cost
7. Click on the plan to see the detail
           A. Make sure you are looking at the correct drug cost data  
          (headings to click on include 2 pharmacies and mail order)
           B. Check plan for restrictions – Quantity Limits, Step Therapy, Prior Authorizations
           C. Click on Pharmacy Network to see other pharmacies that may be preferred in that plan       
8. If you want to make any changes go to the top of the plan sheet and click on the area you want to change
    (here you can change pharmacies, change filling frequencies, add/remove drugs, etc)
9.  Click the enroll button if you are ready to enrollIn about 2 weeks you will receive your new plan including a book with covered drugs, a card, and how to pay your premiums. Usually it is best to pay premiums directly versus having them come out of your Social Security benefits – when you change plans it takes them a while to catch up.

Please note that Clay mentioned that Medicare.gov is the easiest place to check for your optimum drug plan: 

• Your pharmacy may help you but beware – they might be slightly biased
• Your local Department on Aging also offers this service if you need help

So there you have it, step-by-step instructions to help you pick out the best prescription drug plan for you in 2019! Want to learn more? Feel free to check out Clay’s full Medicare 101 presentation here and/or reach out to your local Department on Aging. Best wishes for a happy Medicare season!

Sources

cms.gov/Center/Special-Topic/Open-Enrollment-Center.html