Take (care with) Your Medicine


Prepare yourself for the paper deluge! If you are a Medicare enrollee, you will probably notice an uptick in the amount of mail you receive during the next couple of months. That’s because we are about to enter that special time of year designated to be the open enrollment period for Medicare plans. Various Medicare providers will be vying for your business, so keep an eye on your mailbox. Its capacity could be tested this fall.

If you’ve been enrolled in Medicare for a few years already, you’re probably used to this barrage, and you have become proficient at the “glance and toss” technique of mail sorting. You’ve settled into a routine with your Medicare benefits, you’re pretty happy with the way things work and you have no real desire to change companies. But I’m here to report that perhaps you need to reconsider the status quo this year.

According to retirement and finance guru Mark Miller in his Oct. 8, 2015 retirementrevised column, “premiums for the ten most popular Medicare Part D prescription drug plans (PDPs) will rise an average of 8 percent next year – the fastest clip in five years. And five of the top plans will boost their average premiums anywhere from 16 percent to 26 percent.” This means that if you use Humana Walmart RX, SilverScript Choice or AARP Medicare Rx Preferred, for example, you need to take a closer look at how well your plan is serving you before writing a check for the increase.

Here’s a little refresher on Medicare Part D, which is the prescription medication part of Medicare. Insurance companies offering prescription plans in your state (the companies and plans offered vary by state) are required to notify you of annual premium changes by September 30th. This gives you an opportunity to shop for a new plan during the open enrollment period, which runs from October 15th to December 7th.

How should you compare what you are currently receiving with what another company might offer? The easiest way to do this is to fire up your computer and go straight to www.medicare.gov, hover over the blue “Drug Coverage (Part D)” tab at the top of the page and click on the “Find health and drug plans” button at the bottom of the dropdown column. This will bring you to the Medicare Plan Finder window where you will begin to enter information.

Before you go online, you will need to grab your Medicare card and the updated reference list of all of your prescription medications that you keep handy for doctor’s visits or emergencies. You do have that list handy don’t you? If you don’t, please prepare one ASAP – here’s a link to a form that should help you.

Armed with your list, you’re ready to go to the Personalized Search, enter your zip code, some information about how you receive Medicare and all of your drug names and dosages. You will have an opportunity to save this drug list for future visits to the site. Once you’ve entered this data, you will see a list of all of the companies and plans that fit your specifications.

The Medicare Plan Finder tool gives you lots and lots of useful information about the different plans and their coverage options, but it’s not the most straightforward thing to understand. You have to look carefully around the page and explore all of the tabs and clickable links. The blue questions mark symbols provide added explanations for key terms. For each applicable plan, you will see a chart showing the estimated annual drug costs, the monthly premium, the deductibles and co-pays, drug coverage and restrictions and the overall star rating.

If you go one step deeper (and you should) by clicking on the name of a specific plan, you will open another screen with tabs at the top that give you an in-depth look at that plan’s costs and benefits. One of the best features of this screen is the nice little bar graph in the middle that shows your estimated costs per month for your prescriptions if you receive them by mail order or at the pharmacy. This same area of the page will also tell you if and when you can anticipate entering the dreaded drug donut hole (beginning at $3,310 in 2016) and when you will emerge at the other end (once you’ve spent $4,850).

Accurately entering your drug information is the key element in the plan choice process. Be aware that companies change their covered drug formularies (a fancy word for a list) every year, so that a drug that was once included in your plan can be gone next year. You also need to be sure that the company has not placed any restrictions on the amount of the drug you can receive in a given period. Plans might require you to try a generic version first before they will cover a proprietary drug. Read the fine print at all stages of this process.

All of this reading and digesting is time consuming and can be quite confusing, especially if it’s your first time visiting the Medicare site. I strongly suggest that you do this exercise armed with snacks and a friend or two for moral support. If you have other family members who use Medicare or who will be in the near future, recruit them to sit down with you and work through the process.

The result of your efforts should be a match of your unique needs to the plan that provides you with the best value. It should produce a worthwhile effort to savings ratio, and, now that you’ve done it once, it will be an easier process to follow next October, when you’ll have to do it all again!

Blog by Holly Deni