Medicare open enrollment, it’s time to see what’s in it for you

Enrolling/re-enrolling in Medicare and Part D can be tricky. Our best advice is to work with an expert — who has your best interest at heart.

 

1. Attend one of our FREE Medicare and Part D Made Easy education seminars. You can RSVP online or by calling (402) 506-9376.

Friday, October 12 at 11am – RSVP online

Tuesday, October 16 at 1pm – RSVP online

Wednesday, October 31 at 11am – RSVP online

Friday, November 16 at 10am – RSVP online

Thursday, November 29 at 1pm – RSVP online

2. Schedule your private, no cost consultation with our Medicare Specialist, Terry Adams – she would be happy to sit with you and help you enroll/re-enroll and make sure you choose the right plan for you. Call (402) 506-9127 to make an appointment.

3. Schedule your Welcome to Medicare Annual Wellness Doctor visit. Call (402) 506-9000 to make an appointment with a primary care doctor.

 
You may not know about the money that could be saved by checking your Medicare plan each year during the open enrollment period. It is a simple process that may take anywhere from 15 to 60 minutes depending on how complicated your medications may be. The review can be done online through www.medicare.gov during open enrollment, which runs from Oct. 15 through Dec. 7 this year. You can certainly go through the review yourself, but you may want to get assistance from someone who knows about Medicare enrollment to help as the site can be tricky. It’s best to work with someone who has your best interest at heart, versus someone who benefits from signing people up for certain plans.

 

Why it’s best to go through this process every year.

You should set aside the right amount of time to go through Medicare enrollment/re-enrollment every year because things change, such as your health, your medications, and the coverages provided. Each year, Medicare Part D information packets are sent out to their beneficiaries explaining the coverage for the following year but admittedly, they are often difficult to follow. (This is where a Medicare Part D expert is helpful.) For instance, the following can change every year on each plan:

  1. Monthly premium:This is the amount of money that it costs each month to maintain coverage – regardless if any prescriptions are purchased.
  2. Out of pocket deductible:This is the amount of money that is required to be paid by you upfront before the insurance company shares costs. Sometimes this deductible is only applied for higher tier (read: higher cost!) medications.
  3. Formulary medications:There are multiple medications that work similarly to one another. The insurance company picks and chooses which drugs are covered at a lower cost and which may be a higher cost, which require a prior authorization, or may be completely excluded from coverage.
  4. Copayments:This is the amount of money that you are responsible for at the pharmacy after insurance pays their portion. The co-payments can change from year-to-year on each plan so the costs of your medications this year will probably not match the costs next year.

Quick Tips

  • Do not rely on only the monthly premium: Although the monthly membership to one plan may be the least expensive, after the cost of your medication co-payments, it may not be the least expensive plan, based on your medication regimen.
  • Compare multiple pharmacies:Some insurance plans have “preferred pharmacy networks” where co-payments may be less than at standard pharmacies. It pays to check it out.
  • Correctly enter all medications:Have a healthcare provider, such as a pharmacist, assist you when entering in your medications because the simple difference between a tablet and capsule of the same medication can change the outcome of your search.
  • Consider talking to your pharmacist or doctor on equivalent therapies:There are often multiple medications in the same class which work just as well as the ones you currently take. However, one may be on the formulary of a plan while the other is not, greatly skewing search results. Consider all options and multiple searches to ensure the least costly outcome.
  • Caution: You may incur a penalty! Enroll in a plan if you are eligible and do not have qualifying coverage:If you do not enroll in a plan during open enrollment when you are eligible to, you may face a penalty in the future when you go to enroll.

Sara LaBella, PharmD
Pharmaceutical Care Pharmacist
Think Whole Person Healthcare