Choosing the right Medicare Part D plan during open enrollment (Nov. 15–Dec. 7) can save you hundreds or even thousands on prescription medications. Here's how to navigate the process:
Key Updates
Free Vaccines: Includes the shingles vaccine.
Insulin Cap: Costs limited to $35 per month.
Future Annual Out-of-Pocket Cap: $3,500 in 2024, dropping to $2,000 in 2025.
Drug Price Regulation: Drugmakers penalized for price hikes exceeding inflation.
Steps to Find the Right Plan
1. Enter All Medications on Medicare.gov
- Input your complete list of drugs (name, dosage, and frequency).
- Leaving out even one medication can lead to higher costs.
- Example: Omitting celecoxib (generic Celebrex) could shift the cheapest plan from $250.80/year to $759.60/year in some cases.
2. Do a Thorough Pharmacy Search
- Preferred Pharmacies: Plans often offer lower drug prices at these locations.
- Use Medicare’s plan finder tool to compare costs at nearby pharmacies.
- Example: In Denver, a Humana plan cost $463.56 at Walmart (preferred) but $1,182 at a non-preferred pharmacy.
3. Understand the Doughnut Hole
- The "coverage gap" starts when annual drug costs (excluding premiums) reach $4,660.
- In this phase, you pay 25% of drug costs until reaching $7,400, after which costs drop significantly.
- Consider plans that help you avoid or reduce the doughnut hole impact if your medication costs are high.
4. Consider Cash Discounts
- Sometimes paying cash is cheaper than using insurance.
- GoodRx: Offers discounts even for those with Medicare.
- Amazon Pharmacy: Generic drugs start at $6 for a six-month supply.
- ScriptCo: Wholesale generic drugs available with a $140/year membership (excludes controlled substances).
Tips for Shopping Smart
For New Enrollees
- If you take no medications, choose a plan with a low or no-cost premium to avoid Medicare’s late enrollment penalty.
For Current Enrollees
- Review plans annually since premiums, deductibles, and drug coverage can change.
- Look for plans with both low premiums and drug costs.
Pharmacist Consultation
- Ask your local pharmacist which plans they are a preferred provider for. This can help streamline your decision.
Get Extra Help
- If your 2021 income was under $20,385 (individual) or $27,465 (couple), you might qualify for additional cost assistance through Medicare.
Bottom Line
By taking the time to research and compare plans, you can avoid overpaying for prescription drugs and ensure comprehensive coverage tailored to your needs.
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