Should You Use Licensed Insurance Agents To Find The Best Medicare Part D Plans
Brokers have a lot of training and expertise under their belt, and a good one will be able to spend quality time looking at your individual needs at no cost to you. Be aware, though, aware that most agents work on commission and are in business to sell plans for the companies that will be paying them.
One way to make sure youre dealing with someone who has your best interests in mind is to go to an agent who represents a number of insurance companies.
Ask them: Do you sell all the plans that are available, or do you only represent certain companies? Walker advises.
What Does Part D Cover
Medicare Part D is a private insurance plan that is backed by the federal government.
While there are no federal programs for prescription coverage, Medicare does set a standard for what private plans must cover. Each prescription drug plan must cover at least two medications in each drug category. Each plan can create their own list of covered drugs, as long as there are two in each medication category. These lists are called formularies.
Within the formulary, there are different levels of medications. These levels called tiers are based on your plans preference for certain generic, brand name, or specialty medications. The tier your medication falls on will determine the cost youll pay.
Open Enrollment Goes Until Dec 7 2019 Make Sure Your Plan Works For All Your Meds
If youre already on Medicare, its tempting to just renew last years plan before the sign-up deadline of Dec. 7. But thats not always smart. Each year insurers drop and add drugs to their formulary, or change premiums or deductibles, says Fred Riccardi, president of the nonprofit Medicare Rights Organization.
So you dont overpay, look closely at how your plan for 2020 compares with others offered in your area by using Medicare’s plan search tool. Plus, follow these quick tips.
Go to PlanFinder.gov and enter all of your information. In a test last year, CR Secret Shoppers found that leaving out even a single drug from a list of five could lead to a plan that could cost hundreds extra. The PlanFinder tool lets you create an account where you can keep a list of the drugs you take, making shopping easier.
Compare pharmacies carefully. CR shoppers also found that prices for the same drugs in the same plan purchased at different pharmacies can be very different, even within ZIP codes. Thats because some pharmacies are considered preferred by the Part D plan, Riccardi says. In the PlanFinder tool, note whether any of the pharmacies are preferred and consider those. They are often the lowest-cost options.
Get free help. Choosing a plan is complex, Riccardi says, so dont hesitate to get help. Several resources are available.
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What If I Want To Change My Medicare Advantage Plan To Medicare Part D
You can switch from a Medicare Advantage plan to Medicare part D during Medicares general enrollment period during the first three months each year. If you miss that period, you can sign up during the open enrollment period, from October 15 through December 7.
You may be able to change your plan at other times for some special reasons. These reasons include, but arent limited to:
- Moving to a new address.
- No longer qualifying for Medicaid.
- Losing Medicare coverage through your provider for any reason.
How Much Does A Medicare Part D Plan Cost
There are three costs associated with Medicare Part D:
According to CMS, the average Part D premium in 2020 is $30.
CMS sets the maximum Part D deductible each year. For 2020, the standard deductible is $435.
Copayments are set by the insurance companies and there is no maximum set by CMS.
Premiums and deductibles arent carved in stone, however. Plans are free to set their own premiums, cost-sharing structures, and deductibles as long as the deductible is below the CMS maximum.
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Over the past several years, manufacturers have been required to pay an increasing percentage of costs to close the donut hole.
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Is Medicare Part D Mandatory
Medicare Part D is not mandatory. However, unless you have other creditable coverage, it is critical that you enroll as soon as you are first eligible. If you don’t, you may have to pay a late enrollment penalty in addition to your monthly Part D premium if you decide to enroll later. The late enrollment penalty also applies if you go without Medicare prescription drug coverage for 63 or more days. The penalty adds 1 percent to your premium for every month that you didn’t have creditable coverage.
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Which Plan Should I Choose
The goal is to choose the Part D prescription drug plan that:
Sometimes, a low rating can mean that a company has bad customer service or their rates go up unexpectedly in the middle of the year.
A company with a 4 or 5-star rating often means that its customer service is reliable, and the rates tend to stay the same. There are always exceptions to this rule, but this is the general rule of thumb.
So, itâs somewhat of a balancing act, but try to choose the plan that has the cheapest annual cost with the highest overall star rating.
Remember to sort your drug plan options by lowest drug + premium cost â not just the monthly premium.
Sometimes, a plan is cheaper overall, but the monthly premium might be higher. The lowest drug + premium cost will factor in the premium, deductible, copayments, and coinsurance, which is what really matters.
If youâre not sure which plan to choose, a Medicare Allies agent can help. Please donât hesitate to call us here at Medicare Allies â weâre happy to compare drug plans for you and narrow down your choices. This service is 100% free!
In the meantime, grab the Medicare Part D Cheat Sheet, and start comparing drug costs!
Find The Right Part D Plan
As you can see, finding a Medicare Part D plan that will work well for you takes some effort.
It even may require assistance from a friend or your local pharmacist.
However, taking care of this task each year is the best way to save money while making sure that you get the medications you need.
This content is accurate and true to the best of the authors knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
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Best In Ease Of Use: Humana
Humanas smooth website and simple process for comparing plans make it a winner. When you look into Humanas Part D offerings, the page automatically fills in your location data and immediately shows you the plans available in your area. You may also have access to preferred cost-sharing benefits when you fulfill your prescriptions at Walmart, depending on the plan you choose.
Extremely easy to get access to plan comparisons
Offers basic, moderate, and comprehensive plans, with costs and coverage that scale up from plan to plan
Advertises other Medicare plans on the webpage for Part D enrollment
Humana was rated the easiest to use for its genuine focus on making the health care application process as easy for its customers as possible. It doesnt require you to click through several different windows to get the information youre looking for as you try to apply its all right there, easily accessible. Humana is also ranked highly with a positive rating of A- with AM Best, meaning the company is financially stable. And, Humana has educational material on its website, including a number of help and how-to articles . Live Humana associates are available via phone if you need help with any questions along the way.
Humanas Walmart Value Rx plan, its most basic offering, can cost as low as $28.50 per month, with possibility for reduction based on Medicaid status.
Wellcare Health Plans Medicare: Good Choice Of Plans
Reasons to avoid
WellCare Health is a government-sponsored healthcare plan specialist, and so is a great resource for weighing up which Medicare Part D plan might be suitable for any potential customer.
Since these types of plan are definitely the focus, the customer service agents are equipped to give detailed and specialist knowledge, putting the company in a relatively good position compared to many of the peers in the marketplace.
WellCare has an excellent spectrum of available plans, ranging from very affordable entry-level, basic plans to good value, comprehensive plans for customers with extensive medication needs. Pricing is also nicely varied meaning there should be something for everyone.
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How To Find Prescription Drug Plans For Seniors On Medicare
There are many choices when it comes to Medicare prescription drug plans in 2022. And, if you’re eligible for Medicare, you’re eligible for Part D.You should always consult with an agent to ensure your drugs have coverage on the Part D formulary. Besides, you don’t want to accidentally enroll in Medigap Plan D thinking you have Part D coverage!Our agents can walk you through a needs analysis to help you identify the best options in your service area. Once you can confidently select your policy, they can guide you through the application and enrollment process.If you would like to compare rates in your area, give us a call at the number above. Is calling right now not an option? Fill out our online rate comparison form and start saving money!
Best In Number Of Medications Covered: Cigna
Higher deductible for Tiers 3 though 5 for the Essential and Secure plans
Premiums as high as $68.10
Cigna won this category based on the sheer number of drugs on its formulary. Prescription medication is, after all, the whole point of a Part D Plan, so its important to have as many options for your medication as possible. It can be a relief to know the chances are better for the availability of your preferred medication, or at least one adequate alternative. While Cignas Part D Plan premiums can be a bit on the costly side, , this is balanced out by $0 or low copays, which can help you get your medication without breaking the bank.
Cigna has been in business since 1792, so you know it has the historical understanding and background knowledge required to provide well-rounded care. Cignas A ranking with AM Best indicates that the company is financially strong as well.
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When To Change Medicare Part D Plans
Its a good idea to review your prescription drug coverage each year to ensure youre still in the right plan for your needs, but there are limits to when you can change plans. Most people switch Part D plans during annual open enrollment , which occurs October 15 through December 7 each year.
If youre switching from Medicare Advantage back to Original Medicare and want to add Part D coverage at the same time, you can do so during annual open enrollment or the Medicare Advantage Open Enrolment Period January 1 through March 31.
If you want to switch plans outside these two enrollment periods, you may do so if you qualify for a special enrollment period . There are many kinds of SEPs, and you could be eligible for one if you:
- Move out of your plans service area
- Lose coverage because your insurer withdraws coverage fromform your current area
- Can prove the plan failed to provide promised coverage
- Leave Medicare Advantage to return to Original Medicare
- Move into a nursing home or other institution
- Join Programs of All-Inclusive Care for the Elderly
- Lose or gain Extra Help
Finally, you can switch from any Part D plan to a 5-star plan at any time during the year .
Learn more about Medicare enrollment periods.
Tips For Choosing Medicare Drug Coverage
If youre wondering how to choose a Medicare drug plan that works for you, the best way is to start by looking at your priorities. See if any of these apply to you:
- I take specific drugs.
Look at drug plans that include your prescription drugs on their
. Then, compare costs.
- I want extra protection from high prescription drug costs.
Look at drug plans offering coverage in the
, and then check with those plans to make sure they cover your drugs in the gap.
- I want my drug expenses to be balanced throughout the year.
Look at drug plans with no or a low
, or with additional coverage in the
- I take a lot of generic prescriptions.
Look at Medicare drug plans with
that charge you nothing or low copayments for generic prescriptions.
- I don’t have many drug costs now, but I want coverage for peace of mind and to avoid future penalties.
Look at Medicare drug plans with a low monthly
for drug coverage. If you need prescription drugs in the future, all plans still must cover most drugs used by people with Medicare.
- I like the extra benefits and lower costs available by getting my health care and prescription drug coverage from one plan, and Im willing to pick a drug plan with restrictions on what doctors, hospitals, and other health care providers I can use.
Look for a
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Consider Talking To A Broker Or Consultant
Why wade through overwhelming information if you dont have to? Engaging with a broker or a health insurance consultant is free. Brokers sometimes have access to more plans or better pricing and can use their connections with insurance companies to help find the best plan and coverage for you.
State Health Insurance Assistance Programs can be an excellent resource to help you find all the information you might need if you look for further help with insurance.
Make A List Of The Drugs You Take
Your first step is to drag out the bottles of all of the prescription medications you normally take. You may also want the information of those you have taken during the past year temporarily.
Open a spreadsheet in your computer, and for each medication, list the
Place your current medications first and those youve taken during the year last.
Next, create a column titled Tier.
Then wait until you have the information you need to complete your chart by using the information provided by Medicare.gov.
It is up to you to check your plans every year to make sure you make the best choices for yourself.
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Can Changing My Medicare Part D Plan Lower My Drug Costs
Medicare.gov suggests six ways to reduce the cost of your prescription drugs. They include:
We suggest a 7th method: compare plans annually and switch to the best plan for your health and financial needs. It’s not just about gap coverage, because most seniors never reach the coverage gap. What you need is the best overall plan for you, and it may change every year.
Medicare Part D Plans help you pay for your prescription drugs. All PDPs are different, and the costs can vary significantly. It’s not uncommon for a prescription under one plan to cost you $5 at the pharmacy, while the very same prescription through another plan costs $25. This is why carefully comparing and choosing your Part D Plan annually is so crucial. You need to choose the best plan for you, which includes covered medications, the monthly premium, and the costs for your prescriptions .
Common Medicare Part D Expenses To Know
While prescription drugs costs under the majority of Medicare Part D plans are low, the amount youll pay will vary by the Part D provider. These are the most common expenses youll need to familiarize yourself with…
Premiums: This is the amount you pay each month to ensure your plan is active.
Annual deductible: The amount you pay before coverage begins. This amount is capped at $435 annually, but some Medicare Part D plans offer zero deductibles.
Copayments: This is the set amount youll pay each time you file a prescription.
Coinsurance: The percentage cost you have to cover.
Coverage gap costs: This applies once your Medicare Part D plan covers $4,020 in drugs. Of course, that also means youll have to cover higher out of pocket costs.
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