Find Savings on Medicare Part D Prescription Plans
Medicare prescription plans come in many forms with different coverage levels and premiums to suit your pharmacy needs — and hopefully your budget. You can get Part D prescription coverage in one of two ways, depending on what kind of Medicare coverage you have:
1) With Original Medicare (Part A, Part B, and possibly a Medicare Supplement), you have the option to enroll in Part D coverage. Part D coverage is handled by private insurance companies approved by Medicare and is not free. You will likely have to pay a monthly premium for your plan and will receive a separate insurance card you can show at pharmacies. You may also have a copayment or coinsurance.
2) With Medicare Advantage (also called Part C), your insurance provider may offer you prescription benefits. In most cases, you won’t be able to sign up for a standalone Part D plan since you already have access to medication coverage. If your Medicare Advantage provider does not offer you a prescription drug plan, you’re free to enroll in Medicare Part D.
Regardless of which route you choose to enroll in Part D, the goal is to help you afford the medications you need. Of course, sometimes health or financial circumstances change and your plan may become too costly or no longer meet your needs. If you feel like your plan is no longer a good fit, consider these ways to keeping your wallet full after visiting the pharmacy.
Use the Medicare Plan Finder or the services of an insurance agent like PolicyZip to get the best deal
This Medicare Plan Finder tool is a calculator of sorts that can help you save money by narrowing down the best plans for you. Insurance agencies, like PolicyZip, can also help you determine which plans are available in your area and offer the best benefit level relative to cost.
Take the time to re-examine your plan each year
If you already have a Medicare Part D plan, you might not worry too much when open enrollment comes around each fall. Plans can shift coverage and surprise you with big changes if you’re not paying attention. If you find your plan is no longer effective, you have time during open enrollment to sign up for something new. The PolicyZip team helps its clients review their coverage on an annual basis to ensure that costs stay as reasonable as possible.
Find a plan that offers some coverage through the “donut hole”
Some health situations simply require more medications than others, which can be costly to you even after meeting your prescription plan deductible. The “Medicare Donut Hole” (also called the “coverage gap”) happens when you and your prescription plan pay up to a certain allowed amount for prescriptions and you are temporarily left without coverage until hitting the year’s out-of-pocket limit. If you have multiple medications or costly prescriptions, you should consider looking at plans that offer some kind of assistance when you hit this coverage gap. These plans may continue paying some portion of your pharmacy expenses, which can help limit your costs until coverage kicks back in.
Consider less-expensive drug alternatives
Switching to a generic form of your medication can substantially save you money. According to the Food and Drug Administration (FDA), generic drugs usually cost between 80% and 85% less than the same brand name drugs. And, they work just as well. That’s because generic medications are required to have the same active ingredients, dosages and forms of their branded equivalents. This way, you can still receive the drugs you need without much of the cost.
Switch to a preferred pharmacy
Some prescription plans come with preferred pharmacies — that is a pharmacy that the insurance provider has contracted with to provide the best price on medications. In some cases, this may mean rerouting your prescription through a mail order pharmacy to save money (and save time waiting in line at your nearby store). Other preferred pharmacies may be located near you. The best way to find a preferred pharmacy near you is to contact your Part D plan provider.
Contact your provider to ensure you’re paying the right amount
Have you had a drug bill come back higher than expected? Instead of just worrying about it, contact your drug plan provider to see what’s changed. Even if you’ve had your plan for years, insurance companies can modify how much they choose to cover for certain medications or if they’ll cover brand name or generic versions of a drug. It’s possible that there could even be a billing error — in which case, you’ll likely be on your way to a refund. If the amount is correct but you’re still in shock, inquire about what options you have lowering your out-of-pocket cost for the medications you need.
Apply for Extra Help
Extra Help is a Medicare program that helps people with limited and low income get the medications they need but wouldn’t otherwise be able to afford, even with Medicare Part D. Extra Help can cover insurance premiums, copayments or deductibles, and is provided based upon your income level. You can apply for Extra Help through your local Social Security office or through the Social Security website (link).
Look into other assistance programs
If you don’t qualify for Extra Help but are struggling to cover medicinal expenses, there are other options. Many states have assistance programs that cover a variety of prescription medication expenses and contacting the State Health Insurance Assistance Program (SHIP) can help you get started. Some charitable organizations, such as the HealthWell Foundation, also provide help. But, if you don’t qualify for any of these forms of assistance, you can still contact pharmaceutical companies and manufactures to see if they will help. Many drug companies provide some kind of discount or aid in affording their medications, especially when there are no generic equivalents or alternatives.