It's time for your annual drug test. And ignoring it could be very costly.
This alert goes out to people age 65 and older who have traditional Medicare Part D drug plans or Medicare Advantage plans with drug coverage. You have until December 7 to sign up for a new plan for 2017
Here are five things you should do in order to save yourself a fortune in out-of-pocket costs and get help making your choice.
--Compare, don't guess. If you already have a Part D plan (or Medicare Advantage plan including a drug plan), you have received by mail a thick booklet describing plan changes for 2017. Even if you don't notice many changes, it pays to compare.
Go to www.Medicare.gov and click on "Find health and drug plans" to search for plans available in your zip code. Have your current prescription drugs in front of you to input the correct names and dosages.
Even if you currently don't take prescription drugs, you must have Part D if you don't have comparable coverage. Compare not only the monthly premium but the deductible before coverage begins. It could be as high as $400. If you need a one-time antibiotic prescription during the year for an illness, this deductible could be important.
--Check drug coverage and tiers. Many plans will drop drugs from their formularies from one year to the next. Or, they may change the "tier" in which the drug is placed. That could easily triple the out-of-pocket cost you pay, since tiers 3 and 4 will have significantly higher co-pays. It's worth doing the "Plan Finder" comparison every year.
--Know the difference between a co-pay and co-insurance. The difference could cost, or save, you thousands of dollars a year. A co-payment is a flat fee per prescription. A co-pay on a generic drug could be as low as $2 per prescription, or even zero. But a co-pay on a Tier 3 drug could be $40 to $50 per prescription.
This year more plans are switching to require co-insurance, either on the top tier or on higher tiers of prescriptions. That co-insurance is a percentage of the total cost of the drug -- meaning you could pay as much as 25 to 50 percent of the cost out-of-pocket! And that amount could rise during the year as drug prices increase.
If you can't find a plan that offers co-pays instead of co-insurance, search for the lowest percentage co-insurance.
--Check for substitutions. During the past year a new drug might have come out to treat your condition, possibly with lower costs or fewer doses needed. Or a generic drug might have been approved. Ask your physician if there are lower-cost or generic drugs to substitute in your Part D plan.
--Get help. It is insane that seniors, especially those who are ill enough to need a number of costly medicines, are put through this process every year. If you know a senior in this situation, offer to help. Or, better yet, here are two resources that could save a fortune:
eHealthMedicare.com (888-296-0117): At no cost, you get personalized help from a licensed agent over the phone to make sure you choose the least expensive, and potentially least costly, plan in your area, using your available pharmacies. They can handle the application process as well as the choice and are not incented to direct you to any specific plan.
65incorporated.com (262-223-3433). This terrific group, headed by Diane Omdahl, will work with you to find the best Part D plan using all the criteria above, although they do not sell policies. They also help assess Medicare Advantage plans for physician and hospital coverage and drug costs. The fee for new clients is $119 for Part D and $164 for Medicare Advantage. Definitely a worthwhile investment.
Yes, this is tricky. But avoid the temptation to simply choose the lowest monthly premium. Start now. Get help if you take many prescription drugs. And choose wisely. Doing this will improve your financial health. And that's the Savage Truth.