If you are a Medicare beneficiary, one of the most confusing and difficult tasks is deciding which Medicare Part D drug plan is the right one for you. The following resources should help you better understand how the Medicare system works and where you can get help if you are having difficulty paying for you medications.
One of the most helpful online resources is the Medicare website, which allows you to compare prescription drug plans, learn about plans offered in each state, view each plan’s formulary, and download appeal and exception forms. If you are eligible for Medicare, you can select a plan and enroll online. You can get the same information by calling the Medicare help line at 1-800-633-4227.
What You Need to Know When Choosing a Plan
To narrow your options and select the best plan for your needs, consider the following:
- Are my medications in the drug plan's formulary?
- Is my pharmacy in the drug plan's network?
- How much will the drug plan cost me?
When you go yo Medicare.gov, use the Medicare Plan Finder to search for and compare coverage options available in your area. A general plan search only requires your zip code. To personalize your search, enter your zip and complete Medicare information.
The Medicare Plan Finder is a tool that helps you search for and compare your available options. The tool is very easy to use - all you need is your zip code, the name of the pharmacy you use, and a list of your prescription medications. After you enter the information, the tool generates a list of Part D plans in order of cost.
For Example: Mr. Jones takes five prescription medications, one expensive brand name drug, and four generics. When he used the Medicare Plan Finder, he was provided with 31 drug plan option with a very significant range in the estimated annual cost for his drugs. In fact, the drug costs varied from $1671 $4489 for 2011. And, the plan with the lowest drug costs has a monthly premium of $34.40 while the most expensive plan has a monthly premium of $75.30 a month.
Once you find some plans that may be appropriate, you can access additional information about how the plan works and how the costs are calculated. And, you can enroll online on the Medicare site.
Make sure to enroll early in the enrollment period to make sure that your new Part D plan can mail your plan materials before January 1. This way you can use your coverage without delay.
Also, make sure to enroll when you become eligible for Medicare or during the annual Part D enrollment period. If you don't you may be subject to a Part D late enrollment penalty.
Other sources of information include:
SHIPtalk: The State Health Insurance Assistance Program provides one-on-one counseling and assistance to Medicare patients and their families.
Partnership for Prescription Assistance: Some drug manufacturers offer free or low-cost drugs to qualified Medicare beneficiaries.
Lowering the Costs of Your Medications
Medicare officials suggest the following ways you can lower your costs:
- Explore national and community-based charitable programs that can help with drug costs. Information is available on the Benefits Checkup website
- Use Pharmaceutical Assistance Program. Many drug manufacturers offer assistance programs for people enrolled in Medicare Part D.
- Consider State Pharmaceutical Assistance Program that offer help with paying drug plan premiums or other drug costs.
- Apply for extra help. Enrollees who have limited income and resources may qualify for extra help through the Social Security Administration.