Switch To Save on Your Part D Plan

Medicare Prescription Drug Plans Vary by Hundreds of Dollars Per Year

Updated on: June 29, 2018

Originally posted on: October 11, 2016
The Roadmap for Medicare staff specialize in all topics related to Medicare Part D, choosing a Medicare plan, and making smart health decisions in retirement.

Let’s face it – No matter how many times experts recommend that we reevaluate our Medicare Part D plan each year, many of us don’t!

If you stick with the same prescription drug plan year after year, you are not alone. According to a study by the Kaiser Family Foundation, approximately nine in ten Part D enrollees stay with their Part D plan rather than switch. This is true even though many beneficiaries have access to research on other Part D plans that could lower their premiums or reduce their total drug costs. In fact, a recent study estimated that beneficiaries who stay with their current prescription drug plan will pay, on average, a 13% premium increase.

Comparing Your Plan to Other Options

We understand why many beneficiaries hesitate to make changes. Reassessing your Part D plan during the annual enrollment period can be time-consuming and confusing. Keeping your current plan might seem like the easiest choice. However, doing your homework to ensure your plan is still the best option for meeting your prescription drug needs may save you hundreds of dollars. To learn more about the four simple rules of the road outlined below, please watch this video.

Medicare sets up many of the details around your prescription drug benefit changes from year to year. Your current plan’s premium, deductible and copayments or coinsurance may rise, while another plan may offer lower premiums or copays. These changes can affect your overall costs in a plan. And, while the premium may look good, there are other factors to consider before switching or staying with your plan.

Not only can the premium, deductible and copays change, but the list of covered drugs (the “formulary”) can change also. A drug that may be covered one year may not be covered the next year. Or, it might be moved to a higher tier which means it will be more costly for you. If your medication needs have changed over the last year, or if you think you will need to increase or change the medications you are taking to treat one or more chronic conditions, you may want to consider these important points.

Four Rules of the Road for Evaluating a Part D Plan

To help you choose the best plan, we recommend four rules of the road. Follow these recommendations to help you navigate your way and find the option that best fits your needs.

Rule #1: Lower premiums aren’t always better

  • Plans with lower monthly premiums or a $0 deductible may have higher copays and cost you more overall.
  • When evaluating costs, make sure to prepare a list of all of your medications to easily estimate your total costs. Be sure to talk to your doctor about your current medications to see if there might be any generic versions that might help lower your costs

Rule #2: Make sure your medicines are covered

Always check a plan’s drug list (the “formulary”) to be certain your medications will be covered next year. You can also see if the plan has any new rules like quantity limits or prior authorizations that may be required for your medications.

Rule #3: Find a plan with a pharmacy network that suits you

  • A pharmacy network is the group of pharmacies you can use to fill your prescriptions — look for a plan with a large pharmacy network that includes both standard and preferred pharmacies. This is important especially if you plan to travel.
  • Be sure the plan offers preferred pharmacies that charge lower copays and coinsurance to help bring down your costs.
  • Many plans also offer a home delivery pharmacy, a service that can provide you additional savings, plus the convenience of having your medications delivered right to your door. 

Rule #4: Look for 24/7 pharmacist support

Immediate access to a pharmacist can be very important. Pharmacists can help with questions about drug safety, money-saving drug alternatives, and even offer expert advice in the medications that treat your chronic condition.

Use the Annual Enrollment Period Wisely

On October 1, begin your research on other plans by checking the plans’ websites and calling for information or requesting plan materials to review. Its your opportunity to ask questions and make sure you have the right Part D prescription drug plan for the year ahead.

Remember, switching to a plan that’s better for you cannot only save you money throughout the year, it can also provide you with access to a broader drug list, pharmacist support when you need it, and convenience.