(Washington, DC) Making the effort to check health and prescription drug coverage during the Medicare Open Enrollment Period, October 15th through December 7th, can pay off in significant savings for retirees, says The Senior Citizens League (TSCL). “The job does not have to be overwhelming,” says Mary Johnson, a Medicare and Social Security policy analyst for The Senior Citizens League. “Free one-on-one counseling is available in every area of the country to check coverage options and to switch to other health or drug plans when a better choice is available,” Johnson says. “Checking coverage is especially important since the Social Security cost-of-living adjustment for 2020 is just 1.6 percent, and will only raise an average benefit of $1,460 by about $23 per month.
According to research by Johnson, prescription drug costs vary significantly between drug plans — by the hundreds or even thousands of dollars — even for common generics. Unlike other services, Medicare does not negotiate drug prices on behalf of beneficiaries. The plan with the lowest-priced drug can be hundreds or even thousands of dollars less than the highest cost plan for the very same drug. Yet the majority of Medicare beneficiaries rarely shop for their best drug plan during Medicare’s annual Open Enrollment Period. Consequently, Medicare beneficiaries in Part D and Medicare Advantage plans overpay for their prescription medications even though less expensive, high quality plan choices are available.
The drugs covered by each plan can vary dramatically, and plans frequently push drugs into a higher formulary tiers which are more expensive, unbeknownst to even the most conscientious consumers. “That can result in a drug price shock next year at the pharmacy counter, unless you nip that in the bud right now,” says Johnson.
Since the start of Medicare Part D in 2006, Johnson has volunteered to help friends, neighbors and family members compare Part D plans and switch to new plans when better choices are available. Doing so often results in substantial savings on drug prices —sometimes hundreds of dollars, lower premiums, and better access to brand and pricey drugs.
How should Medicare beneficiaries prepare for Open Enrollment? Here’s a checklist from The Senior Citizens League:
- Review: By now, people covered by Medicare Part D or Medicare Advantage plans should have received an Annual Notice of Changes for 2020 from their current plan. In addition to changes to the premiums, the notice will explain increases, if any, in the deductible, copayments and coinsurance. The notice will tell you where to find information about the pharmacies in the drug plan’s network, and it will refer to “the drug list” or plan formulary of covered drugs which usually can be found online or requested from the plan. “What the notice does not include is a list of the drugs you currently take, the tiers that your drugs will be on in 2020, whether coverage has been dropped for any of your drugs in 2020, or what those drugs will cost if co-insurance is charged,” Johnson says. “Plans will provide most of that information, but it requires calling your plan directly and speaking to someone who can estimate the cost of your drugs in 2020. Once you have this information, it’s very important to compare all your health and drug plan options to find your lowest-costing coverage,” Johnson says.
- Gather and write legibly: Gather all of the drugs you currently take and carefully make a list, printing the name of the drug, dosage, quantity taken per day, and quantity required per month. Do this for each drug taken. Make sure your writing is legible. Type it into a Word document and print it out if possible. Keep this list on file where you can find it easily. Not only will you need it to compare drug plans, it’s handy to take with you on each visit to your doctor.
- Get free, unbiased assistance from a Medicare counselor: You can get great help from a local Medicare benefit counselor who provides free one-on-one counseling through State Health Insurance Programs (SHIPs). Local contact information can be found at: https://www.shiptacenter.org. Call and make appointment now, because Open Enrollment will take more time than usual this year. The Medicare Drug Plan Finder comparison tool which counselors use to compare drug plans and estimate costs has recently been re-designed. “It’s likely to take longer than usual to sort through plans and determine the best choice for clients while all of us are learning how to use the new system,” Johnson says.
- Narrow your choices and contact the prospective drug plans directly to confirm details: Once you have picked out three or so plans that look like your best bets, contact the plans directly to confirm the details. This includes coverage of all your drugs, estimated co-pays and co-insurance, which pharmacies participate and other questions you may have.
- Switch plans by going through the Medicare website: It’s better to switch plans through the Medicare website than trying to do so directly with the insurer. This way Medicare will make sure your previous plan unenrolls you by the end of the year and your new coverage begins on January 1, 2020 with the new plan. Your SHIP Medicare benefits counselor can help you do this.
To learn more, visit www.SeniorsLeague.org.
With 1.2 million supporters, The Senior Citizens League is one of the nation’s largest nonpartisan seniors’ groups. Its mission is to promote and assist members and supporters, to educate and alert senior citizens about their rights and freedoms as U.S. Citizens, and to protect and defend the benefits senior citizens have earned and paid for. The Senior Citizens League is a proud affiliate of The Retired Enlisted Association. Visit www.SeniorsLeague.org for more information.
JOURNALIST: Analysis and table illustrating wide variation in drug costs - https://seniorsleague.org/assets/Part-D-Drug-Price-Variance-Report.pdf