When to switch your Medicare Part D Rx plan

I tell all of my clients, they should compare their Medicare Part D Rx plan annually.  Medications change, along with drug plans moving drugs to different tier levels, causing changes in how companies cover certain meds.  Part D drug companies make changes to their plans annually, so if you simply renew your plan without at least looking into the changes, you may be surprised at the beginning of the calendar year when your costs have gone up.

I’m happy to help you search and enroll in the best plan for your medication list.  Simply email a list of your meds to me and I’ll run the comparison for you.

Most plans have a monthly premium of $7 to $30, although if taking specialty drugs, the plans may have higher premiums.

Most plans will have a $480 annual deductible which is typically only for brand drugs.  If you only take a few generic drugs, you will most likely not have to pay into the deductible.

The monthly premium is an important amount, although not as important to the “annual cost” which is your total out of pocket amount, including; annualized premium, any deductibles and your annualized copays or percentages for your different prescriptions.

You may find that a higher premium plan may provide better coverage than other low premium plans.  Again, look at the annual total, not necessarily the monthly premium.

Coverage Gap 2022  (Donut Hole)  …  The coverage gap or also termed, the Donut Hole, and begins after you and your plan have paid $4,430 for your drugs.  Once this happens, you will pay no more than 25% for your Generic or Brand drugs.

Once you have spent $7,050 in drug costs, you move out of the donut hole and into the “Catastrophic Level.” At this level you will pay $8.95 copay for brand drugs, and $3.60 for generic.  Or, 5% of the retail charge, whichever is higher.

These amounts are set annually by CMS and are required for both Medicare Part D stand-along plans along with the Part D section within a Medicare Advantage plan.

Enrolling in a new Part D plan is easy and quite quick.  One can enroll online, over the phone or with a paper application.  If you are new to Medicare part B, you have 3 months to enroll in a plan, otherwise you will need to wait until the next annual open enrollment which is every October 15 through December 7. Enrolling during this open enrollment your new plan will start January 1.

If you have questions or need some assistance please let me know, I’m happy to help.

John Conner

Medicare Plan Options ... Medicare Supplement, Medicare Advantage, Medicare Part D Rx

Leave a Reply