Medicare Open Enrollment Part D

Are you 65 years of age or older and looking for a new or updated Medicare Part D plan? Are you unsure of where to start or who to review with? Maybe you haven’t heard of a Part D plan or are unsure of what it is? Medicare Part D covers prescription drug costs, both generic and brand name, and can be reviewed each year during the open enrollment period. Open enrollment for Medicare Part D is every year from October 15 to December 7 and here at your local pharmacy, we can answer any questions you may have about choosing the perfect plan to fit your needs.

What is Open Enrollment?

Open enrollment is a set time frame, in this instance for Medicare Part D, where you are able to join, switch, or drop a plan depending on your eligibility. The Open Enrollment period for Medicare Part D beings on October 15 and lasts until December 7 each year. During this time, you can join, switch, or drop a plan, with coverage beginning on January 1 if the plan is requested by December 7. You are able to make as many changes as you would like during those weeks, however, to avoid any enrollment problems, it’s typically recommended to make as few changes as needed.

When am I Eligible for Medicare Part D?

Initial Enrollment Period (IEP) begins 3 months before you turn 65 and ends 3 months after you turn 65 or begins 3 months before your 25th month of getting Social Security or Railroad Retirement Board (RRB) disability benefits and 3 months after that time. You also must already have Medicare Part A and/or Medicare Part B in order to join a separate Medicare drug plan (Part D), must be a United States citizen or lawfully present in the United States.

What Can I do During Open Enrollment Period?

During the open enrollment period of October 15 – December 7, you are able to do the following:

• Change from Original Medicare to a Medicare Advantage Plan

• Change from a Medicare Advantage Plan back to Original Medicare

• Switch from one Medicare Advantage Plan to another Medicare Advantage Plan

• Switch from a Medicare Advantage Plan that doesn’t offer drug coverage to a Medicare Advantage Plan that offers drug coverage

• Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn’t offer drug coverage

• Enroll in a Medicare Part D plan if you didn’t enroll when you first became eligible for Medicare

• Switch from one Medicare drug plan to another Medicare drug plan

• Drop our Medicare drug coverage completely.

If you have any questions about how to do any of these options, stop into your local pharmacy or give us a call to set up a review time that works best for you. During this time, the pharmacist will answer any questions you have pertaining to Medicare Part D Open Enrollment.

Four Signs You Should Change Your Medicare Part D Plan

Each year it’s a good idea to review your plan and see if it still fits your needs. Here are some signs to be aware of when considering changing your plan.

1. Plan formularies change from year to year

Part D plans have formulary to help place various medications into different tiers. The lower the tier, the lower the copay, whereas the higher the tier the higher the out-of-pocket costs. These tiers can change from year to year so it’s important to review what medications you are taking and what tiers they fall under.

2. Your medication needs have changed

If you are taking new medications, there’s a good chance that there’s a better plan that you can choose so you get a better deal! For example, let’s say you are paying a high price on a premium for a plan that places your medications on a low tier. If you switch to a generic, cheaper version of that medication, you may have a lower premium. Or, if your current plan has placed your medication in a high tier, you can see if there’s a different plan that has the same medication under a low tier.

3. Some pharmacies included in your plan’s network aren’t convenient for you

Most Part D plans require enrollees to fill prescription at in-network pharmacies. However, if you use an out-of-network pharmacy you more than likely will end up paying full price for the medication. If this is the case and you don’t have a conveniently located pharmacy that is in-network, it may be a good idea to review your Part D options.

4. You’re paying a high premium for a plan you don’t use often

You may be paying for a Part D plan that has better coverage with a higher premium, but you might not have any regular prescriptions that need to be filled. If this is the case, you should consider looking at a different plan that has a lower cost.

Once you have reviewed your current plan and see that you may want to make changes based on those four tips, you will want to search for a plan that fits whatever your needs may be.

We are Here to Help!

If you are considering changing your Part D plan based on the information you have read, or maybe just need help understanding what prescription drugs you are taking and what plan covers what, we are here to help! Our team is dedicated to you and will answer any questions you have regarding Part D open enrollment and help you choose a plan that will work best for you. We provide in-depth reviews of the current plan you are enrolled in as well as other plan options that you could consider. Even if you are not wanting to change your current plan, it is always a good idea to review the medications you are currently taking to ensure you are keeping the best plan possible for your needs.

Sources:

• https://www.medicare.gov/sign-up-change-plans/joining-a-health-or-drug-plan

• https://www.medicareresources.org/medicare-open-enrollment/#

• https://www.medicareinteractive.org/get-answers/medicare-prescription-drug-coverage-part-d/medicare-part-d-enrollment/changing-part-d-plans

• https://www.healthmarkets.com/resources/medicare/when-is-the-medicare-part-d-open-enrollment/

• https://www.medicareresources.org/medicare-benefits/four-signs-you-need-a-new-medicare-part-d-plan/#formulary

• https://www.nerdwallet.com/article/insurance/medicare/what-is-medicare

• https://www.medicareresources.org/states/

• https://www.medicare.gov/drug-coverage-part-d/how-to-get-prescription-drug-coverage

• https://blog.medicaresolutions.com/open-enrollment-checklist/