The window is open. If you’re using a Medicare Part D plan to help pay for your prescription drugs, now is the time to review your coverage to see if you can pay less for your drugs. The open enrollment window, the one time each year that you’re allowed to change your coverage plans, opened October 15 and runs until December 7.
Medicare Part D costs are rising
You’d be wise to look at plans carefully, because it appears that monthly premiums are going up. According to a study by the Kaiser Foundation, those 2017 premiums are rising about 9 percent, to an average of around $42 a month. The premiums will continue to vary widely, depending upon which plan you choose, as in previous years.
Among the ten plans with the highest enrollment, the Humana Walmart Rx PDP has the lowest: $16.81 per month, or $202 annually. The AARP Medicare Rx Preferred PDP has the highest: $71.66 per month, or $860 annually. That’s a difference, out of your pocket, of $658. And it’s not just premiums that are rising. The Kaiser research shows that deductibles are going up about by about 7 percent.
Premiums, deductibles and cost-sharing
But there’s more to choosing a plan than just considering the monthly premium and the yearly deductible. You need to consider cost-sharing — the amount of cash you still may need to lay out each time you fill a prescription. You may be charged a “copayment” or you may have to pay “coinsurance.” With a copayment you pay a set amount (like $10) for the prescription. With coinsurance you pay a percentage of the drug’s cost (like 25%).
The Kaiser report says that virtually all plans in 2017 have five cost-sharing tiers, as in recent years, but the specific cost-sharing amounts vary widely. Nearly all plans charge coinsurance for higher-cost specialty and non-preferred drugs, which usually results in higher out-of-pocket costs than when plans charge copayment amounts. About one-third of plans charge $0 for preferred generics to encourage use of these drugs.
There’s help online
So, you need to consider three things when choosing a plan: The monthly payment, the yearly deductible and the cost-sharing amount that you’ll be charged for each of your drugs. That’s not an easy task, but there are online tools to help you compare the costs of various plans.
One is Medicare’s Medicare Plan Finder. Go to the page, enter your zip code and then follow the instructions. After you enter each of your drugs you’ll be shown a list of the plans that cover those drugs and your monthly cost, including the monthly payment, the yearly deductible and the cost-sharing for each drug.
Another site is ehealthinsurance.com. This is a private service that acts as an agent for the drug plans but it’s also a good comparison tool and provides a good description of everything you need to know about Part D plans. Interestingly, its cost estimates vary, slightly, from the Medicare web site.
Check them out. I’m about to change my plan and it looks as if doing that will save me nearly $800 in 2017.