Medicare Part D Drug Plans

Open Enrollment for Part D 2017 (rev: 11/11/2016)

Open enrollment season is nearly upon us. Starting October 15th through December 7th, your patients currently enrolled in a Medicare Part D plan may switch to a new plan if they desire, as well as newly eligible patients may enroll in a Part D plan to start in the new year. As October quickly approaches, we wanted to give you all of the information you would need before patients start coming into your pharmacies to compare and enroll in their

Medicare Part D Plans.

• Newly eligible patients have a 7 month window in which to apply for Medicare – 3 months before they turn 65, the month of their 65th birthday, and 3 months after their 65th birthday. If they don’t enroll in this time frame, they face a penalty that is applied to their premium.
• 80% of Medicare patients need to change plans each year to find the most affordable plan and, on average, they can save over $700! Not only that, but checking their restrictions and helping them find therapeutic alternatives can help them save even more!
• Medicare Advantage patients can switch to another advantage plan or to original Medicare during open enrollment. They also have from January 1st through February 2nd to dis-enroll in an advantage plan and enroll into original Medicare.

Do I really need a Medicare Part D Prescription Drug Plan?

The simple answer is yes!  Here’s why, first of all if you don’t have a drug plan and in future years you decide you need one, it will cost you more from penalties that you will accrue.  Second of all think of this insurance like you would home owners insurance, you still have home owners insurance and don’t plan to have a fire do you?  Even if  you don’t take any prescription medications, or very few, you should sign up for the least costly plan available at that time.  Several years ago a patient decided to go without Part D insurance and half-way through the year he was hospitalized for a gall bladder attack and had to have surgery.  When he got out of the hospital all the money he thought he was saving by going without a Part D plan was wiped out with the dismissal medications he needed after leaving the hospital.  Needless to say that patient never made that mistake again.

Each year in the fall, usually October to the first week of December the Medicare Part D Drug plans are released for the next year.  Each year you should always look at your existing plan and see if it still meets your needs.  Most people change plans yearly, and that is because each year the premiums change as well as co-pays, and what is covered.  Don’t get the Medicare Part D plans confused with a supplement plan, they are not the same.

Just because you have a supplement plan doesn’t mean you have a Part D drug plan.  Also resist the urge to pick a Part D plan based upon your supplement plan,  we’ve found that rarely is the supplements Part D plan your best choice( AARP in particular).  You can get help with supplement plans by talking to a volunteer here on Lopez who provides assistance under a State program called Shiba.  Remember if you talk to an insurance agent or broker you might not get unbiased recommendations.  Once again we can help you if you want to speak to an agent or broker.

We have a program in our pharmacy computer that will look at your medication list and analyze it, (SAMPLE) and then we can e-mail it to you for your review, then you can call us for any questions.  We’ve seen all the angles that these plans do,  and we can make a complicated system much easier.  We keep a list of patients from year to year who have asked for our help, if you would like to be on that list or need a report now just let us know.  We encourage you to go over your coverage and bring us any questions you might have, you’d be surprised the number of things you might overlook.  Remember that the MOST important criteria in choosing a Part D Plan are as follows:

1.  What is the TOTAL YEARLY COST (premium, copay’s,  & deductible)?  Don’t get fooled into getting a plan  with a low premium when this is just part of the equation.

2.  Are all my drugs covered( can be tricky to pin down, but we can help)

3.  Is it a plan that Lopez Island Pharmacy participates in.

 

While our report can make a complicated task easier, you can do it the hard way and go to www.medicare.gov and hopefully come up with the same results.  If you decide to go that route, you can still bring your report in and we can give you a second opinion.  Finally what Part D Plan works for your neighbor, friend, butcher, etc., may not be the best choice for you.  

How to sign up for a Medicare Drug Plan

On the report we give you there will be phone numbers and you can just call them, or you can look up the plans on www.google.com and do it on-line. No matter how you sign up here are some things to remember.

1.  If you call on the telephone, get comfortable, have a drink and sandwich available and go the bathroom first.  When the agent answers be prepared to give them exactly the plan you want.  Every plan has multiple types, it’s like the old Sears catalog, good, better and best.  The agent might try to change your mind on the plan you initially wanted.  My response to you is if there were a better plan we’d have shown it to you.  If you want just stop them right away, get the plan they are recommending and let us look at it again, just to be sure.

2.  When you’re done with the call, get some proof you got signed up, the agents name, date and time and best of all a confirmation number.  If signing up online print something at the end as proof you did indeed sign up.  We have a horror story about that as well.

3.  NEVER pre-pay for a Part D Plan for more than a couple of months.  In fact don’t pre-pay at all, let them take the premium out of your social security, then you never have to worry about missing a payment.  We have at least one horror story of a patient that pre-paid for a plan for the whole year that didn’t work out so well.

4.  Starting a new plan  for any given year will automatically cancel your old plan at the beginning of the year.

5.  Last but not least, if you’re not sure give us a call or e-mail us at rph@lopeislandpharmacy.com

 6.  If you’d like to be put on our list to for us to send you a report on what drug plan might best suit your needs send an email to the following address.

                               rph@lopezislandpharmacy.com   and in the subject line enter  “Part D 2017” ( or whatever year).  

                               Also be sure in the email to tell us how the report should be for.

 

 

 

 

 

 rev: 03/21/2015 Richard McCoy