Medicare has introduced prescription drug plans to help save money on prescription drugs. Medicare offers these plans through private insurace companies. If you would like to receive this coverage, you will need to select and purchase a plan. Medicare has installed a financial incentive for all to enroll immediately. If you enroll after your open enrollment date - you will be paying a higher premium of 1% per month that you wait to enroll. For example, if you wait three years to enroll in a plan (36 months) your penalty and added premium will be 36% higher each and every month for the rest of your life. (The Penalty is calculated on the national threshold premium determined by Medicare which could be a higher premium than the plan that you select.)
If you spend as little as $15 per month for prescription medications, you will save money with a Medicare prescription drug plan. Your savings will vary depending on your prescriptions and their formulary classification under each plan!
Even if you don't use a lot of prescription drugs now, you should still think about purchasing a plan during your open enrollment period. As we age, most folks need prescription drugs to maintain their health and to prolong life by reducing risk factors that your body is unable to control on its own. A prescription drug plan can help control the cost of medications in the future. There are plans designed for different levels of need. You will be able to switch plans once per year as your needs change.
All prescription drug plans are not the same!
Medicare requires core benefits that all plans must cover at a minimum - There are many variations, just as there are wide variations in premiums for identical coverage for standardized Medicare supplement plans.
I have spent a great deal of time picking through the various prescription drug plans. I am happy with the results. Every plan that I place for an individual is tailored to their specific drug assortment. I was surprised to find that the annual out-of-pocket costs vary so widely from plan to plan for each person. My job is to show you which of the 20+ plans available will take the least amount out of your pocketbook at the end of a twelve month period.
I truly believe that one must start with a choice of prescription drug plans and then put the appropriate Medicare Health plan around that drug coverage to accomplish a person's budgetary objective.
I have also found that the Medicare Health Plans that bundle their insurance plan with Prescription benefits tend to hide your true costs more and you need to break it down into the two components before making a decision.
Here is a summary of the minimum benefits outlined by Medicare:
- Premium no greater than $36 per month. (lowest is $15 - highest is over $100)
- $405 deductible (many plans have waive the deductible)
- 75% coverage for the next $3,750 dollars (you pay 25% - the plan pays 75%) (some plans have fixed co-pays here)
- Coverage from $3,750 to $8,172 - the GAP (depends on the plan benefits and tier level of the drug) generally generics you pay 44% for generics and 35% for Name Brand drugs here.
- 95% coverage for all costs over $8,172 in a calendar year. (you pay only 5% the rest of the way)
- There must be coverage for at least two medications in each drug classification (YES there are more than two drugs in each class and some may not be covered - you must be a good consumer - I can help)
- People on Medicare Advantage plans or Employer plans will have fewer or no choice in drug plans - they must take the plan offered by their Medicare Advantage program or Employer plan. This can be a bad thing if you what you take is not a covered item or has High Co-Pays.
- Some employers do not offer prescription drug benefits that conform to Medicare requirements.
- People on standardized plans (Plan F for example) and PFFS plans will have several plans to choose from to ensure that they can get a plan that covers the medications they are currently taking. This is good!
Use the link below for a form to supply me with the information that I need to send you plan specifics for your best buy.