by Carol Chybowski
American Legacy Solutions
We have all been bombarded lately with TV ads and mailed circulars the last month or so touting various plans and companies to choose from during the Annual Open Enrollment Period for Medicare. Just what is Open Enrollment and who should utilize it?
The Annual Open Enrollment Period for Medicare is designed to allow people to change their part D Prescription Drug Plan if needed. This is the only time of the year people are allowed to change (barring a special circumstance) prescription plans. Those with Medigap / Medicare Supplements and stand-alone Prescription Drug Plans are affected, as are those who have Part C plans that include prescription drug coverage.
There are many reasons to take this opportunity to review your current coverage. One is that the plans themselves change from year to year. Premiums go up, deductibles get higher, and prescription medications are added or subtracted from formularies from year to year. What has been a good plan for you this year may not be a good plan next year.
Another reason to review your plan is that your own needs have changed. Have you stopped taking an expensive medication? If you chose a plan based on coverage of that medication you are no longer taking, you may be paying too much for coverage you no longer need.
How can you find out which plans are available in your area? The annual Medicare & You book includes a list of plans for our area. HICAP can also provide you with a list, and give more detailed instructions on how to choose a plan. But those lists can be confusing, particularly when you try to compare costs of individual medications across plans. Prices can vary greatly depending on the dosage and whether the medication is tablet, caplet or liquid-even if it’s the exact same medication in all three instances. Prices also vary by which pharmacy you are using and what type of contract they have with the manufacturers.
The same reasoning holds true for Part C plans that include drug coverage as well. Those plans can and do change their formularies from year to year. Because your medical coverage is tied in with your prescription coverage, it might not be as simple to change as a stand-alone plan. It is not necessarily a good thing to switch provider networks because of prescription coverage. But there are still options available to you if you need help with getting a medication covered or affording the cost of a high priced medicine. If this is a concern, make sure you compare all options equally and talk with a trained and licensed individual to help with these decisions.
