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10 tips for Medicare prescription drug coverage open enrollment

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Theo Thimou

If you’re on Medicare, this is the time of year when you can change your Medicare Advantage or Medicare prescription drug coverage for the following year.

The open enrollment period began October 15, 2016 and will go through December 7, 2016.

If you have questions about this process, we’ve got answers!

Understand the alphabet soup

First things first, let’s breakdown the letters that confuse everyone so much.

With Parts A, B, C and D, Medicare can be difficult to understand. But don’t fret, we’ve got a primer for you here.

In a nutshell, Part A and Part B cover your main health care costs, such as hospital and outpatient care. It’s government-provided insurance coverage.

Medicare Part D, which offers prescription drug coverage, is provided by private insurance carriers. Each plan has its own list of approved drugs (also known as formularies) and beneficiaries should carefully review each plan’s list to ensure that their medications are covered. 

Part C, meanwhile, is also known as Medicare Advantage.  This is a program that combines Parts A and B, adds additional benefits (i.e. vision or dental), and typically includes prescription drug coverage (Part D).

Keep in mind that while using Medicare Advantage Part C, Part A and B do not go away and you are still responsible for those premiums.

Again, for a better understanding of what Medicare and its alphabet soup on letters cover, see this article.

Review your plan

This is the time of year when you can make changes to your coverage under Part C and Part D.

So the first thing to do is to check your plan and make sure it’s optimized for the best balance of premium costs and coverage options for your life. You need to weigh the costs of copayments and deductibles against the cost of your prescriptions. It might make more sent to pay higher premiums if it offers better out-of-pocket costs for your prescriptions.

Everybody’s individual situation will vary!

Get some expert advice

How can you determine which plan is best for your individual situation? You can spend hours going around in circles on the official Medicare site trying to do that simple task.

That’s why you need to know about a new nonprofit site called MedicareDrugSavings.org. This site is a labor of love started by an Atlanta-based internist named Dr. Cohen. He grew frustrated when he saw his patients struggle with medication costs and that was the start of MedicareDrugSavings.org.

The site has a helpful YouTube video you can watch to get started. The video walks you through the process of saving money, step by step. While the website isn’t anything fancy to look at, all the information is conveyed in simple English!

Buy generic

You’ve heard it a million times before, but it bears repeating: Generic drugs will save you big money.

Nearly 80% of prescription medications have a generic alternative, which costs four times less on average than brand name drugs. Use a tool like GoodRx, which finds the least expensive price on your prescription near you. 

More tips to consider:

  • Consider online purchases that could typically save you 20% to 30%. But read this first to make sure you’re dealing with a legitimate pharmacy.
  • Are you over age 50? AARP offers discounts on mail-in orders.
  • Are you a member of a managed care health program? Consider a 90-day supply of your medicine vs. a one-month supply. You’ll pay one co-payment vs. three.
  • Ask if your medication is cheaper in a higher milligram dose. Then, cut the tablet as needed for your proper dose. This method can save up to 75% of the cost.
  • Check the warehouse clubs. They often have low prices. And you don’t even need to be a member to use Costco’s pharmacy!
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