Theo Thimou, Clark.com
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, 2017, and will go through December 7, 2017.
If you have questions about this process, we’ve got answers!
First, let’s understand the basics of Medicare
OK, first thing’s first, let’s breakdown those 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 covers, see this article.
What’s new for Medicare in 2018?
The 2018 Medicare enrollment period is here and there are a few carrots and sticks for your wallet that you’ll want to know about…
The “D” in Part D stands for discount this year!
Avalere Health pored through the prescription drug pricing data that the Centers for Medicare and Medicaid Services release every year ahead of open enrollment period.
You’ll be happy to learn you’re likely going to pay less for your medications next year.
Their analysis finds that Part D premiums will “decrease slightly in 2018” because of higher-than-predicted rebates from manufacturers.
Watch those out-of-pocket limits on $0 monthly premium plans
The good news is that you’ll continue to have access to plans that require no monthly premiums in 2018. But there is a trade-off.
For Medicare Advantage beneficiaries, Avalere’s deep data dive finds that fewer and fewer $0 monthly premium plans will let you off the hook with an out-of-pocket (OOP) limit below $4,000.
That means plans with OOP limits in excess of $4,000 will be far more abundant in 2018.
So be sure to determine the OOP limits you’ll have with the plan you choose!
Part B premiums won’t increase in 2018 — unless you’re wealthy
Part B premiums aren’t expected to increase in 2018, but that’s not necessarily cause for celebration for everybody.
If you earn north of $133,500 annually as an individual or $267,000 as a couple, you could pay a potentially higher Part B surcharge in 2018.
Here’s what USA Today correspondent Sean Williams says you can expect to pay:
- $134/month: less than $85,001 (single)/less than $170,001 (married)
- $187.50/month: $85,001-$107,000 (single)/$170,001-$214,000 (married)
- $267.90/month: $107,001-$133,500 (single)/$214,001-$267,000 (married)
- $348.30/month: $133,501-$160,000 (single)/$267,001-$320,000 (married)
- $428.60/month: more than $160,000 (single)/more than $320,000 (married)
Of course, the reality is the lion’s share of Medicare beneficiaries don’t earn above the $133,500 (individual)/$267,000 (family) limits. So for most Americans, Part B premiums will effectively remain the same as they were in 2017.
Here’s some basic Medicare plan shopping advice
Remember to 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 sense to select a plan with 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.
His 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!
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 to find 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!
Where to get common prescriptions for less
Consumer Reports did some research on drug prices at different pharmacies. Check out the chart below to see which pharmacy sells common prescription medications at the cheapest price.