Many people are surprised to find out that Original Medicare doesn’t generally cover prescription drugs. For help with the cost of your medications, you can choose a stand-alone Part D plan or a Medicare Advantage plan with prescription drug coverage.
With Medicare Annual Enrollment fast-approaching from Oct. 15 to Dec. 7 – the yearly window when you can make changes to your Medicare coverage – now is a good time to arm yourself with information to help you make an empowered decision this fall.
1. Your drugs
Prescription drug plans can vary significantly. Each Part D plan has a list of drugs, called a formulary, which shows the drugs it covers.
“When considering a Part D plan, be sure your medications are covered,” Anderson said. “Even if you don’t expect to change plans, it’s important to make sure your drugs will still be covered next year, as plans can change from year to year.”
2. Your pharmacy
Most Part D plans have preferred pharmacy networks. People can typically get their drugs for a lower copay when they visit preferred pharmacies.
“Make sure the plan offers access to pharmacies that are convenient for you,” Anderson said. “Some plans also have mail-order pharmacy benefits, and you can get prescriptions delivered to your home for a lower cost than purchasing from a retail location.”
3. Your total costs
Plans sort drugs into several tiers, with generic or lower-tier drugs generally costing less than drugs on higher tiers. Talk to your doctor about whether a lower-tier drug might be suitable for you, which could help you save money.
“A low monthly premium plan doesn’t necessarily mean it will be the lowest cost plan,” said Anderson. “You should also understand the other out-of-pocket costs, including the annual deductible and drug copays.”
The bottom line
Now is a great time to start thinking about your health and budget needs for the upcoming year. Whether you’ll be enrolling in Medicare for the first time, looking to change your coverage during Medicare’s Annual Enrollment Period, or helping a loved one make decisions, visit GetToKnowMedicare.com to access resources to help you prepare and make confident choices.