Prescription drug costs continue to be a concern for many people — in fact, the vast majority of Americans believe the cost of prescription drugs is unreasonable. Medicare annual enrollment is upon us, and understanding what prescription coverage you might need is important — especially given Original Medicare generally doesn’t cover medications.
Instead, you can get drug coverage in two ways:
- Through a separate stand-alone Part D plan, which works with Original Medicare and Medicare Supplement Insurance plans.
- Or through a Medicare Advantage plan that includes prescription drug coverage. A Medicare Advantage plan bundled with a prescription drug plan provides an “all-in-one” package and can be a great way to help keep your prescription costs in check.
In addition, here are three simple tips to help you get the most out of your coverage.
1. Consider home delivery. Check to see if your plan has mail-order pharmacy benefits – if it does, this can be a great way to save money and a trip to the pharmacy. Through ordering a three-month refill on medications, you may get a discount on your prescriptions and the added convenience of having your drugs come to you.
- What else? As access to medication in the home continues to prove critical during the COVID-19 pandemic, in 2022, most standard UnitedHealthcare® Medicare Advantage plans offer $0 copays for tier 1 and tier 2 drugs ordered through the OptumRx home delivery pharmacy, or through participating preferred retail pharmacies.
2. Consider generics or preferred formulary alternatives. Prescription drugs are typically sorted into several tiers on the health plan’s list of covered drugs, known as a formulary, with generic or lower-tier drugs typically costing less than drugs on higher tiers. Often, there are clinical alternatives available on lower tiers, and your doctor can help determine what might be an appropriate option for you. You also have the power to ask whether more affordable alternatives are available, such as a generic or a drug on a lower tier of your plan’s formulary.
- What else? Good news for UnitedHealthcare Medicare Advantage members: more than 20 generic drugs are moving to a lower tier, giving members greater access to a wider variety of drugs for a $0 copay.
3. Check to see if your plan offers other savings opportunities. It’s never a bad idea to simply call your health plan, or your agent, to see if there are other ways to save that you might not be aware of. For example, if you like visiting the pharmacy rather than using a mail-order service, you should check to see if your plan has a preferred pharmacy network, which means you can get your drugs at a lower copay when you visit these preferred pharmacies.
- What else? Through the Part D Senior Savings Model, millions of people will have access to UnitedHealthcare Medicare Advantage and Part D plans that limit monthly out-of-pocket costs in most phases of the Part D plan to $35 for all covered insulin, driving significant savings and more predictable monthly expenses. This year, eligible UnitedHealthcare members have saved an average of nearly $450.
The prescription drug landscape can seem complex. But it doesn’t have to be. And there is help available. Call the number on the back of your insurance ID card and ask for help about your plan’s coverage. And if you are a UnitedHealthcare member, there is a new tool within the member portal – an Rx Online Marketplace – that enables members to compare drug prices, manage refills and have orders delivered to their home or picked up at a convenient pharmacy.
For more information on UnitedHealthcare Medicare plans, visit UHCMedicareHealthPlans.com.
$0 copays may be restricted to preferred home delivery prescriptions during the initial coverage phase and may not apply during the coverage gap or catastrophic stage. Benefits vary by plan/area. Limitations and exclusions apply.
You will pay a maximum of $35 for a 1-month supply of Part D select insulin drugs during the deductible, Initial Coverage and Coverage Gap or “Donut Hole” stages of your benefit. You will pay 5% of the cost of your insulin in the Catastrophic Coverage stage. This cost-sharing only applies to members who do not qualify for a program that helps pay for your drugs (“Extra Help”).
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies. For Medicare Advantage and Prescription Drug Plans: A Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in these plans depends on the plan’s contract renewal with Medicare.