Franklin Prosperity Report: Save Money on Medicare Part D Drug Plans

Tuesday, 04 Feb 2014 04:10 PM

By Newsmax Wires

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It’s Medicare enrollment time, which means you will be considering numerous Part D drug plans available in your area. The confusing nature of them is obvious when you consider this shocking fact: “Only about 5 percent of Medicare beneficiaries are enrolled in Part D plans that would give them the lowest cost,” says Ross Blair, who heads up eHealth’s Medicare division at PlanPrescriber.

Blair adds that choosing the right plan can save you more than $600 per year. To realize such savings, beneficiaries need one that covers the medications they use. The first step in finding such a plan is to visit www.medicare.gov or www.planprescriber.com. Enter the drugs you currently take, along with dosages and frequencies, to compare co-pays among different plans.

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Taking this step will tell you the exact out-of-pocket cost for each plan, which you can compare to what you are currently paying. Based on this information, either site will then identify the available plans that are most cost-effective for you.

Of course, it may seem easier just to ask friends or family what they use. But that’s a shortcut to avoid. “Don’t choose a plan because your friend or neighbor is happy with it,” Blair cautions. “There’s no substitute for going through your medication list to find out what plan is best for you.”

Another no-no is buying your plan from an agent who comes to your home. You may find speaking with an agent in person instead of a computer comforting, but most of those agents offer only a handful of choices available in your area. If, after comparing plans, you need to speak with someone, call 800-MEDICARE (800-633-4227) instead.

Be aware on Medicare Part D plans of the coverage gap commonly known as the “doughnut hole,” says Stuart Millard, owner of Senior Insurance Solutions in Scituate, Mass. The coverage gap begins once you reach the Part D plan’s initial coverage limit, which is $2,970 in 2013, and ends when you’ve spent $4,750 out of pocket. (The $4,750 figure is for 2013; 2014 could be higher.)

“This year, those who enter this coverage gap and are taking brand-name drugs will be responsible for paying 47.5 percent of the cost of those brand-name drugs and 79 percent of the cost of the generic drugs,” Millard says.

If you can avoid that doughnut hole by exploring drugs that can reduce your expenses — in other words, get more from the money spent before reaching the hole — you definitely want to do so. (Search online for a “Part D doughnut-hole calculator” to help.)

Here are four more strategies to cut your costs:

1. Buy generic whenever possible. Brand-name drugs drive costs skyward, Blair and Millard warn, which makes it important to use generic drugs whenever possible. “The co-pays for generics are almost always much lower than for the nongeneric versions,” Blair says. “A co-pay for a brand name could be $40 and the co-pay for its generic cousin a mere $4.”

Pharmacists don’t always automatically choose generics, Blair cautions, so make your preference for generics known before the prescription is filled. This is especially important because several commonly prescribed brand-name drugs, such as Niaspan and Cymbalta, will become available in generic versions by the end of this year.

2. Compare pharmacies, use mail order, and consider Canada.
It pays to shop around, including across the border. Of course, you may get a lower co-pay if you use an in-network pharmacy, so be aware of that too.

Also, Blair advises purchasing prescriptions by mail whenever possible. “Carriers will typically reward you with the lowest cost if you sign up for mail order, which is also the most convenient way to refill your maintenance medications and could save as much as 30 percent on co-pays,” he says. “Buying a three-month supply by mail will typically cost you the same co-pay as buying a two-month supply at the pharmacy.”

If, despite your best efforts, you find yourself in a coverage gap, be aware that many states offer some type of assistance based on income or income and assets. Contact local agencies to find out what assistance is available in your area. You also could get your prescriptions filled in Canada, where drug costs are lower than they are in the United States.

3. Splitting tablets is another money-saving tactic to try if your doctor approves. “If you are prescribed a 10-milligram dose and the co-pay is the same as on a 20-milligram [dose], ask your doctor to prescribe the higher dose and use a pill cutter to split your co-pay in half simply by splitting the tablets in half,” Blair says.

4. Finally, if you don’t have coverage beyond Medicare Part A and Part
B, consider a Medicare Advantage Plan
, which is often less expensive than buying a supplemental plan, Blair advises. “Medicare Advantage Plans must cap out-of-pocket expenses at no more than $6,700 per year,” he says.

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