MedicareForAll

Dear Marci, I hear that I can change my Part D prescription drug coverage this fall if I would like. My Part D plan has worked fine for me this past year, but I still want to look at my other options. How do I use the Medicare.gov Plan Finder tool to compare Part D plans? - Grace (Richmond, VA)...Continue reading

Dear Marci, I have had Original Medicare for a few years. I’m considering enrolling in a Medicare Advantage Plan during Fall Open Enrollment this year. What should I consider when I’m looking at Medicare Advantage Plans? -Reva (Detroit, MI) ... Dear Reva, Fall Open Enrollment runs from October 15 through December 7 each year. During this time, you can make changes to your health insurance coverage, including adding, dropping, or changing your Medicare coverage. Even if you are happy with your current health and drug coverage, Fall Open Enrollment is the time to review what you have, compare it with other options, and make sure that your current coverage still meets your needs for the coming year. Ask yourself the following questions before choosing a Medicare Advantage Plan: How much are the premium, deductible, and coinsurance/copay amounts? What is the annual maximum out-of-pocket cost for the plan? This amount may be high, but can help protect you if you have expensive health care costs. What service area does the plan cover? Are my doctors and hospitals in the plan’s network? What are the rules I have to follow to access health care services and my drugs? Does the plan cover additional health care benefits that are not covered by Original Medicare? How will this plan affect any additional coverage I may have? What is the plan’s star rating? Medicare Advantage Plans usually include prescription drug coverage. You should also consider these questions when choosing a Medicare Advantage Plan to make sure that the prescription drug coverage that the plan offers meets your needs: Does the plan cover all the medications I take? Does the plan have restrictions on my drugs (i.e. prior authorization, step therapy, or quantity limits?) Prior authorization means that you must get approval from your Part D plan before the plan will pay for the drug. Step therapy means that your plan requires you to try a cheaper version of your drug before it will cover the more expensive one. Quantity limits restrict the quantity of a drug you can get per prescription fill, such as 30 pills of Drug X per month. How much will I pay for monthly premiums and the annual deductible? How much will I pay at the pharmacy (copay/coinsurance) for each drug I take? Is my pharmacy in the plan’s preferred network? You pay the least if you used preferred network pharmacies. Can I fill my prescriptions by mail order? If I have retiree coverage, will the Medicare drug plan work with this coverage? What is the plan’s star rating? You may find it helpful to use Medicare’s Plan Finder tool, which gives you a list of Medicare Advantage and Part D plans, the drugs they cover, and their estimated costs for the year. You can access Plan Finder by going online at www.medicare.gov or calling 1-800-MEDICARE. -Marci