If you have Original Medicare and are enrolled in a Prescription Drug Plan (PDP), you may be considering making a change during this year’s Annual Election Period (AEP). Many Medicare recipients depend on prescription drugs to treat chronic illness, but expensive medications can have devastating effects on your financial well-being. Out-of-pocket costs for drugs that are not covered by your Part D plan can put a strain on your budget. If you have experienced stress over your prescription medication expenses, or your needs have changed over the past year, it might be time to explore your options.
Part D Prescription Drug Coverage
When you first became eligible for Medicare, you had the option of getting your benefits from Original Medicare, the program administered by the federal government, or through a Medicare Advantage (MA) plan offered by a private insurance company. Many people who choose Original Medicare Part A and Part B decide to enroll in a stand-alone Prescription Drug Plan to help cover the costs of medications they need. If you do not enroll in a Part D plan when you are first eligible, you may have to pay a late enrollment penalty when you sign up later. With this in mind, many people choose to enroll in a PDP immediately, but medical needs change as we age. If your prescription drug needs have changed and your out-of-pocket costs for prescriptions have increased, you may want to consider other plans that may better meet your needs.
Exploring Your Options During AEP
If you have developed a condition or were diagnosed with a disease that requires new medications that are not covered by your current Prescription Drug Plan, you can use Medicare’s Annual Election Period to search for other plans available in your area that may meet your specific needs. AEP begins on October 15 and ends on December 7, and is the time of the year when you can make changes to your Medicare coverage. Thanks to online comparison tools, you can compare plans side-by-side to determine which one will provide the coverage that is right for you. Each PDP has a unique formulary, or list of covered drugs, and tiers of pricing based on generic, brand name, or mail order drugs, and costs can vary. Before switching to a new plan, make sure that it includes your prescriptions and dosages at a price you can afford.
Medicare Advantage with Prescription Drug Coverage
If you currently have Original Medicare and a stand-alone PDP, you can choose to drop Original Medicare and your PDP and switch to a Medicare Advantage plan with prescription drug coverage (MA-PD) during AEP. Medicare Advantage plans are required to provide at least the same benefits as Part A and Part B but many offer additional benefits at little to no additional cost. Take your time during the Annual Election Period to consider all of your options, and feel free to speak to a licensed sales agent if you have any questions or concerns. Just make sure you make any changes and enroll by December 7.
Your Guide to Understanding Medicare Parts A – D