Between now and December 7, it’s Medicare open enrollment season. If you’re already enrolled in Medicare, you can choose to keep your current coverages or select a new policy that can better meet your needs during 2023.
There are a handful of elections and coverages that you might want to review during open enrollment, but this post focuses solely on your Part D Prescription Drug coverage. Retirees who elect Traditional Medicare need this coverage, since the basic parts of Medicare (Parts A and B) don’t cover the cost of most prescription drugs.
If you elect a Medicare Advantage (MA) plan instead of Traditional Medicare, however, most MA plans come bundled with prescription drug coverage. In this case, you don’t need to buy separate Part D Prescription Drug coverage.
As a Medicare enrollee, you’re entitled to change your Part D Prescription Drug coverage every year during open enrollment, without any restrictions for pre-existing conditions. Since many insurance companies change their coverages each year, it pays to shop around to see if you can save any money. Unfortunately, the fine print of these policies might as well be a rocket science manual, making it hard for people to comparison shop.
During this year’s open enrollment, my wife and I shopped our coverage by working with an independent Medicare consultant. The consultant reviewed the drugs we take, identified alternative policies that could better meet our needs, and estimated the differences in both premiums and out-of-pocket expenses that we might incur. They estimated that each of us could save more than $1,000 each year by changing to a different policy. Roughly half of this savings would result from reduced monthly premiums, with the other half of savings resulting from differences in our out-of-pocket costs for the drugs we take. The expected savings was much more than the fee we paid the consultant.
What could cause such a savings? It depends on something called a “formulary.” Prescription drug plans list the drugs they cover in their formulary. They place common drugs into five benefit levels, called tiers. The lower-tier drugs generally cost less than drugs in a higher tier. Each year, the insurance companies review their formularies and may change the tier level for some of the drugs they cover.
My wife and I each take only two prescription drugs, one of which is a generic medication. If you take several prescription drugs and some are expensive, your savings could be higher than our own expected savings.
Here’s an insightful quote that can illustrate the possibilities from Diane Omdahl, president and founder of 65 Incorporated, a firm that shops drug coverages for their clients: “A client we helped in 2020 takes seven medications, [of which] two are very costly. He didn’t pay attention last year, just tolerated the rising costs. He can save almost $6,400 in 2023 by switching plans.”
But you don’t have to use a consultant to garner savings: If you have the time and are comfortable doing your own comparison shopping, you can use Medicare’s helpful website.
No matter which option you choose, it’s either a very good use of your time to comparison shop for coverage or a very good use of your money to work with an independent consultant.
Good luck with your shopping!