PharmacyChecker Blog

Helping Americans Get The Truth About Prescription Drug Savings
Published by:

Part D Medicare Drug Plans 2016 – Know the Basics, Then Get Down to Work

Photograph of Pills and Money
We’re two weeks into the open enrollment period of Part D Medicare Drug Plans and it is my deepest hope that if you are a Medicare enrollee then you are taking time to find the best plan. It’s not easy. Finding the right plan, however, could mean getting the medications you need to stay healthy, saving money, and avoiding lots of headaches throughout the year. Our website, MedicareDrugPlans.com, gives you basic information, such as premiums, deductibles and coverage levels, but also ratings and reviews about Part D plans that can inform you about the experiences of your peers in using the different plans. Your final search should be with the government’s website – Medicare Plan Finder – where you can find the plans that cover the medications you are already taking now and specific costs related to those plans. Below are key points about costs and coverage.

Part D Plan Costs

Plan costs have gone up this year. The deductible cap increased by 12.5%, from $320 to $360. Fifty-three percent of the plans are charging the full deductible, while the other 47% charge less. Average premiums have increased from $36.68 in 2015 to $41.46 in 2016. The lowest monthly premium is $6.80, that’s if you live in Puerto Rico and choose the Humana Preferred Rx Plan. The highest premium is $174.70, that’s if you live in Florida and choose Blue MedicareRx Option 2.

Part D Plan Choices

The overall trend of having fewer Part D plans to choose from continues this enrollment season, down to 886 this year compared to 1001 last year. Looked at historically, the declines are even more striking, as there were 1,875 plans in 2007. These numbers are the totals available in all states and U.S. territories but options are really state-based. Alaskans had only 19 plans to choose from, compared to a high of 29 in West Virginia and Pennsylvania.

Part D Plan Coverages Phases

There are four coverage phases for Part D plans: deductible, initial coverage period, the coverage gap, often referred to as the “donut hole,” and catastrophic coverage. The deductible is pretty straightforward–you pay the full cost of your medications up until that dollar amount, which can be as high as $360. During the initial coverage period, you usually pay about 25% of drug costs and the plan picks up 75% until total costs have reached $3,310. At that point you’re in the coverage gap, but you’re paying discounted prices, 45% and 58% of brand and generic drug costs, respectively. Once total costs have exceeded $7,515, you are in catastrophic coverage territory, and only have to pay 5% of your total drug costs until the next year begins.

Understanding these generalities about Part D plans is important, but the devil is in the details, which can only be understood through research. It’s not enough to just stick with the plan you have. Nine out of 10 Medicare enrollees do not change plans, and many end up with higher drug costs because they don’t. The landscape of plans changes every year; so do your research, shop around, and get the best plan for your health and wallet!

For a thorough plan analysis see Kaiser Family Foundation.

For ratings and reviews, check out www.medicaredrugplans.com.

To finalize your decision go to Medicare Plan Finder.

Share
Tagged with: , , , , , ,

Seniors Find Frustration With Medicare Drug Plans

Since open enrollment began two days ago, Medicare beneficiaries all over the country have been looking for new Medicare Part D plans. In fact, based on our analysis of recent Part D Reviews on MedicareDrugPlans.com, you’d think most enrollees were looking for new plans! Of the past 50 reviews on the site, this is what we found:

  • 44% had customer service issues, including unresponsive service, rude representatives, and billing and enrollment errors.
  • 42% complained about mail order issues, such as shipments taking too long, poor packaging and instructions, and poor website experiences.
  • 30% had problems prescribed drugs not being covered, inaccurate pricing, or coverage refusal after requesting authorization.

While we can’t say much about how to prevent dealing with mail order pharmacy or customer service issues, we know that you have the power to tackle formulary problems. Just so we’re clear, the way to find out which plans cover the drugs you need is at the government’s site, Medicare.gov – not on MedicareDrugPlans.com. MedicareDrugPlans.com serves as a listening board for what you need to look out for when you pick your plan, and is meant to be a supplement to the government’s site, so we recommend using both while selecting a plan. That way, you can make sure your drugs are covered and hopefully avoid any unforeseen issues.

Finally, it’s unfortunate that most of the reviews and ratings of Part D plans are negative ones. We want positive ones! We know that many Americans are benefiting from the plans. To whomever this applies: please help your peers by reviewing and rating the Part D plans that you like.

Good luck searching for the right plan!

Share
Tagged with: , ,

It’s That Time Again – Selecting a Medicare Part D Drug Plan

October 15th is just under two weeks ago, and while that date might not mean much to those not enrolled in Medicare, it marks the beginnings of open enrollment for Medicare’s Part D pharmacy benefits. That means that if you are looking for a new Medicare plan, you have until December 7th to do so. Even if you don’t think you need a new plan, you should check out what’s available, for a variety of reasons:

  1. Your plan may be discontinued, in which case, if you do not act, you might be transferred to a plan that is worse for you. There are 14% fewer plans in 2015 than there were in 2014.
  2. New plans exist, and they might be better than your current plan.
  3. Your prescription needs have changed. If you started taking a new medication in 2014 and it wasn’t covered by your current plan, or required you to spend more out-of-pocket than you expected, it might be time to switch to a plan that covers any new meds.

Our sister site, MedicareDrugPlans.com, can help you find a new plan. It compares premiums, deductibles, and even lets you know if drugs are covered during the coverage gap. More importantly, you can read reviews from enrollees who have actually signed up for these plans! Knowing the costs and coverage can only go so far, as these reviews tell us:

Alabama, TennesseeCigna-HealthSpring Rx –Reg12

“I have been trying to sign up for this plan but have a very hard time getting answers. Many of the telephone reps answer questions with “I don’t think so or I’m not sure” which is not helpful. They also require you to sign a statement that says “Humana has the right to change the program at any time if they notify the customer.” I have been told that this is just a formality but it makes me nervous.”

New YorkFirst Health Part D Value Plus

“I used this plan in 2013 and it was pretty good…most prescriptions cost me 0. But some prescriptions were not covered and I had to scramble to find the drugs elsewhere. Their cost per month was good, but now it is going up, and I will be switching to a cheaper monthly cost plan.”

Once you read reviews and compare plans on MedicareDrugPlans, head over to the government’s site, www.Medicare.gov, at which you can type in the drugs you take and find out which plans offer the best coverage for you. Using Medicare.gov and ratings from MedicareDrugPlans.com will help you make a fully informed decision. And don’t forget to leave a review on MedicareDrugPlans, so your fellow enrollees can learn from your experiences. Good luck finding the plan that is best for you, and don’t forget to enroll by December 7th!

 

Share
Tagged with: , ,

Look Out for Changes to Premiums and Deductibles for Medicare Part D Plans

As we wrote a few weeks ago, there are loads of changes coming to Medicare Part D next year. Changes to your plan’s deductible and monthly premium can impact your wallet, for better or for worse! We’ve analyzed the plans from 2013 and 2014 and identified those with notable changes to their deductibles and premiums.

Keep in mind that there may be other important changes to a plan, such as those to its formulary or cost sharing structure. For example, the deductible for Blue MedicareRx Value plan double in 2014, and it is also losing about 700 drugs from its formulary. On the other hand, this plan and others might see increases in deductibles or premiums correspond with lower co-pays or better donut hole coverage, which could save you a lot of money.

The tables below show you examples of plans with large changes, and aren’t meant to be comprehensive. To view more plan options, and read reviews and ratings by members, head over to MedicareDrugPlans.com.

Notable Decreases in Plan Deductibles

Plan Name States 2013 Deductible 2014 Deductible Dollar Change % Change

Express Scripts Medicare – Choice (PDP)

Many States $200 0 -$200 -100%
Health Alliance Medicare Prescription Plan – Enhcd (PDP)

Illinois $325 0 -$325 -100%
United American – Enhanced (PDP) Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota, Wyoming, $40 $20 -$20 -50%

Notable Increases in Deductible

Plan Name States 2013 Deductible 2014 Deductible Dollar Change % Change
Blue MedicareRx Value (PDP)

Arizona $150 $310 $160 107 %
Prescription Blue Option A (PDP)

Michigan $125 $195 $70 56%
Blue Rx Plus (PDP)

Pennsylvania, West Virginia $250 $310 $60 24%

Notable Decreases in Monthly Premiums

Plan Name States 2013 Premium 2014 Premium Dollar Change % Change
WellCare Classic (PDP)

Mississippi $36.60 $17.30 -$19.30 -53%
Aetna Medicare Rx Essentials (PDP) Oregon, Washington $72.90 $35.20 -$37.70 -52%
Express Scripts Medicare – Choice (PDP) Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota $102.70 $70.60 -$32.10 -31%

Notable Increases in Monthly Premiums

Plan Name States 2013 Premium 2014 Premium Dollar Change % Change
Aetna CVS/pharmacy Prescription Drug Plan (PDP)

Florida $32.50 $75.00 $42.50 131%
AARP MedicareRx Saver Plus (PDP)

Oregon, Washington $15 $29.50 $14.50 97%
First Health Part D Value Plus (PDP)

Colorado $32.30 $58.40 $26.10 81%

Once again, you need to shop around and do your research to get the best plan. Check out some reviews and ratings at MedicareDrugPlans.com – and rate your current plan to help others – then head over to the government’s site www.medicare.gov to compare plan formularies, and choose a plan that covers the medications you take.

Share
Tagged with: , , , ,

CBO Study Shows Access to Lower Cost Medication a Critical Factor in Healthcare Spending

High prescription drug costs make Americans sicker and contribute to our national budget woes, according to a report by the Congressional Budget Office (CBO) released at the end of last year. The report serves as a reminder to always take your prescribed medicines. We view this study as further evidence that access to affordable medication from reputable international online pharmacies improves the health of Americans and decreases healthcare spending.

To put it simply, as consumers’ out-of-pocket drug costs rise, they are less likely to take their medicine as prescribed, which leads to more medical services and increased healthcare spending. The CBO report tells us that the converse follows: when out-of-pocket prescription costs fall there is less need for medical services, and as a result less healthcare spending.

The CBO’s report is based on an analysis of relatively new studies that have tracked out-of-pocket prescription drug costs and overall healthcare spending in employer and government-based health insurance programs. The result is that CBO has now internalized out-of-pocket prescription drug costs in its methodology for calculating the effects of legislation affecting drug costs. This means if a new bill aims to bring down prescription drug prices in the United States or through drug importation, CBO would calculate how many more prescriptions would be filled and estimate the resulting decrease in healthcare spending.

It is critical that our elected leaders and government officials take this into account when considering new laws or taking actions that affect access to affordable medication .Just yesterday, Minnesota U.S. Senators Al Franken and Amy Klobuchar re-introduced a bill, The Medicare Prescription Drug Price Negotiation Act, to enable the federal government to negotiate lower Medicare drug prices with drug manufacturers. Such legislation would most certainly lower drug costs, improve health, and decrease the taxpayer burden on healthcare spending

Share
Tagged with: , , , , ,