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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.

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Part D Open Enrollment Ends Today

Today is the last day for the Medicare Part D open enrollment period. For most Medicare enrollees, those who do not have a plan by midnight tonight will face a penalty charge, which will be added to future Part D monthly premium payments.

The Medicare drug plans have certainly frustrated many seniors, who’s experiences can be found in the ratings and reviews on www.MedicareDrugPlans.com. Some of the most frequent problems with plans communicated by seniors are drugs being dropped by plan formularies mid-year; information on drug coverage was not initially made clear; co-pays were higher than expected; and customer service was often inadequate.

On the other hand, some seniors were completely satisfied with their plans. The bottom line is that you need to pick a plan now or you will pay more later.

Sharing her optimism for Medicare Part D benefits, and the discounts provided under the Affordable Healthcare Act, Secretary of Health and Human Services Kathleen Sebelius commented on Medicare.gov’s official blog: “Through the end of October, 2.65 million people with Medicare have received discounts on brand name drugs in the donut hole. These discounts have saved seniors and people with disabilities a total of $1.5 billion on prescriptions – averaging about $569 per person.”

If you’ve yet to choose your plan, you can easily compare reviews on MedicareDrugPlans.com before making the final decision. If you want to share your experiences with others then please rate your plan.

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Medicare Part D Drug Plans – Find the Best Plan For You

If you are eligible for Medicare Part D (Drug Plans), you should be aware that 1) open enrollment starts tomorrow, October 15th and 2) you can now research Medicare Part D plans on our site MedicareDrugPlans.com. On the site you find out which plans are rated best (or worst) by people enrolled in them. You’ll also get the 2011 pricing information for every plan in each U.S. state and territory. The information is completely objective – we are not affiliated with any plan.

If you are already enrolled in a Part D plan, MedicareDrugPlans.com allows you to rate and review your current plan, so others can learn from you.

To actually sign up for a plan, we recommend using the government’s website, Medicare.gov – at which you can best determine which plan covers all the prescription drugs you take. Comparing costs and features can be crucial to your health and your finances. Annual deductible, monthly premium and drug coverage (especially in the “doughnut hole”) are important to consider when choosing or changing your prescription plan.

This year the average premium nationally is $55, actual $1 lower than last year! The standard deductible, on the other hand, increased from $310 to $320. Less than ten plans offer coverage through the doughnut hole. However, under the new health care law, brand name drugs are now 50% off through this coverage gap period.

As open enrollment begins, Medicare enrollees interested in a drug plan are urged to research carefully. Whatever plan you choose will go into effect starting January 1st, 2011 and last for one full year – so get it right! Go to www.MedicareDrugPlans.com now.

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Pharmacies May Not Be the Right Place to Help Find Medicare Drug Plans

Many seniors enrolling in a Medicare drug plan these last 15 days of the open enrollment period may turn to their local pharmacy, presumably a trusted source of medical support and information, for answers and advice. Often pharmacists know a patient’s medical and medicinal history so can give professional and educated advice on which plan could best serve the enrollee; however, this isn’t always the case.

An article in American Public Media suggests that the answers and advice some pharmacy’s give could be guided by the influence of insurance companies. Some drugstores have made deals with and will be rewarded by the drug plan company for steering enrollees toward purchasing their specific plan, whether or not the plan is best for the individual. This is not to say that all pharmacies and pharmacists have a conflict of interest when it comes to Medicare drug plans, but we’re confident that research is the best way you can find your best plan. Ask your doctors and loved ones, check out Medicare.gov and MedicareDrugPlans.com – but do so by December 31st!

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