The Best Medicare Drug Plan for You!

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The first of the Baby Boomers turn age 65 in 2011.  In the next few years, millions of these boomers will enroll in Medicare, the federally funded medical, hospitalization and prescription drug insurance plan for seniors.  Although Medicare includes a drug benefit, purchasing a Medicare Plan with a drug benefit through a private insurance company might be a better way for seniors to save money. 

Under traditional Medicare, the prescription drug benefit is called Part D.  However, consumers can purchase their own Medicare Plans, offered by private insurance companies.  Here are some things to keep in mind when choosing a Medicare Prescription Drug Plan:

Drug Benefit as a Part of a Medicare Advantage Drug Plan

If you have already made the decision to opt out of traditional Medicare and purchase a private plan, your plans might include a drug benefit that can be built into your monthly premium.  Contact your current agent and see if this is included in your policy and, if not, how much it would cost you per month to add a drug benefit.   If you are just starting the process of shopping for a Medicare Advantage Plan, make sure to ask if drug coverage is included in plans you are considering.

The “Doughnut Hole”

Some plans, including traditional Medicare Part D, have a “doughnut hole” or coverage gap, depending on your drug costs.  The coverage gap starts when you reach a certain amount of total drug costs and ends when you reach a certain amount of out-of-pocket costs.   Some private plans offer alerts to tell you when you get close to the gap by a letter, email or phone call.  Some companies also offer you money savings tips to avoid paying high costs for drugs and postpone entering the coverage gap, such as providing you with resources to lower your co-payment for generic drugs received by mail during the coverage gap period.

What is the Co-pay For Your Drug?

Medicare prescription drugs plans classify prescription drugs into tiers.   Each tier has its own co-pay.  In additional to getting a premium quote, you should carefully compare private plans to see which of your prescription drugs are covered and how much your co-pays will be for these drugs.  Your agent is a great resource for this information but some companies also offer online tools for cost comparisons for different drugs so you can compare costs.  Before you purchase a policy, make sure you are getting the maximum benefit for your unique health needs.    

When to Enroll?  

Enrollment in traditional Medicare or a private Medicare Part D Plan is available near the time you are eligible for benefits and annually during certain dates.  Your initial enrollment period is the seven month period that starts three months after the month you qualify for Medicare (for most people, when they turn 65) and ends three month after.  Also, each year, you can enroll, cancel or change plans from October 15 to December 7. 

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