I encourage seniors to closely consider their options in choosing their Medicare Part D plan for 2013. The open enrollment for Medicare Part D plans end on December 7th. Up until this time, beneficiaries can 1) Join or switch a Medicare prescription drug plan, or 2) Join or switch a Medicare Advantage Plan.
Be sure to take time to review health and drug plan choices and choose the plan that fits your needs. Remember, coverage begins on January 1, 2013 and you will have membership card/materials in hand. Remember, for 2013 Part D estimated average basic premium and estimated total premium will slightly increase. It is estimated the average premium will be $30 in 2013. For people who reach the “donut hole”, they will see a 52.5% discount on covered brand name drugs, and a 21% discount on covered generic drugs.
Some things to consider as you evaluate each plan:
- Are the services or drugs needed covered?
- Does the plan have a $0 generic copay
- Do they have or are they eligible for other health and drug coverage?
- Costs - Premiums, coinsurance (copays), deductibles
- What is the out-of-pocket limit for medical care?
- Are your doctors/hospitals part of the plan?
- Are your prescription drugs covered?
- What are the plan’s quality ratings?
- Are the offices/pharmacies/hospitals convenient?
- Does the plan allow you to use the local community pharmacy and pharmacist of your choice?
- Do you travel for long periods during the year?
Benefits of $0 generic Plans
A number of Part D plans, including SilverScript and SmartD , offer $0 co-pays for certain generic medications beginning on the first day of coverage. This means patients will not pay co-pays for generics during the deductible and initial coverage stage. These plans can help patients
by lowering their drug costs and encouraging better medication adherence.
So What You Can Do:
• Familiarize yourself with the Medicare Drug Plans in your area that
offer $0 generics. This information may be obtained by using the Medicare
PlanFinder tool at www.medicare.gov.
• Understand the benefits of generics. These drugs are approved by the FDA, are
as safe as brand-name drugs, and have the same dosage form, safety, strength,
quality, and performance as their brand-name counterparts.
• Look for cost-saving opportunities. For patients who choose to enroll in a
plan that offers $0 generics, ask your pharmacist to review your medication profile to see if
there are any opportunities to recommend lower-cost generics.
Also, be sure to take advantage of Medication Therapy Management (MTM) services that your pharmacist should be offering. Medicare pays for you to have one comprehensive medication review per year with your pharmacist by appointment as well as other special interactions with your pharmacist that will help you save money and improve your health and wellness.
Best In Health,
Paul Hueseman, PharmD
301 S. Kirkwood Rd.
Kirkwood, MO 63122