A commonly repeated saying in our culture is “If it ain’t broke, don’t fix it.” I know that I am certainly guilty of saying it and definitely of applying it to my life. When things are moving along well, why would we want to do anything differently? I would say that this mantra works in many scenarios, however, if you are on a Medicare Part D plan, you might be surprised if you do not do an annual review to determine what adjustments you should make. Open enrollment for Medicare runs from October 15 to December 7 each year and it is the ONLY time (with few exceptions) that you can make changes for the coming calendar year.
According to Q1Medicare.com, the monthly premium for your plan is predicted to DECREASE by about 5% in 2019, however, that does NOT mean that your overall costs will go down! Your Medicare drug plan’s prescription coverage (which drugs are covered and at what cost) can, and probably will change every year — even if your Medicare plan’s monthly premium remains about the same. Therefore, you could have some brand name medication that is very expensive but covered by your plan for 2018, however, in 2019, it is no longer covered, yet you are stuck with the plan for the entire year. Your only option would be to have your physician prescribe a similar medication or pay out of pocket for that medication for the year.
Unfortunately, choosing a plan is not as simple as choosing a low monthly payment. It is best to use a tool, such as www.medicare.gov, to list all of your medications and the pharmacy of your choice to determine what you’re anticipated out of pocket will be. This tool will factor in your monthly premium, any deductible, a preferred or nonpreferred pharmacy, the formulary coverage of the plan and more. It will also predict if or when you are likely to enter the coverage gap, also called the donut hole, during the year.
Another thing to consider is our baby boomer population who is just turning 65 at the rate of 10,000 per day. Many boomers will transition from employer-sponsored insurance plans to Part D plans and the benefits will be vastly different, so boomers also need to head the advice of choosing carefully.
If you need assistance choosing a plan you can reach out to SHINE, a free State of Florida service found by dialing 211. Also, local insurance representatives can help choose a Part D plan, along with a Medigap plan if needed or, alternatively, they can help evaluate between those options and a Medicare Advantage plan. Finally, Bay Street Pharmacy offers a FREE service each year to meet with you by appointment to help choose a Part D plan. Please call 772-589-2043 to schedule an appointment starting in mid-October.
So, take a few minutes to consider your choices for 2019. You may find out that the plan that has worked for you really isn’t the best one for next year. And, maybe it will keep you from going broke by fixing it before that happens! We wish you the best and are here to help if we can.