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Medicare enrollment period ends this week – December 7th. Have you checked your policy?

By Lee Bellinger / November 24, 2014
According to a new analysis, the number of Medicare Part D standalone Prescription Drug Plans (PDPs) will shrink by from 1,169 in 2014 to 1,001 in 2015.



This reduction is largely driven by a consolidation of offerings by a number of top plan insurers, including Aetna, Cigna, CVS, and UnitedHealth.



Average monthly premiums for standalone PDP market will decrease. These consolidations are expected to shift a large number of beneficiaries into lower-cost plans, driving down average premiums in the market by 2% from $39.88 in 2014 to $38.95 in 2015.
However, significant premium variation exists among the top PDPs . While Aetna’s Medicare Rx Saver plan (a new offering for 2015 that combines the sponsor’s Aetna/CVS pharmacy PDP and its Aetna Medicare Rx Essentials PDP) will reduce premiums by more than 30 percent, WellCare’s Classic plan will increase its premiums by more than 50 percent. Despite sizeable premium increases from some sponsors, there continue to be many low-cost options available for consumers – in 2015, five of the top ten PDPs will have average premiums below $30.



What this means! Many Medicare Part D drug policies are going up. Some are going down. It’s time to check your plan.



Open enrollment for Medicare continues through Dec. 6, giving Medicare beneficiaries just a few days to compare and contrast dozens of private drug plans offered through Part D for next year.



Experts advise seniors not to simply “re up,” and keep their current Medicare Advantage HMOs, PPOs, and Part D plans without checking to see if coverage levels, premiums, out-of-pocket costs, and doctor and hospital networks are still appropriate.



The Medicare Part B premium, which covers doctor visits and outpatient services, will remain the same in 2015 – $104.90 a month, according to the Centers for Medicare and Medicaid Services.



But, as the new numbers show, some Medicare recipients could wind up paying twice as much for Part D prescription plans next year, if they don’t take care to weigh their options.



Part D plan copays vary widely, even for the same drug. For example, costs for the insulin drug Lantus SoloSTAR will range between $24 and $170 for a 30-day supply in 2015 among 31 Part D plans offered to seniors in California. Fourteen of those plans will charge under $45 a month and eight plans bill for more than $80.



Seniors can compare and contrast plans and costs for the drugs they take by logging onto the “plan finder” feature at Medicare.gov, which automatically determines plans that cover your drugs at the lowest cost. (Seniors can also call Medicare at 800-633-4227 for help).



Those who do not switch plans are automatically re-enrolled in their current plans for 2015. Which could work out to be a costly mistake.



Seniors with Medicare Advantage plans — private plans that offer benefits beyond those of traditional Medicare — will also see their costs increase next year because of lower government payments tied to Obamacare.



Other changes in Part D coverage for 2015:
  • Drug plan options narrow: The total number of plans nationwide will drop to 1,001, the lowest since Part D began, but most state residents will still have dozens of options. Some insurance companies that offered three Part D plans in the past will consolidate to two or one. Among top plans that will go that way: AARP MedicareRx Enhanced; SilverScript Basic; Aetna/CVS. Monthly premiums range from $12.60 to $171.90; the average monthly premium will be $38.83.
  • Part D doughnut hole shrinking. In 2015, seniors will get more discounts to cover the “donut hole” gap in prescription drug coverage gap — 55 percent off the cost of brand-name drugs and 35 percent off generics. Medicare officials say that shrinking the gap is a result of the Affordable Care Act, which the Obama Administration says has saved 8.3 million enrollees more than $12 billion.
  • Fewer plans provide extra gap coverage. In 2014, six to eight plans in California, Florida, Illinois, New York, and Texas gave additional coverage to seniors who fall into the gap (on top of the Obamacare “donut hole” discounts), but in 2015, none will.
  • Drug deductibles increase. Next year, the maximum Part D annual drug deductible rises by $10, to $320. More plans will also charge a deductible (from $1 to $320) and fewer will waive the deductible.

Shop around!

LIFEHACK: Tips to help you pick your plan

  • Buy generic whenever possible. Brand-name drugs drive costs up, which makes generic drugs a money-saving alternative. But be sure to check with your doctor about the use of generics.

  • Compare pharmacies, use mail order. Shopping around for plans and drug costs can lead to a lower co-pay if you use an in-network pharmacy. Purchasing prescriptions by mail, or in three-month supplies, can also save you money.

  • Ask your doctor about free samples. The average physician receives more than $21,000 per year in samples from drug companies. All you have to do is ask for them.

  • Consider pill-splitting tablets. Some tablets can be cut with a pill-splitter, effectively cutting your drug costs half. For instance, if you pay a $15 co-pay for a one-month supply of the statin Zocor (containing 40 milligrams), ask your doctor to write a script for 80-milligram Zocor pills and cut them in half. That will save you $90 per year.

  • Investigate drug assistance programs. Look into drug assistance programs that provide free or low-cost drugs to those who meet income-eligibility guidelines. The RXAssist program — at rxassist.org — provides a clearinghouse of such programs.


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