Choosing the Best Prescription Drug Plan During the Medicare Annual Enrollment Period in 5 Easy Steps
One of the most crucial decisions you must make as a Medicare beneficiary is picking the best prescription medication plan. You have the chance to consider switching to a Medicare Advantage plan or check around for a new Medicare Part D plan during the Medicare Annual Enrollment Period, or AEP.
Although this procedure could seem frightening or overwhelming, that’s where we step in. Here are five steps you can follow to pick the best plan for you as a starting point.
- Buy during the Oct. 15–Dec. 7 Medicare Annual Election Period.
Every year, from October 15 to December 7, the annual enrollment period for Medicare takes place. Medicare beneficiaries have the opportunity to review and alter their current coverage during AEP. No action is necessary right now, although customers frequently discover more economical alternatives or policies with more coverage. It’s a good idea to evaluate your alternatives each year to ensure that your health and prescription drug needs are covered for the upcoming year because Medicare plan specifics can change from year to year.
Schedules for the 2023 Annual Enrollment Period
- 15 October, 2022
The annual enrollment period for the Medicare Advantage and Prescription Drug Plan begins.
- 7 December, 2022
The annual enrollment period for the Medicare Advantage and Prescription Drug Plans expires
1 January, 2023
This is the first day your new plan will take effect if you enroll in it or change plans during AEP.
- Go over the Prices of Your Covered Prescription Drugs
Every year, Medicare prescription drug plans can alter their formularies, or lists of approved pharmaceuticals, as well as the prices for these drugs, which could result in you paying more (or less) for the same medication. You must get an annual notice of change from your insurance company that details any modifications to the plan’s coverage. You should take the time to carefully read this paper since it will help you determine what kinds of adjustments you will need to make when reevaluating your Medicare plan.
- Recognize the Four Stages of Prescription Drug Coverage under Medicare Part D.
Medicare Part D provides assistance to beneficiaries in paying for their prescription drug expenses. Depending on the stage you’re in, your out-of-pocket expenses for prescription drugs may alter over time. Prescription drug coverage under Medicare Part D consists of four stages, including:
Medicare Deductible Period, Phase 1
You will be responsible for covering all covered prescription drug expenditures during the deductible period up until your Medicare Part D deductible is met. Deductibles differ amongst plans, but they shouldn’t go over $505 in 2023.
Your Medicare Part D plan will help cover some of the cost of your prescription medications during the Medicare Initial Coverage Period in exchange for a copayment (a predetermined sum) or coinsurance (a percentage of the drug’s cost) that is set by your plan.
Medicare's Initial Coverage Period, Phase 2
During the Medicare Initial Coverage Period, your Medicare Part D plan will help cover some of the cost of your prescription medications in exchange for a copayment (a predetermined amount) or coinsurance (a percentage of the drug’s cost) that is determined by your plan.
Medicare Coverage Gap (Donut Hole) Period, Phase 3
You will pay 25% of the retail price for both brand-name and generic prescription medications during the Medicare Coverage Gap period, sometimes known as the “donut hole.” This gap will begin once you and your plan have spent $4,660 or more on your covered prescription medications and will come to an end in 2023 when your total out-of-pocket expenses for prescription medications exceed $7,400.
Medicare Catastrophic Coverage Period, Phase 4
Medicare Part D beneficiaries only have to make a minimal coinsurance or copayment for the rest of the year while they are enrolled in the Medicare Catastrophic Coverage Period. Once your total out-of-pocket expenses for prescription drugs have surpassed $7,400, this period will begin.
- Look into the Benefits for Low Income Individuals
Despite the fact that Medicare is meant to assist in covering medical expenses, you may still be required to pay premiums, deductibles, and copays. There are savings programs available to Medicare members with lower incomes to help reduce these out-of-pocket costs.
The goal of the Medicare Extra Help Program is to assist people with low or fixed incomes in covering at least some of the Medicare Part D out-of-pocket expenses. Extra Help is neither a substitute for Part D or a strategy in and of itself. To receive Extra Help, you must be enrolled in a Part D plan. Drug coverage is frequently offered as part of Medicare Advantage plans (Part C), as opposed to a separate Part D plan.
For more information and knowledge building, please do go through the following resources:
Explore the Medicare Annual Enrollment Period Guide for 2023
- Consult DreamhealthQuotes to identify Medicare prescription drug plans that are accessible to you.
In addition to helping you better understand your alternatives for prescription medication plans, SelectQuote can potentially save you money and time. We can quickly assess the local Medicare alternatives to make sure you’re receiving all the advantages you’re entitled to. There is no requirement to sign up.
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