Every year from October 15th - December 7th Medicare beneficiaries have an Open Enrollment Period (OEP) when they can compare their Part D Drug Plan or Medicare Advantage Plan and enroll in the plan that best meets their needs their needs for new calendar year.
Part D Drug Plans and Medicare Advantage Plans have the ability to change their contracts, coverage and benefits every year. That means current plans may not cover existing prescriptions next year, they could change cost-sharing requirements or could even add prior authorization requirements needed to get prescription covered.
Despite all these great reasons to get an annual plan comparison done, a recent study by Kaiser Family Foundation revealed that only 29% of Medicare beneficiaries compare their current plan with other Medicare plans during the annual open enrollment period.
Completing a plan comparison does not have to be painful there are several options available:
- Reach out to a local SHIIP- SMP Office to schedule an appointment with a trained SHIIP- SMP Counselors. Visit https://shiip.iowa.gov/find-a-shiip-counselor to find a local office. Most SHIIP-SMP Offices begin scheduling OEP appointments in mid-September for in person or virtual appointments (via phone or video).
- Set up an account at https://www.medicare.gov. Medicare.gov provides an amazing online tool which lets you add in your prescriptions, select the pharmacies you use and then compare plan options. The Center for Medicare & Medicaid Services (CMS) has a short video tutorial that walks you through how to run your own comparison to see your options: https://www.youtube.com/watch?v=8bLdJoPRiBo.
- Call Medicare at 1-800-Medicare (1-800-633-4227) and ask for assistance running a comparison during the OEP. A Medicare Customer Service Representative can provide this assistance over the phone. They are available to 24 hours a day, 7 days a week.
No matter what route you take here are some tips to make sure you get the most from your comparison.
- Make sure you have all your prescription information available. Your comparison will not provide realistic pricing information if you do not have the correct prescription names and doses.
- Ensure you look at pricing available through different pharmacies. Some plans have preferred pharmacies which may provide better pricing. Some people also find savings by using mail order pharmacies. A willingness to explore a range of pharmacies may provide significant savings.
- If you are completing a comparison with a SHIIP- SMP Counselor ask if they can also screen you to see if you are eligible for any programs that assist with covering the costs of prescriptions. There may be federal and state programs available to you, depending on your income and resources.