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 can change their contracts, coverage and benefits every year- or even be cancelled. That means current plans may not cover your existing prescriptions next year, they could change cost-sharing requirements or could even add prior authorization requirements needed to get your prescription covered. And if your Drug or Medicare Advantage Plan is cancelled failing to take action will result in no coverage January 1, 2027.
Despite all these great reasons to get an annual plan comparison done, a recent study revealed that only 31% of Medicare beneficiaries compare their current plan with other Medicare plans during the annual open enrollment period.
How comparing plans can save you money. Every fall you will receive an annual notice of change (called an ANOC) that list changes in your drug or Medicare Advantage plan. Changes can include increased premiums, what prescriptions are covered, pharmacies in plan network and even providers covered (if you are in a Medicare Advantage Plan). Reviewing this ANOC so you know about the changes that will impact you is critical to ensuring your plan coverage is the most affordable and best fit for your needs.
These tips can help you save money during the OEP and beyond:
- Pharmacy Choice: Check out plan prices at several different pharmacies when comparing plan. Plans differentiate between “standard” and “preferred” pharmacies. Using a preferred pharmacy can provide significant savings.
- Ensure Providers are In-Network: Providers such as doctors and hospitals can enter and exist Medicare Advantage networks. Make sure your key providers are in network for any plan you consider.
- Check your eligibility for programs that help cover costs: The Low Income Subsidy (LIS) and the Medicare Savings Programs (MSPs) are two programs that can help cover prescription costs or even the Part B premiums and copays. If your income is below $2015 (single) or $2,725 (married) and your resources are below $18,090 or $36,100 you may be eligible. If you believe that you are eligible reach out to the Iowa SHIIP at 1-800-351-4664 for application assistance.
- Coupon programs may help: Companies such as GoodRx, SingleCare, and RxSaver—as well as club-based programs like Costco Member Prescription Program or Amazon Pharmacy—negotiate bulk cash pricing and may be able to offer more affordable coverage of prescriptions.
- SafeNetRx (Iowa's Drug Repository): SafeNetRx takes sealed, unused medications donated by long-term care facilities and redistributes them to Iowans making at or below 200% of the Federal Poverty Level. Applications for the program can be found at: https://safenetrx.org/files/galleries/EnglishIntakeForm.pdf
- Medicare Prescription Payment Plan: The Medicare Prescription Payment Plan (MPPP) offers the ability to spread out-of-pocket costs for prescriptions into monthly installments across the year. While this plan does not reduce the cost of prescriptions, by balancing prescription costs across the year (rather than requiring large out of pocket payments in January or February) it can help relieve cash flow issues.