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. 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.
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.
There are several options available to assist you with a plan comparison:
1.) 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.
2.) Medicare.gov provides an amazing online tool which lets you add in your prescriptions, select the pharmacies you use and then compare plan options. Start by setting up an account at https://www.medicare.gov. You can learn more about completing your own comparison, including viewing an online video and brand new comparison tip sheet on our website- https://shiip.iowa.gov/find-resources/medicare-open-enrollment-period
3.) Call Medicare at 1-800-Medicare (1-800-633-4227) and ask for assistance in running a comparison. Medicare Customer Service Representatives can provide this assistance over the phone and are available 24/7.
No matter what route you take here are some tips to make sure you get the most from your comparison.
- Ensure 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.
- Make sure 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 or CMS Representative ask if you are eligible for any programs that assist with covering the costs of prescriptions or plan premiums. There may be federal and state programs available to you, depending on your income and resources.
- If you are comparing Medicare Advantage Plans contact your providers (i.e. family doctor, specialists, local hospital and those who provide your medical supplies) to ensure they are in network for the Medicare Advantage Plan you are considering. If your providers are NOT in the Medicare Advantage Planβs network, you could face considerable out of pocket costs.