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Valued Social Butterfly
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Re: Medicare Part D

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Message 11 of 16

@te1271 wrote:

Thanks. I just got a notice that open enrollment starts on Oct 15th. only a little over a month from now. Will I be able to change part D plans then and will they be at the same price they show for the new plan now? For example I now pay $35.50 for the AARP medicare RX SaverPlus. The AARP MedicareRx Preferred Plan that I want to switch to shows $74.80. Does the fact that I am now taking medication change what that premium will be?


Just for clarity - Open enrollment will be for a Med D plan that starts January 2020.

Plan details will be available when they come out by 10/15/2019- lots could change - premiums, deductibles, formulary, copays -

 

Sounds like you need some help with how Medicare Part D works and finding the right plan for yourself (or wife) - these are individual plans. 

Just some BASIC highlights:

  • Plans are set up by area of the country - zip code
  • Med D plans can be free-standing or part of a Medicare Advantage plan. 
  • Each plan covers a selection of medication in different medication classes.  In (5) classes of Meds, they cover all of them.  Each med they cover is listed on their formulary.
  • each medication has a tier - the lower the tier number, the cheaper
  • each medication may have some other qualifiers - like PA (prior authorization) or QL (quantity limits), etc.
  • most all plans give a pharmacy-type choice that give some savings from more to less - mail order, preferred pharmacies

Medicare.gov - Medicare Plan Finder

I am not goinna get into how the deductible, donut hole, catastrophiccoverage works - you can read about that in the plans which you are considering. 

 

FOR now -

 - make sure that your wife's doctor is ordering the medication best for her and her pocketbook since you may not have coverage for it.  Tall him your situation - there maybe something cheaper that will do the same thing, if that be the case.

- if you are paying out of pocket - find the cheapest route - GoodRx might be a good source to check

- your current plan might give a pharmacy source that gives you a better price - check her plan.

 

If you still remain confused, you may need some additional help -

 A local independent Medicare insurance specialist (am I right here, somarco?)

SHIP vounteer (good/better/best here) - Medicare.gov - Find a contact

 

Remember you can change a Medicare Part D plan and/or a Medicare Advantage plan EVERY YEAR during open enrollment based on need.

 

This is purely hitting the highlights - Read your plan.

 

 

 

 

* * * * It's Always Something . . . Roseanne Roseannadanna
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Bronze Conversationalist
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Re: Medicare Part D

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Message 12 of 16

Thanks. I just got a notice that open enrollment starts on Oct 15th. only a little over a month from now. Will I be able to change part D plans then and will they be at the same price they show for the new plan now? For example I now pay $35.50 for the AARP medicare RX SaverPlus. The AARP MedicareRx Preferred Plan that I want to switch to shows $74.80. Does the fact that I am now taking medication change what that premium will be?

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Frequent Social Butterfly
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Re: Medicare Part D

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Message 13 of 16

@te1271  Once you choose a Medicare Part D or Medicare Advantage plan during your IEP, then you will not be given an opportunity to choose another plan, even if your health or medication needs change.

https://q1medicare.com/q1group/MedicareAdvantagePartDQA/FAQ.php?faq=What-is-the-Medicare-Part-D-IEP-...


Bark less. Wag more.
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Re: Medicare Part D

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Message 14 of 16
Somehow I thought there was a grace period when you first start Medicare that wasn't included in the open enrollment period.
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Frequent Social Butterfly
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Re: Medicare Part D

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Message 15 of 16
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Medicare Part D

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Message 16 of 16

My wife actually starts Medicare today. When she signed up she was on no medication so she picked the cheapest Part D coverage. Two days ago she had a stroke which will require much medication in the future. Is there a grace period and can she change to a better part D plan right now?

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