Why You Should Shop Your Medicare Drug Coverage

Are Medicare beneficiaries paying too much for prescription drugs?

It’s entirely possible, according to Susan Pittman, Medicare Coordinator at The Law Practice of Dennison Keller, a Life Care Planning Law Firm in Cincinnati, Ohio. In addition to guiding the firm’s many clients, Susan has also spent the last seven years as a certified counselor with Ohio’s Senior Health Insurance Information Program (OSHIIP), a Medicare-sponsored program that provides free unbiased advice to Medicare beneficiaries.

Susan says there’s only one way to know if you’re overpaying, and that’s to compare your current plan to the available options during Medicare’s annual open enrollment. The open enrollment period for 2021 begins later this week on October 15 and runs through December 7. Changes made during open enrollment go into effect on January 1, 2021.

“Each drug plan has its own formulary which lists the medicines that it will cover and at what price,” Susan explains. “There are also differences in which plans fit best with which pharmacies. Most plans have preferred pharmacies, which can affect the price. It’s important to look at your current coverage and compare it to other options every year.”

In her work with clients, Susan uses the prescription drug plan finder on Medicare.gov to generate a comparison. “You enter the medications you take and the pharmacies you use, and then the website takes all of the plans available in your area and sorts them from the best deal to the worst,” she explains. “It’s interesting because you can see where your current plan ranks on the list.”

When the drug plan finder shows that changing to a different plan may save just a few dollars a month, people often stay where they are. “In some cases, making the change just isn’t worth it,” Susan notes. “Signing up for a new plan and waiting for a new card is a hassle that some people would rather avoid.”

More often than not, the savings are substantial. During 2020 open enrollment, Susan helped one client save $1,300 for the year.

Another reason that people might be paying more for their prescription drug coverage than is needed is complacency. “A few years ago, I had a 90-year-old client who had kept the same drug plan for years,” notes Susan. “Like so many of us, she just accepted that her premium would go up a little every year, so she paid no mind to those small increases. Eventually, however, her premium had increased to $100 a month. By switching to a drug plan that covered her medicine at similar costs, but with a lower monthly premium, she saved $800 that year, just on the premium.”

People on Medicare Advantage Plans are also wise to see how their current plan stacks up to others during annual open enrollment.  Maybe you wanted to see a doctor in the past year that wasn’t on your plan, or maybe you were prescribed a medication that wasn’t covered,” advises Susan.

For people who work with Life Care Planning Law Firms, Medicare guidance is often part of a Life Care Plan. If you would like guidance but don’t have a Medicare specialist like Susan at your disposal, one option is to contact your state’s Senior Health Insurance Assistance Program. Medicare’s website at Medicare.gov includes a link that makes it easy to find a SHIP counselor in your state.