Medicare Part D


Prescription Drug Insurance for 2019

Are You Currently Enrolled In A Part D Plan? Or Plan To Enroll Soon?

It is very important that Seniors who are enrolled in a Medicare Part D Prescription Drug Insurance Plan review their Part D insurance every fall to make certain that the drug insurance coverage for the following calendar year will cover all of their prescription medicines. Even if the list of medicines prescribed for an individual does not change from the previous year, a plan that is appropriate for an individual one year may not be the best plan for that person for the next year due to the many changes that the insurance companies make each year.

Why Re-evaluate Part D Drug Plans Every Year In The Fall?

Every year each Part D plan is re-negotiated by the insurance company with Medicare. All Part D Plans start on January 1st and continue thru December 31st. In the fall, your insurance company will encourage you to continue for the next year and no action on your part is needed, if you wish to continue with the same plan. However, it can be an expensive mistake to continue with a Part D plan from year to year without first re-evaluating the cost of your plan as compared to all the other plans. Your list of prescribed medicines may have changed or the insurance company may have made changes to the plan that mean your current plan will not be the least expensive plan for you for the coming year.

If you decide to switch plans for the coming year, you can only do so by enrolling in the new plan between October 15th and December 7th. The new plan will become effective January 1st. There is no fee or penalty for changing plans. After the December 7th deadline, it is not possible to switch plans until the following October.

Could One Part D Plan Be More Expensive Than Another?

Yes. The total annual cost of buying drugs under some Part D Plans can cost an individual hundreds (in some cases thousands) of dollars more than other plans. This is a buyer beware market. There are a number of reasons for the significant differences.

Medicare Part D Prescription Drug Insurance plans are sold by a number of commercial profit making insurance companies. These plans are worthwhile for most seniors, because they are subsidized by the United States Government through Medicare. If an individual takes one or two or more prescription medicines, it is very likely that a Part D plan will save money as compared to shopping at a pharmacy without insurance. Even though all Part D plans must meet Medicare's minimum standards, the plans differ considerably in many respects including the following:

Total Annual Cost Of Your Drugs Under A Part D Plan Varies By Plan

The annual cost to an individual is determined by the following factors:

  • The amount of the monthly premium
  • The amount of the annual deductible, if any
  • The amount of the co-payments, if any
  • The list of drugs covered in the "gap" or "donut hole", (usually generics only)
  • The specific drugs prescribed for an individual (including quantities and dosages)
  • The pharmacy used to fill the prescription (local as well as mail order)
  • The list of drugs (known as the Formulary) covered by the plan

How To Evaluate Part D Drug Insurance Plans

In most areas there are approximately 22 plans from which to choose. Manually calculating the total annual cost of a plan for an individual's required drugs is time consuming and tedious. The best way to evaluate the various plans is to use the computer program provided by Medicare at www.medicare.gov. This is a powerful computer program that generates a listing of all available plans and ranks the plans from least expensive to most expensive depending upon the medicines required by the individual. The program provides detailed cost information for every drug for every plan. All Medicare approved Part D plans are included in this analysis. The difference in Total Annual Cost among the various plans is surprising. It is not uncommon for the most expensive plan to be several times the cost of the least expensive. Without the use of the Medicare website it is extremely difficult to determine these cost differences. We have seen cases wherein the appropriate selection of a plan would save the individual literally thousands of dollars over the coming year.

Why Evaluate All Plans – Why Not Pick One At Random?

No two Part D plans are the same, even though all plans must meet Medicare's minimum standards. Remember that the insurance companies are attempting to sell their Part D plans by making them appear attractive, but in the last analysis the insurance company is mainly interested in making a profit. Profits can be maximized by a variety of subtle variations between Part D plans that may not be obvious without careful examination of the details. We can help with this evaluation. A plan that is least expensive for one individual may prove to be very expensive for another, because of the variation in prescriptions required by the two individuals. Thus, it is not wise to simply enroll in the same plan as a friend or relative unless a thorough evaluation of all plans has been undertaken.

Should I Continue Next Year With the Same Part D Plan as This Year?

Not until you have evaluated all of the other plans and have decided your current plan will be best for you for calendar year 2019. Most seniors will find a less expensive Part D plan is available.

Each insurance company offering Medicare Part D plans distributes detailed sales literature including brochures, letters and pamphlets describing their plans. Unfortunately, the package of sales literature explains only their plans and fails to mention that there may be as many as 20 different plans offered by the competition. Many seniors make the costly mistake of selecting from among the two or three plans described in just one company's literature without analyzing the plans available from other insurance companies. It is important to understand that the total annual cost you will pay is dependent upon the specific list of prescription medicines that you take and this cost varies significantly from plan to plan. Selecting an unsuitable plan could cost you hundreds or even thousands of dollars over the course of a year.

How To Obtain Free Help In Evaluating Part D Plans

Information can be obtained directly from each of the insurance companies (concerning only their own plans) or you can obtain the same information detailing all of the available plans from all of the insurance companies by using the Medicare website (www.medicare.gov).

The Medicare website program is available to anyone using the internet. This program is relatively user friendly and anyone may use it to evaluate the various plans for themselves. If an individual is uncomfortable using the internet or does not have internet access, there may be a friend or relative who can perform this evaluation for them. There are also independent, non-profit organizations, such as The Senior Initiative Inc., ready to help.

The Senior Initiative Offers Consulting to Help Seniors Pick Best Part D Plan

Over the past ten years we have assisted hundreds of seniors with this annual re-evaluation.

You do not need an appointment

There is no need to come to our office

We can help you by telephone

No Charge or Fee for Our Counseling

Our Advice Is Unbiased and Objective

As an independent, non-profit organization, The Senior Initiative avoids conflicts of interest. We do not accept payments of any kind from insurance, pharmaceutical, or drugstore companies. We are financed through the generosity of individual contributors. We do not earn a commission for helping you pick a plan.

Help can be obtained by contacting The Senior Initiative Inc.

Contact Us Today

  • By telephone - 781-828-1875
  • By email - seniorinitiative@gmail.com
  • Our mailing address is as follows:

    The Senior Initiative Inc.
    636 Washington St.
    Canton, MA 02021

Turning 65 Soon?

If you are turning 65 years of age in the near future, and are considering enrolling in a Part D plan, we strongly recommend that you evaluate all of the plans offered to assure yourself that you will be enrolled in the most cost effective plan given your individual list of prescription drugs. Enrollment in a Part D plan is limited to one person per policy. A spouse would need a separate policy (not necessarily with the same insurance company).

You can enroll in a Medicare Part D Drug plan anytime from three months before you turn 65 to three months after your 65th birthday. If you enroll later than three months after your 65th birthday, you will be subject to a penalty. You can enroll in only one Part D plan and it must be a plan offered in your zip code area – generally where you reside.