Medicare drug plans fail when you least expect it. I remember it well. It was sunny and warm. After leaving my dermatologist and stopping by the drug store to pick up my new prescription my Medicare drug plan failed me.
Right there in the pharmacy. I was betrayed by my Humana drug plan.
It was humiliating.
Trusting my Medicare drug card was a costly mistake. It had never let me down before but today was different.
I felt cheated.
I followed all the rules. Used generic medications to save money vs. brand names. Every year during Medicare open enrollment I faithfully checked to see if I had the best Medicare Part D. The one with the lowest drug out of pocket cost.
This was a new prescription for a medication I use only when needed. It is only filled once a year or so. In the past the medication never cost more than $20, but today it was $92.
I had the money, but I knew something was wrong. Had my drug card gone over to the dark side? Was I being ripped off?
I walked out without my prescription.
When Your Medicare Drug Plan Fails You
Prior to 2006 Medicare beneficiaries usually had to pay full price for their prescription drugs. Then things changed.
For some people, Medicare Part D was a godsend. For others it was the work of the devil. These are times when your Medicare drug plan can fail you.
- Many PAP’s (Patient Assistance Programs) are not available if you have a Medicare drug plan
- You take a brand name drug and a generic is available, your drug plan probably won’t help
- Your doctor prescribes a new drug in the middle of the year, you may be paying too much for your new medication
- You fill a prescription that you only take once in a while
- You assume all pharmacy’s charge the same price
- You buy an OTC medication with a prescription
- When you are not aware of the best price available
- You assume your Medicare drug plan is giving you the best price every time
Too often retirees automatically use their Part D card and never consider they might be paying too much. They don’t know where to look or don’t bother to research. They assume they are always getting the best price.
Some drugs are covered by Medicare Part B. If you have original Medicare and a good Medigap plan your out of pocket cost could be $0 instead of hundreds or even thousands of dollars each year.
Most people we talk to are paying too much for their Medicare supplement plan. With over 240 different Medigap plans you probably didn’t see the best pricing.
Regardless of the excuse, they are wrong and are spending money that could have been kept in their pocket.
Medicare Drug Price Transparency
Unlike most other health care, prescription drugs have almost 100% transparency.
If you know where to look.
Here are some general tips for controlling medication costs.
- Run a free Medicare drug report every year when you receive your ANOC (annual notice of change)
- Consider using a different pharmacy and if possible, use only preferred pharmacy’s
- Learn how to manage your drug costs and avoid the donut hole
- Ask if you qualify for Medicare Extra Help
- Consider using a discount drug card
- Save money by using mail order, especially from Canadian pharmacy’s
- Never fill a new prescription without first checking prices
Medicare Part D is the most complex and confusing aspect of Medicare. If you don’t understand your plan, and how to use it, you will definitely pay too much.
How I Saved Over $60 on One Medication
I run reports for my Medigap clients all the time. Almost every time we find ways to save hundreds, or even thousands of dollars over the course of a year.
Some clients have been taking OTC medications for years but paying a pharmacist to fill their prescription. On more than one occasion clients are paying over $100 per month for a cholesterol medication that could be bought off the shelf or online. A years supply of this drug is available from Amazon for less than $30. Compare that to paying over $1500 per year for the exact same medication.
Others will needlessly go into the donut hole. Had they managed where and when they bought their prescription the donut hole could have been avoided completely.
In my case the $92 fill at CVS was available across the street for $27.
When will your Medicare prescription drug plan fail you?
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