by Gabriel Levitt, President, PharmacyChecker.com and Prescription Justice | Feb 9, 2018 | Politics and policy
Due to a little provision in the 2019 budget bill passed by Congress today, fewer Medicare enrollees may need to look online to international pharmacies for lower costs. That’s because the Part D discounts mandated under Obamacare are being phased in a year earlier. These are discounts provided to enrollees who fall into the Medicare Part D coverage gap “the “donut hole”.
Without the new provision, people in the donut hole would be responsible for around 50% of the cost of their medication until 2020, when they would only need to cover 30%. Now they will only need to cover 30% in 2019 – a year early.
This is a small win but perhaps it was a consolation prize. Regardless, some drug price relief is always welcome. It’s the drug companies who are forced to cover these discounts so they’re probably none too happy about this. On the other hand, maybe there was a backroom deal. The Creating and Restoring Equal Access to Equivalent Samples Act (CREATES), which would have helped lower-cost generics come to market faster, was slated to be a part of this bill. CREATES had massive support from groups on the left and the right, but it was knocked out of the final bill.
I’m glad that older Americans get a small discount next year on prescription drugs, but I have the feeling we got thrown a bone.
Tagged with: creates, Medicare Drug Plans, Part D
by Lucia Mueller, VP, PharmacyChecker.com | Oct 19, 2017 | Medicare Drug Plans
It’s time to shop Medicare Part D plans! Research shows that most of you are saying “why bother?” but you should know that those folks that change plans often lower their out-of-pocket drug costs. Each state has anywhere from 19-26 Prescription Drug Plans (PDPs) you can choose from. We suggest you compare plans based on the drugs you take to avoid being hit with surprise out-of-pocket costs in 2018.
Here’s a heads up on the changes to look out for the 2018 plans:
Tagged with: Medicare Drug Plans, Medicare Part D, Medicare plan ratings, Medicare plan reviews
by Gabriel Levitt, President, PharmacyChecker.com and Prescription Justice | Oct 30, 2015 | Drug Prices, Medicare Drug Plans
We’re two weeks into the open enrollment period of Part D Medicare Drug Plans and it is my deepest hope that if you are a Medicare enrollee then you are taking time to find the best plan. It’s not easy. Finding the right plan, however, could mean getting the medications you need to stay healthy, saving money, and avoiding lots of headaches throughout the year. Our website, MedicareDrugPlans.com, gives you basic information, such as premiums, deductibles and coverage levels, but also ratings and reviews about Part D plans that can inform you about the experiences of your peers in using the different plans. Your final search should be with the government’s website – Medicare Plan Finder – where you can find the plans that cover the medications you are already taking now and specific costs related to those plans. Below are key points about costs and coverage.
Part D Plan Costs
Plan costs have gone up this year. The deductible cap increased by 12.5%, from $320 to $360. Fifty-three percent of the plans are charging the full deductible, while the other 47% charge less. Average premiums have increased from $36.68 in 2015 to $41.46 in 2016. The lowest monthly premium is $6.80, that’s if you live in Puerto Rico and choose the Humana Preferred Rx Plan. The highest premium is $174.70, that’s if you live in Florida and choose Blue MedicareRx Option 2.
Part D Plan Choices
The overall trend of having fewer Part D plans to choose from continues this enrollment season, down to 886 this year compared to 1001 last year. Looked at historically, the declines are even more striking, as there were 1,875 plans in 2007. These numbers are the totals available in all states and U.S. territories but options are really state-based. Alaskans had only 19 plans to choose from, compared to a high of 29 in West Virginia and Pennsylvania.
Part D Plan Coverages Phases
There are four coverage phases for Part D plans: deductible, initial coverage period, the coverage gap, often referred to as the “donut hole,” and catastrophic coverage. The deductible is pretty straightforward–you pay the full cost of your medications up until that dollar amount, which can be as high as $360. During the initial coverage period, you usually pay about 25% of drug costs and the plan picks up 75% until total costs have reached $3,310. At that point you’re in the coverage gap, but you’re paying discounted prices, 45% and 58% of brand and generic drug costs, respectively. Once total costs have exceeded $7,515, you are in catastrophic coverage territory, and only have to pay 5% of your total drug costs until the next year begins.
Understanding these generalities about Part D plans is important, but the devil is in the details, which can only be understood through research. It’s not enough to just stick with the plan you have. Nine out of 10 Medicare enrollees do not change plans, and many end up with higher drug costs because they don’t. The landscape of plans changes every year; so do your research, shop around, and get the best plan for your health and wallet!
For a thorough plan analysis see Kaiser Family Foundation.
For ratings and reviews, check out www.medicaredrugplans.com.
To finalize your decision go to Medicare Plan Finder.
Tagged with: donut hole, Kaiser Family Foundation, Medicare Drug Plans, Medicare Part D, medicare plan finder, Medicare.gov, medicaredruglans.com