The summer has flown and autumn is upon us. The leaves on the trees are turning the vibrant colors of fall, and the air is cool and brisk. The captivating smell of fireplaces burning logs permeates the air. It is also the time of year to begin to think about our Medicare prescription drug coverage. From October 15 until December 7, each Medicare beneficiary who part A, Part B, or both has the opportunity to enroll, dis-enroll, or change their prescription drug plan choices. This period is commonly known by two terms – the Open Enrollment Period (OEP) for Part D or the Annual Election Period (AEP) for Part D.
You may be thinking to yourself, ‘I have a Medicare Part D plan and I am quite satisfied with it. Why should I review my coverage?’ As you may know, in 2020, there are 24 Part D plans to choose from in Alaska. These plans are being offered by nine different companies. Obviously, many of the companies are offering multiple plans – one company, WellCare is offering six different plans. These companies have the opportunity each year to make changes to the plans they offer. These changes can include:
Choosing to stop offering a particular plan
Offering a new plan
A new company may offer plans
Changing the Formulary of a plan
Changes to a plan’s pharmacy network status
Changing the monthly premium
Changing the annual deductible
Changing the tier level of a medication
Changing the co-pays for a tier level
All of these changes can cost you money. You may also have made changes over the past year. Perhaps you have more medications or are taking less medications than before. Possibly you have made a change in your pharmacy choices. All of these possible changes make it very important to review your prescription coverage during this time.
This is also a great time to have a review of your eligibility for assistance programs. The Limited Income Subsidy (LIS) program, also known as the Extra Help program, can assist you in paying for your prescription coverage through Medicare if you meet the eligibility requirements. The qualifications for this program are: If you are single, you can make up to $2,014 per month and have assets that total $14,610 or less. This does not include your home, your car, or your personal possessions. As a couple, you can make up to $2,714 per month and have up to $29,160 in assets. There are multiple privileges that come with this program. You will have more opportunities to enroll in the plan of your choice, and you can change your coverage under certain circumstances up to four times a year if needed. Any Late Enrollment Penalties (LEPs) you may have accrued will be waived. This is in addition to the benefits of low or no premiums, lower deductible or no deductible and lower co-pays or no co-pays.
Here are some ways you can prepare for this upcoming, important opportunity:
Check-Out mymedicare.gov. Establish your own confidential, personal account at mymedicare.gov. This account can house and provide you with an ongoing account of all of your Medicare information. It also provides a link to the Medicare Plan Finder Tool to assist you and/or your Medicare counselor with picking the best Prescription Drug plan for you in 2021 based on your specific medication and your pharmacy choices. When creating this account, be sure to write down your user name, password and the answer to your secret question and store them in a secure, but accessible place – perhaps where you store other important papers. Establishing a Medicare file or binder is a great place to keep this information. If you have already established an account, be sure and find that access information in anticipation of your review or an appointment with a Medicare counselor for a Part D review.
Obtain your current drug list. Write down a list of all of your current medications – even those you only take occasionally. Be sure to list the name of each medication and generic version if you use them, the dosage, the means of delivery, such as by mouth, or sublingual, etc., and the frequency with which you take the medication. The Medicare Plan Finder tool now has the ability to insert a broader range of re-fill frequencies – even up to six months or a year. You can also ask your pharmacist for a list of your current medications. This will help you and your Medicare counselor update your drug list within your personal myedicare.gov account.
Make an appointment. If you do not plan to go online yourself to review your coverage using the Plan Finder tool, contact the Medicare Information Office and make an appointment. There are now well over 100,000 Medicare beneficiaries in Alaska so you will want to schedule that appointment in a timely manner if you want to work with a local counselor.
Check your coverage. Be on the lookout for a package from your current prescription plan. They will be sending to you an “Evidence of Coverage” (EOC) document each year, usually in the fall. The EOC gives you details about what the plan covers, how much you pay, and more. This will tell you if all of your medications will be covered next year and what cost changes are on the horizon for 2021. Remember each year your coverage can change and your needs may change.
Check your mail. Be watching your mail for communications from the Social Security Administration (SSA) regarding changes to your coverage or assistance through the Extra Help program, or Low Income Subsidy (LIS) program. If you have never been screened for this assistance program, you can ask your Medicare counselor to do so. The counselor can also assist you with the online application. This program can lower your medication costs if you qualify.
Look for the book. Expect your new “Medicare and You” handbook in the mail or perhaps via email if you have signed up for electronic delivery. This will have a brief overview of the prescription plans available in Alaska for 2021. You can compare costs between plans.
What if I have never signed up for Medicare Part D prescription drug coverage, but I would like to? Or what if I had coverage, but lost it? The Open Enrollment Period is the annual opportunity for those who have not had Part D or lost Part D to begin or resume participation. You can sign up for a plan during this OEP and your coverage will begin on January 1, 2021. If you have gone without Medicare prescription coverage, you may have to pay a Late Enrollment Penalty in addition to your monthly premium for Part D. Medicare calculates the penalty by multiplying 1% of the “national base beneficiary premium” ($32.74 in 2020) times the number of full, uncovered months you didn’t have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium, per Medicare.gov.
Ready, Set, Go. When you are ready, if you would like assistance, contact the Medicare Information Office for an appointment to review your coverage. Counselors across the state are anticipating hearing from you. Here are some phone numbers to call for an appointment: State of Alaska Medicare Information Office toll-free in Alaska: 1-800-478-6065, their local Anchorage number, 907-269-3860, and the Medicare Information Office located at the Anchorage Senior Activity Center, 907-770-2025 or 907-770-2070.
Keeping abreast of the changes in the plans available to you, the new plans that may be introduced, and the changes in costs and pharmacy relationships can save you money, sometimes a lot of money! Take advantage of the Open Enrollment Period.
Nila Morgan is a Certified Medicare Counselor who works at the Anchorage Senior Activity Center.
