- Switching to generics or other lower-cost drugs;
- Choosing a plan (Part D) that offers additional coverage in the gap (donut hole);
- Pharmaceutical Assistance Programs;
- State Pharmaceutical Assistance Programs;
- Applying for Extra Help; and
- Exploring national and community-based charitable programs.
We suggest a 7th method: compare plans annually and switch into the best plan for your health and financial needs. It’s not just about gap coverage, because most seniors never reach the coverage gap. What you need is the best overall plan for you, and it may change every year.
Medicare Part D Plans (PDPs) help you pay for your prescription drugs. All PDPs are different, and the costs can vary significantly. It’s not uncommon for a prescription under one plan to cost you $5 at the pharmacy, while the very same prescription through another plan costs $25. This is why carefully comparing and choosing your Part D Plan annually is so crucial. You need to choose the best plan for you, which includes covered medications, the monthly premium, and the costs for your prescriptions (copay).
Can I switch my Medicare Part D Plan?
If your Medicare Part D Plan does not meet needs, you can and should switch plans. The most common reason people switch from one plan to another is because their medications change. However, you might also discover that a plan that was a great deal last year is not such a good deal this year.
Before you do anything, you need to know your options. In most cases you can’t simply switch from one plan to another, except during the Medicare Annual Election Period (AEP). If your plan does not meet your needs, you need to take the time to educate yourself about your current plan and other plans so you can make an informed decision. That way, when AEP comes around, you can review the new plans, and changes to your preferred plans, before making a final decision. It all comes down to the numbers.
Is there a penalty for switching Part D Plans?
You cannot be penalized for switching plans. However, you can be penalized if you do not enroll in a Part D plan when first eligible. That said, you can only switch plans once a year, during the Annual Election Period. If you don’t switch during the AEP, you’ll have to wait another full year.
When can I switch Part D Plans?
The Annual Election Period, sometimes called “Open Enrollment”, starts on 15 October and ends on 7 December. In rare cases you may qualify for a Special Enrollment Period. Also, if you enroll in a Medicare Advantage plan, and then later change your mind, you can go back to Original Medicare and join a Part D plan from 1 January to 14 February.
When does Part D coverage begin?
When you join a PDP during open enrollment, your coverage starts on 1 January and continues for the full year. If you join during a special enrollment period, or during an Individual Enrollment Period, your coverage generally starts the following month or on the first month that you are eligible for Medicare benefits.
How do I compare Part D Plans?
Medicare.gov has an excellent tool to help you compare plans. Here’s what you do:
- Enter your zip code and medications.
- View the participating plans and compare options.
- Select the plan you want and enroll online.