Skip to content

Age Spots: Time to Check Medicare Prescription Coverage

Jackie Dover

Football, beautiful foliage and Halloween are all signs that fall is here and we can enjoy some (hopefully) cooler weather. Another fall event to look forward to is the annual Open Enrollment Period for Medicare. Open Enrollment is October 15 through December 7 every year. Open Enrollment allows Medicare Beneficiaries to join a Medicare Prescription Drug plan or a Medicare Advantage Plan if they have never enrolled previously. Beneficiaries may also switch their drug plan, or switch between a drug plan and an Advantage Plan. Any changes made during this time will take effect on January 1, 2023. Medicare Part D plans cover prescription medications. Medicare Advantage Plans also known as Medicare Part C Plans are Medicare approved plans that cover Medicare Part A, Medicare Part B and usually the Part D. Medicare Advantage Plans sometimes offer services not covered under Original Medicare, things like vision, dental and fitness benefits, these additional benefits vary from plan to plan.

Medicare beneficiaries should receive an Annual Notice of Change (ANOC) from their Medicare Part D plan. This notice will explain what changes there will be to the plan in 2023. Plans can change many things from year to year and they are required to alert their members before Open Enrollment begins. A Medicare prescription drug plan can change the amount of the monthly premium they charge. A premium is a set amount of money paid to an insurance company to provide coverage.

Plans can also change how much the deducible is for each plan. A deductible, in this instance, is an amount that is paid for medicine before the plan coverage starts. Medicare sets a maximum amount for the deductible each year and the plans can charge from $0 up to the Medicare maximum, which is projected to be $505 for 2023.

Another big change that can be made to drug plans is what medicines are covered,how they are tiered and how much each copay is. Each Medicare Part D plan chooses its own formulary structure, they can drop coverage of medications, just because something is covered, this year does not guarantee it will be covered next year. Plans have the ability to determine how they tier covered medications.

Generally, lower tiers would cover generic medications with lower costs and higher tier medicines have a higher cost. Having a plan that covers your medicine is the goal of a Medicare Part D plan, so it is very important to check your ANOC for coverage changes.

At Aging Matters, we help Medicare beneficiaries determine which drug plan will best suit their needs for next year. The Medicare Plan Finder is the tool used to look at Medicare Prescription Plans and Medicare Advantage Plans. Prescription information such as name of medicine, dosage and frequency are entered along with preferred pharmacy and zip code. The available plans are sorted by least expensive coverage. The costs for each medicine, the premium amount and the deductible are easy to see. You can also compare the Advantage Plans and see the different benefits they offer. This will allow you to make an educated choice about what coverage you want for next year.

When reviewing Medicare coverage for 2023 it is also a great time to check if there are any Extra Help programs you might qualify for. Those who meet the income and asset guidelines could get help to pay the Medicare Part D premium and help with co-pays for medicine.

Aging Matters will have Open Enrollment events at senior centers, libraries and other locations throughout our service area to assist Medicare Beneficiaries, let us know if you need assistance. To make an appointment for Medicare Part D or for more information call Aging Matters at 1-800-392-8771, because Aging Matters.

Leave a Comment