10 Ways to Lower Medicare Part D Costs

by Julie Rains on 7 June 2013 (0 comments)

My dad tells me that healthcare is one of his biggest bills in retirement. He had open bypass surgery several years ago but is otherwise healthy, walking two miles each day at the local mall and living in his own home without a chronic illness such as Parkinson’s or diabetes.

His experience must be like that of many other retirees. An article by personal finance columnist Michelle Singletary of The Washington Post suggests that you’ll need to save over $200,000 to cover healthcare costs during your retirement just to pay Medicare premiums, copays, etc., and not counting in-home health services or long-term care if you happen to need those services.

Healthcare expenses, including Medicare Part D costs, are often higher than many people expect or can afford to pay. According to a recent Walgreens survey, more than one-third of the 31.5+ million Medicare Part D beneficiaries (37%) surveyed have daily concerns about their prescription drug costs, and one in five say they help manage medication costs by making sacrifices such as skipping doses or delaying filling a prescription.

To educate Medicare beneficiaries about cost savings opportunities and getting the most from their health plans, Walgreens has developed the You’re Worth Savings initiative with three easy steps to help save as much as 75% on prescription drug costs:

  1. Review your Medicare Part D Plan.
  2. Talk to a pharmacist, such as one at Walgreens, about cost concerns and ways you might be able to save. You can schedule a free appointment directly online.
  3. Compare copay and other costs against your current plan and pharmacy.

Through this process, you may discover ways to control Medicare Part D costs, such as:

1. Choosing a Medicare Part D Plan That Better Matches Your Needs

According the Center for Medicare Advocacy, only 5.2% of beneficiaries choose the least expensive plan. Compare Medicare Part D Plans and talk with your pharmacist to help you find the most suitable selection.

2. Getting Prescriptions Filled at a Network Pharmacy

Even if you choose one of the best plans for your situation, you may still pay more than a thousand dollars too much each year if you get prescriptions filled at a pharmacy that’s not in your plan’s network. Note that Walgreens is in the network of hundreds of Medicare prescription drug plans.

3. Using a Preferred Pharmacy If One Is Available With Your Plan

Some plans have both in-network pharmacies and preferred in-network pharmacies where drugs will be even cheaper. Using preferred network pharmacy can potentially save beneficiaries hundreds of dollars each year on prescription copay costs. But only 21% of respondents in the Walgreens survey switched to a pharmacy within their plan’s preferred network as a way to save, and 24% are unaware of whether their plan offers a preferred pharmacy option.

Walgreens participates in the preferred networks of four national Part D sponsors, offering savings of up to 75% on prescription copays over select pharmacies for a number of the plans in which it is a preferred pharmacy.

Determine whether your plan has a preferred pharmacy option in your area by reviewing your plan documents and/or using the Medicare plan finder (click on the “network pharmacies” listing under “Pharmacy and Mail-Order Information” when comparing plans to locate a preferred pharmacy if one is available; you may need to expand the radius search from the default of .5 miles to 3 miles to review nearby options). 

4. Switching to a “Preferred” Generic or Name-Brand Drug

Your medication may be on your plan’s formulary but may carry a non-preferred status as indicated by its drug tier; as a result, your copays or coinsurance may be higher than expected. By switching to a different but still effective drug, you could save money.

5. Asking for an Exception

You and your healthcare provider may find that the drug you need is not on your plan’s formulary or considered a non-preferred drug. For example, similar (and lower-cost) medications to the drug you have been prescribed may not be effective or carry unmanageable side effects. In such a scenario, you or your prescriber can request an exception with the plan to reduce your cost for the desired medication.  

6. Signing Up for 60-Day or 90-Day Supplies

You may be able to enjoy cost savings if you use 60-day or 90-day programs for refilling regular prescriptions.

7. Getting “Extra Help” From Medicare

If you meet certain conditions for low income and limited resources, you may qualify to receive extra assistance for prescription drug costs from Medicare.

8. Checking Out Programs in Your State

Your state may have a program that can help with prescription drug costs. Locate your state (if listed) on the State Pharmaceutical Assistance Programs page of the Medicare website to learn more. 

9. Learning About Cost-Savings Programs Offered by Drug Manufacturers

The manufacturer of your prescription drug may help you with the cost of your medication. Search for a Pharmaceutical Assistance Program from the Medicare website or go directly to the drug maker’s or the prescription drug’s website to determine if a program is available and if you qualify for assistance.

10. Making Sure You Get the Proper Discounts in the Coverage Gap

If you are in the coverage gap, Medicare recommends these steps:

  1. Review your Explanation of Benefits (EOB) to determine if you have received discounts.
  2. Contact your drug plan to make sure your prescription records are current and accurate.
  3. File an appeal if necessary.

There are many potential ways to save. Some require extensive research and time for implementation while others are much simpler and faster. But taking just a few steps, such as switching to a network or preferred pharmacy within your plan or finding a plan more suitable to your needs during open enrollment, can mean significant savings.

This post was made possible by support from Walgreens. For more insights from their Medicare survey, check out the infographic below.

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