You thought you did it all right. You used the Medicare annual enrollment period to compare plans and found a plan that was a good match to your prescription drug list. But when you get to the pharmacy the price is a lot more than you expected.
What’s going on?
Here are 6 tips to understanding your Medicare drug plan costs (and maybe saving some money):
1. Does your plan have a deductible? If it does you have to pay the deductible amount before the plan begins paying part of the cost. So, for example, if your prescription costs $230 and you have a $360 deductible you will pay $230 the first time you get it filled; you have $130 remaining and will pay that the next time you get a prescription refilled. You continue to pay out of pocket until you have spent $360 – then you and your plan begin to share costs. Plans change each year so even though you didn't have a deductible last year, your plan may have one this year. Check your plan details.
2. Did you get a brand name rather than generic? If your plan was priced at the generic cost and your doctor called in a brand name – sticker shock! Ask your doctor if you can take the generic or another less costly drug.
3. Is it a new drug for you? Since you chose your plan, your doctor has added a new prescription. So, there is no way that could have been calculated into your original cost comparison. You’ll most likely need to wait until the next annual enrollment period to see if there is a plan that is better at covering your new list of drugs. But for now, ask your doctor if there is a lower cost alternative. Look it up in the formulary (drug list) the company sent you when you signed up to see how much you will pay.
4. Does your Medicare drug plan have a preferred pharmacy network? If your plan has a preferred pharmacy network, you will pay the lowest price using one of those pharmacies. Look up the information in the directory your provider sent you when you signed up or look it up online at the plan website. Driving a few extra miles could save you money.
5. Could mail order save you money? If the prescription is a maintenance drug mail order can be an easy way to make sure you get your refill and save some money. But check your plan costs. Sometimes mail order can cost more than going to a retail pharmacy!
6. Buying two pills can be less expensive than one. Crazy as it sounds, taking multiple units of different dosages to equal your total dosage can save you money. For example, at Longevity Alliance we recently saved a customer $500 per year on her prescription by suggesting she get her prescription adjusted to take two 500Mg per day rather than the 1000mg once a day her doctor ordered. Sometimes there are limited suppliers of a certain dosage of a medicine so the cost is higher. Check with your pharmacy to see if there are other dosages for the medication.
Bottom line. Always check your Medicare drug plan information to see if you have easy options that can save you money (different pharmacy, generic, mail order). Ask your pharmacist for alternatives and always check with your prescribing doctor.
Remember, doctors don’t know what your drug plan charges for a drug. If it is too much let your doctor know or ask the pharmacist if there is an alternative lower cost drug that you can speak with your doctor about.