Blog

Medicare

November 8, 2016
By Frank Marano

Fall is here, and that means it’s time for hot drinks, pumpkin-flavored treats, turning back the clocks, and Medicare Enrollment.

Rising prices, the addition of new medications, and changes in formularies will raise Part D rates for 2017. Here’s what you need to know to make sure you’re ready for the new year:

The annual deductible for some Part D plans is increasing to a maximum of $400 in 2017. Most plans will change from a fixed copay to a co-insurance of 30%, 40%, or 50% for nonpreferred drugs. This is adding a lot of confusion and extra cost for many of my clients.

In 2017, people will reach the Medicare Part D coverage gap — also known as the donut hole — possibly later in the year than they did in 2016. They’ll enter the gap when their total drug costs, including the plan deductible, reach $3,700. They remain there until their total out-of-pocket spending reaches $4,950.

Another change in the coming year is that when Medicare participants reach the gap, they’ll pay 40% of the cost of brand-name drugs and 51% of the cost of generic drugs. The good news is this is down from 2016. The decline will continue until 2020 when the gap is theorized to disappear.

All Part D plans have different preferred pharmacies. I recommend that clients shop all their medications at many pharmacies to find the best rates. Some clients have saved hundreds of dollars getting each drug at a different pharmacy. When filling prescriptions, it’s important to ask the pharmacy to run each drug without the Medicare prescription card. This may save on some of the more expensive drugs.

Join the conversation.

Please share and contact me if you have any questions.