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.

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