Prescription Drugs Benefit program began where people could get some coverage for their prescription drugs by getting Pharmacy Benefits. You can choose to get Medical plans or drug plans as these benefits are only available through them. Because they are a type of private insurance, they come with co-payments, deductibles, and premiums. You can change your plan every year when the open-enrollment phase starts for six weeks. Senior citizens most benefit from these plans because they can also switch around every year. Also, cost sharing and premiums fluctuate regularly and the switching option can be quite helpful.
Here are the top 3 tips to consider while selecting the right Pharmacy Benefits –
Look Beyond The Premium – You need to include more factors than just the premiums. Always start by looking up your drugs in the list for every tier. There are different tiers for generic drugs, drugs with preferred brand name, drugs with non-preferred brand names, and specialty drugs. When you see your drugs falling into a plan, you also need to take a look at co-payments and how the cost sharing pans out. With the lower tiers, the co-payments are smaller because generic drugs are prescribed. With the higher tiers, the co-payments are larger. You can also ask your healthcare provider for lower tier alternatives to fit into your plan.
Navigate The Doughnut Hole – There is a coverage gap that hits when people reach a certain amount on their drug plans. It became quite famous in 2009 when seniors had spent $2700 on their coverage. For a certain time after that, there was a coverage gap when all the costs had to be borne by the seniors until it hit $4350 after which, every cost in the year would be borne by the plan. You can, however, pay some extra money to navigate through this doughnut hole. What you have to decide is whether paying this extra amount is worth it and whether you, in fact, need that much coverage. Would you end up spending more than you would save?
Research Online – There are many tools available online that would help you get the best plan that you desire. If you are unfamiliar with the internet, you can have friends and members of the family do this research for you. The best source is the Medicare.gov website where you can choose the perfect drug plan and get a lot of information about it. You can also call Medicare at 1-800-MEDICARE where they would help you out on the phone.
Every state has Health Insurance Assistance and you can also turn to them for some counselling or help about the right plan to select.