Medicare Part D: Are you paying too much for your drug plan?

Most seniors are in the wrong Part D plan.  I saw a study last year that found  only 5.2% of seniors chose the most economical Part D plan available to them. Yesterday, I met a person who is a good example of what the study talked about.

I visited the home of Janet and Walter because Janet is turning 65 next month.  Janet told me what drugs she takes and I put them into the Medicare.gov Plan Finder. It gave me a list of the most economical Part D plan for her.  She also signed up for a Plan F Medicare supplement.

Out of curiosity, I asked Walter what Part D plan he has.  Walter said he has First Health, but he didn’t know what he pays for it.  His wife, as is often the case, knew exactly what his Part D premium was because she keeps track of the family finances.  Janet said Walter pays $53 per month for his First Health Part D plan.

I asked Walter what drugs he takes and he said, “Simvastatin and Lisinopril”.  These are two drugs he could get for $4 even if he did not have a Part D plan.  Yikes!  He’s paying $53 a month for a plan he doesn’t even need!

Walter could not tell me why he ever signed up for the First Health plan and that is understandable as he is 72 years old.  That plan might have cost a lot less five years ago.

Walter cannot change his Part D plan now.

I told Walter he cannot change his Part D plan now, but he needs to make a note on his calendar to call me during the Open Enrollment Period (October 15 – December 7).  I’m pretty sure it will be Janet making the call.

Based on his prescriptions, I told Walter he should be in a Part D plan with a $12 or $14 premium. I also told Walter and Janet they need to review their Part D plans every year during the Open Enrollment Period.

Part D makes me mad.

Medicare Part D is a good benefit, but why the heck did they make it so complicated?  There are 33 Part D plans available in Arizona, with premiums ranging from $12 to $90 per month. And those plans can change a little – or a lot –  next year. Why should people have to study their Part D plan every year?  It’s bad enough when they are “young” at 65, but how can Medicare expect people in their 80’s and 90’s to do annual reviews?

Janet signed up for a Plan F Medicare supplement and I told her she will have the “get it and forget it plan“.  I say this because Plan F fills all the gaps in Medicare, so she should have no bills for her medical care – as long as Medicare covers the service, Medicare will pay first and the F medigap plan will pay second.  But I told Janet that her Part D plan is not a “get it and forget it” plan.

Actually, Medicare supplements need to be reviewed because some companies have raised their premiums by 33% each year.  Janet told me what Walter pays for his Plan F:  $220 per month.  I looked up the rates for a healthy 72-year old and found that Walter could be paying $191 or less.   So Walter decided to change his Medicare supplement to the same company Janet chose. (I can’t name names lest someone say I am promoting a particular company.)

The lesson learned from Walter’s experience is:  Everyone needs to review their Part D plan and their Medicare supplement each year.

For a detailed explanation of Part D and how it works (and the donut hole), take a look at a short video presentation I prepared: Part D and  the Donut Hole Explained

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5 Responses to "Medicare Part D: Are you paying too much for your drug plan?"

  1. Donald Wechsler says:

    Hello…
    My responses follow for “Medicare Part D: Are you paying too much for your drug plan?”

    RE: “. . . review their Part D plans every year during the Open Enrollment Period.” COMMENT: Actually, Walter could start by reviewing his current plan’s ANOC, which should arrive in September. This, also, is a good annual practice.

    RE: “. . . but how can Medicare expect people in their 80′s and 90′s to do annual reviews?” COMMENT: For seniors with Internet access, using the Plan Finder tool on Medicare.gov is a great way to compare Part D or MAPD plans. Just enter your zip code, preferred retail pharmacy, prescription information, and the plans you want to compare. Plan Finder does the math.

    RE: “So Walter decided to change his Medicare supplement to the same company Janet chose.” COMMENT: Did Walter have guaranteed issue rights? If not, he should understand his new company’s acceptance terms before dropping his current Medigap plan.

    Don

  2. Denise says:

    Walter is healthy, so he could change his Med supp plan to a better-priced plan. He did not cancel his Med supp plan until he was accepted by the new, lower-cost plan. He applied early in the month, so he had plenty of time to get his new plan set up before cancelling his old, overpriced plan.

  3. Denise says:

    How many people do you know in their 80’s and 90’s who can muddle through the Medicare.gov Plan Finder? Why should they be at risk of ending up in an overpriced plan? Part D is needlessly complicated. 29 plans in Arizona. Why?

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