How To Find Medicare Part D Costs For Your Medications


one of the most challenging parts of
Medicare is finding the right Part D drug plan for your situation but not to
worry I’m here to guide you through the process my name is Joann Quinn I’m an
independent insurance agent and co-founder of remedigap.com a few
years ago I created a video about how to find the right part D drug plan for your
medications using Medicare’s plan finder tool since that time Medicare has made a
few updates to their tool and I’ve come across some valuable tips on how to
really narrow down the right Part D drug plan for you so in this video I’m going
to step you back through the process and this time I’m going to include how to
actually look at your medications and find the cost that Medicare is showing
you per medication this will help you see how a deductible comes into play and
how other coverage levels may impact your cost and as always if you stay to
the end of the video I’ll share with you some additional bonus tips on how to
make the Part D process less stressful so let’s get started by going to
Medicare gov the first thing you want to do when you’re at Medicare gov is select
fine health and drug plans this first green button and then you’ll want to put
in your zip code then find plans and this is step one of four so you’ll
select Original Medicare tell a little bit more about yourself so I get help
from Medicaid or any of these other areas would you like to add drugs yes we
do and we’re going to continue to plan results in step 204 is to enter your
drugs so here you will you have two choices if you’ve already done this
before you’re going to put in your drug list ID over here and your password date
from when you created the drug list if you’re new you’re going to now put in
your medication so let’s start with one that I know is expensive and add that
Eliquis and then we’ll add a couple other
and ones like losartan smbus that everything looks great go to my drug
list is complete the next screen step 3 of 4 select your pharmacies so I’ll just
select a couple of pharmacies nearby and then continue and prescription drug
plans with Original Medicare is going to be our selection that’s the first option
this is step 4 for and I also want to point out that we’re going to be viewing
plan data for 2019 if you’re watching this video and it is towards the end of
the year you may need a drug plan for the last couple months for the last
month of the year then you’ll want to make sure you’re looking at the right
year ok so that was just a little side note now on step 4 or 4 we’re going into
prescription joy plans with Original Medicare and continue and also another
side note if you’ve entered your drugs go ahead and write down your drug list
ID number that was created and your password date but that in a safe place
so that next year when you come back in here to review your drug plan you can
easily pull up your information and you don’t have to start all over
so what Medicare is showing us is this would be the cost if you did not have a
charge plan in place meaning a full price for the medications so we’re just
gonna scroll on down and find the plans for our medications how Medicare sorts
these is by louis estimated cost for your medication so they are an order
based on that so Medicare’s telling us for the drugs that I put in that this
silverscript choice plan is the lowest cost option and here’s how it breaks it
down by an annual cost here’s the overall cost this does include the
monthly premium here’s the mail-order cost also includes the monthly premium
this plan does not have a drug deductable
all my drugs are on formulary that’s fantastic
and here’s a drug copay coinsurance amounts this is what gets very confusing
when you just look at this information because it’s so broad but so what we
need to do is look at the breakdown of cost and that’s what I’m going to show
you today the next plan is well care value script monthly premium annual cost
drug deductible and then you can just keep scrolling down the list and as
you’ll notice the annual cost get a little bit higher and that’s because how
Medicare sorts us by louis estimated cost so let’s do this let’s look at the
breakdown of cost for the medications this name the name care of the plan is a
hyperlink so if you click on it it’s going to open up into a whole new screen
and it’s going to give us information just for this plan
so here’s silverscript choice here are the star ratings this little end right
here just means it’s provides covered name coverage nationwide and here’s the
monthly premium no drug deductible here’s our cost at CBS at Publix
mail-order remember this also includes the drug premium and if I come down even
further this is where we get all the good information here’s CBS as a
preferred retail cost sharing pharmacy with this plan so I’m going to get the
best price at CBS we’re gonna be a little bit more at public so I’m gonna
stick with CBS and it’s showing me that Eliquis is $45 during the initial
coverage level losartan is a dollar 47 the statin is a dollar thirty seven well
what does this all mean because we see initial coverage level coverage gap
catastrophic coverage we also see full cost of drug so what applies to you not
this come full cost of drug is just letting you know this is the cost if you
had to pay out-of-pocket the initial coverage level equates to the green on
this bar graph since you don’t have a deductible with this silver skirt plan I
don’t have to worry about satisfying you know initially $400 towards this
medication so I just go right into initial coverage level and then what
happens is towards the end of the year I start creeping into this red portion
which is the coverage gap which is also known as the infamous
doughnut hole and that’s because the drug company has paid their portion of
costs for the medications they’ve met their threshold so now it’s becoming
more my responsibility especially for the Eliquis the good news is that the
drug manufacturer this year in 2019 for the doughnut hole is picking up more of
the cost about 75% so that means your portion is getting smaller during the
doughnut hole if you fell into catastrophic coverage which would be
this column right here we would see blue on on the bar graph so let’s scroll down
a little further and here’s my Eliquis is a little more expensive it’s a Tier
three preferred brand so that’s why we’re hitting that doughnut hole
coverage gap I’m gonna come back up and stay within Medicare is a tool here and
just hit return to previous page okay so now we’re back and we’ve got the other
plan the WellCare value script just open it up and take a look and we can see
that CBS as a preferred pharmacy here and Publix is still standard so now
here’s where we’re gonna see a difference because let me skull rock ups
sorry about that annual joint deductible with this plan is four hundred fifteen
dollars so because Eliquis is a Tier three preferred brand you have to
satisfy the deductible before you receive the initial coverage level price
the losartan and the statin are both low tier either Tier one or tier two
preferred generic and so with this plan there’s a zero dollar copay you don’t
have to satisfy the deductible first for these medications because they are low
tiered so that’s the good news with those medications but with this
particular Tier three medication got us you have to set us
that deductible first and then you drop down into initial coverage level so this
deductible column equates to the orange and then the green that you see here is
this column initial coverage level and then of course we’re falling into the
doughnut hole and the coverage gap which is the red and the only thing that you
can do is compare plans side by side so I’ll take the silver script choice the
well care value script because you see even though it has a lower premium
doesn’t necessarily mean it has lower cost for you and we’ll do the at none
the top three it will compare these plans side by side compare this is one
of my favorite things to do aside from looking at the breakdown of cost I like
comparing side by side so we they all have nationwide coverage here’s their
premium here’s the drug deductable and here is your cost so I like to find okay
whose the lowest CBS or mail-order here and this is silver script choice and but
what’s really cool about this is you can look at the breakdown cost month 1
through 12 so in these two plans off the get-go and on the front end you’re
paying real high portion cost for that medication because of the tier 3 status
so you’ve got you have to meet the deductible but with a silver script plan
I didn’t so my cost out-of-pocket are pretty
predictable I do meet the donut home with each one of these plans and here’s
what happens and tells me what month and then the cost associated the other thing
I can do is look at any restrictions with the plans so no restrictions with
this plan or this one this particular plan has some quantity limit
restrictions what if you’ve determined the plan that you want what do you do
now well you have a couple options you can call Medicare directly and they’ll
enroll you over the phone Medicare’s open 24 hours and you can also go
through the enroll button I know I have another video that tells you to be
careful of the enrollment button and definitely always be careful
of that but this is Medicare’s tool this is Medicare gov as long as you’re on
Medicare gov and you use the Medicare Plan Finder tool they’re not going to
sell your information because this is Medicare’s tool and you’re enrolling
directly in a Medicare Part D plan through Medicare and you can also call
the insurance company directly so remember to click open that hyperlink it
says non-member called this number to enroll directly so you will have those
three options for enrolling so if you’re still here with me that means they’re
ready to see the bonus tips to make this process a little bit smoother what you
put in Medicare’s Plan Finder tool is not set in stone that means any
medications you put in there any pharmacy information you put in there
doesn’t mean that you have to get those drugs at the pharmacy that you’ve put
into the plan finder tool so let’s say you’re reviewing cost at a CVS or a
Kroger that doesn’t mean you have to go to those pharmacies because you put them
in Medicare’s plan finder tool it just means you were looking at the cost for
those medications at those particular pharmacies you can go to any pharmacy of
course it’s always best to go to a pharmacy that is going to provide you
the preferred pricing the best price for your medications for the plan you choose
but whatever you put into the plan finder tool is not set in stone so
Medicare is not looking at that saying you must go to XYZ pharmacy that’s not
the purpose of that tool the tool is there for you to use to find the right
part d drug plan but Medicare doesn’t hold your feet to the fire and make sure
that you go to those particular pharmacies double-check the cost of your
medications now not everyone has to do this because some people are going to
take lower generic tier one to your two medications with a very low co-pays but
sometimes we have expensive medications and we may come across a part D drug plan
that is half the cost overall compared to other drug plans and it may seem too
good to be true so I like to recommend that perhaps you go to that company’s
website or you can call the company but find out
if their information matches Medicare’s information in the drug plan
finder tool check your enrollment status so you’ve enrolled with your Part D drug
plan either you did it by contacting Medicare directly you did it through the
plan finder tool or you called the actual Part D drug plan and enrolled but
how do you know that your enrollment went through well after a few days
typically three to five days you can go back into Medicare gov and see your
enrollment status you are signing up for a new drug plan during the annual
election period which is October 15th through December 7th and your new Part D
drug plan is beginning January 1st what do you do with that all drug plan
you don’t have to worry about it Medicare’s going to take care of that
for you they actually cancel your old drug plan
for you with the last day of coverage being December 31st and they’ll let that
drug plan know that you’re starting a new plan effective January 1st don’t
forget you have a mind medicare.gov account maybe you’ve already activated
it maybe you haven’t but you may want to go ahead and do that because if you’re
waiting for your Part D drug plan card because you’ve enrolled in a plan and it
hasn’t arrived it’s been a couple weeks generally does take about ten days
business days to get your information but let’s say time is dragging on and
you haven’t received it or you enrolled in your plan towards the end of the
month and you have not received your card it’s now the beginning of the month
you can go to your mind med Medicare gov account and print out your Part D drug
plan information and take it to the pharmacy well I hope this information
has been helpful but if I missed anything please let me know in the
comment section so that I can address it for you and if you are new to Medicare
and you’re finding the whole process overwhelming don’t worry you don’t have
to do this alone I have a free Medicare eCourse that will guide you through the
process it’s one email lesson a day over the course of a week just to make the
process a little bit smoother for you and as always I’m very thankful that
you’re here with me today and if you found this video helpful
please give it a thumbs don’t forget to share it with others who
may benefit from this information and I look forward to seeing you next time bye
for now pear no yes you thought now the cost for each individual item in
not necessarily the one put in the Medicare planner