The Most Overlooked Way Medicare Beneficiaries Can Save On Drug Costs

Diane Omdahl Contributor Aug 13, 2019, 11:33am

We all know that the cost of prescription medications keeps increasing.

A recent JAMA (Journal of the American Medical Association) study of the 49 common top-selling brand-name drugs available since 2012 found that 78% have seen an increase in insurer and out-of-pocket costs by more than 50%, and 44% have more than doubled in price.

What can you do about the ever-increasing cost of drugs? Typical advice includes the following: 

·         Switch to generic medications. 

·         Talk to your doctor about drug costs. 

·         Shop around. 

·         Search for prescription assistance programs. 

These are all very good suggestions and worth pursuing. But there is one other important strategy that most beneficiaries do not use.

Compare your plan to others available in your area.

How important is this? Another recent study discovered that over 90% of Medicare beneficiaries were not in the most cost-effective plan for their drug regimens. 

Let’s take a look at some recent examples I’ve discovered that show how easy it is to overpay, especially if one does not pay attention. 

·         Minna takes an estrogen medication and she has paid increasingly more for it over the last three years. She was very surprised to find the copayment for this drug in plans in her area ranged from $20 to $600. She thought all plans charged the same.

·         Barbara was not happy when she started paying over $500 for her eczema cream this year. She discovered that the plan she has been with since age 65 took this medication off its formulary (drug list) as of January 1, 2019. If she had caught this change and switched plans, her copayment would have dropped to $4.

·         Finally, Tom selected the plan with the cheapest copayment for his insulin, $24. However, because he took eight other drugs, he found the donut hole. His insulin cost increased to almost $200 a month. The plan with a $47 initial copayment would have saved him over $125 in the donut hole.  

These examples illustrate how much can change in a plan from year to year and the importance of paying attention. Your opportunity to do this is starts in October.  The Open Enrollment Period runs from October 15-December 7. Take these action steps:

·         Pay attention to the changes in your current plan. 

·         Compare the benefits and costs of other plans available in your area. 

·         Make your decision and take action by December 7.

Pay attention during Open Enrollment or you might pay more for your medications in January. 

https://www.forbes.com/sites/dianeomdahl/2019/08/13/the-most-overlooked-way-medicare-beneficiaries-can-save-on-drug-costs/#42860d5d5b19