Medicare Open Enrollment – What’s Changing

What’s Changing for Part D

Medicare open enrollment is October 15 – December 7 every year (with new plans starting January 1). It’s the time of year to take into consideration if anything has changed with your health and prescriptions.

Your current insurance carrier will be mailing the Annual Notice of Change (ANOC) to you, showing what will be changing on your current coverage.

Prescription Drugs (Part D)

The Part D standard benefits are changing (carriers must provide, at minimum, the standard benefits (or the actuarial value equivalent). Some plans provide enhanced coverage for additional premium.

There are four stages of Part D coverage: 1) Deductible, 2) Initial Coverage (where copays/coinsurance are paid), 3) Coverage Gap/Donut Hole, 4) Catastrophic.

Every Part D plan has its own formulary (or list of medications) and must include at least two drugs in each therapeutic category, and both generic and brand name options. Formularies can change annually.

Plans typically will have Tiers 1) Preferred Generic, 2) Non-preferred Generic, 3) Preferred Brand, 4) Non-preferred Brand, 5) Specialty.

If you’re looking for help searching for a new plan, please contact us so we can assist you.


 

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