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Medicare Annual Enrollment Period Guide
5 Steps to Choose the Right Prescription Drug Plan During Medicare Annual Enrollment Period
As a Medicare beneficiary, you have a number of choices to make, but one of the most important can be selecting the right prescription drug plan. The Medicare Annual Enrollment Period—also known as AEP—provides an opportunity for you to look into switching to a Medicare Advantage plan or shop around for a new Medicare Part D plan.
This process might seem overwhelming or intimidating, but that’s where we come in. To get you started, here are five steps you can take to choose the right plan for you.
1. Shop During Medicare Annual Enrollment Period: Oct 15th – Dec 7th
The Medicare Annual Enrollment Period runs from October 15-December 7 each year. During AEP, Medicare beneficiaries can evaluate current coverage and make changes. There’s no requirement to take any action at this time, but people often find more affordable options or plans with more coverage. Medicare plan details can change from year-to-year, so it’s a good idea to compare your options annually to make sure your health and prescription drug needs are covered for the coming year.
2021 Annual Enrollment Period Dates
October 15, 2021
The Medicare Advantage and Prescription Drug Plan Annual Enrollment Period Begins
December 7, 2021
The Medicare Advantage and Prescription Drug Plan Annual Enrollment Period Ends
January 1, 2022
If you enroll in or change plans during AEP, this is the first day your new plan will go into effect.
2. Check Your Covered Prescription Drugs & Their Costs
Medicare Prescription Drug plans can change their lists of covered drugs—also known as formularies—and the prescription drug costs each year which can lead to you paying more (or less) for the same medication from one year to another. Your insurance provider is required to send you an Annual Notice of Change which includes any changes to plan coverage. It’s important to take the time to read through this document, as it will give you an idea of what kind of changes you will need when reevaluating your Medicare plan.
3. Understand Medicare Part D’s Four Phases of Prescription Drug Coverage
Medicare Part D helps Medicare beneficiaries cover the costs of prescription drugs. Out-of-pocket prescription drug costs may change overtime depending on which phase you are in. The four phases of Medicare Part D’s prescription drug coverage include:
Phase 1: Medicare Deductible Period
During the deductible period, you’ll be expected to pay the full negotiated amount for your covered prescription drug costs until you meet your Medicare Part D deductible. Deductibles vary from plan to plan, but it should not exceed $4451 in 2021.
Phase 2: Medicare Initial Coverage Period
During the Medicare Initial Coverage Period, your Medicare Part D plan will pay some of the prescription drug costs, while you will pay a copayment (a set dollar amount) or coinsurance (a percentage of the drug’s cost) set by your plan.
Phase 3: Medicare Coverage Gap (Donut Hole) Period
In the Medicare Coverage Gap period—sometimes referred to as the Donut Hole—you will pay 25% of the retail cost for both brand name and generic prescription drugs. This gap starts once you and your plan have spent a total of $4,1302 on your covered prescription drugs and will end once your total out-of-pocket costs for prescription drugs reaches $6,5503.
Phase 4: Medicare Catastrophic Coverage Period
While in the Medicare Catastrophic Coverage Period, Medicare Part D beneficiaries are only required to pay a small coinsurance amount or copayment during the remainder of the calendar year. This period starts once you have reached $6,550 in out-of-pocket prescription drug costs.
4. Research Benefits for those with Lower Income
While Medicare is intended to help cover health costs, you may still be required to pay for premiums, deductibles and copays. To help limit these out-of-pocket expenses, there are savings programs available to Medicare beneficiaries with lower incomes.
The Medicare Extra Help Program is intended to help individuals with limited, fixed incomes pay for some of, if not most, out-of-pocket costs that come with Medicare Part D. Extra Help is not a replacement for Part D nor is it a plan on its own. You must be enrolled in a Part D plan to receive Extra Help. Medicare Advantage plans (Part C) can often include drug coverage in lieu of a stand-alone Part D plan.
5. Let SelectQuote help you find Medicare prescription drug plans available to you.
At SelectQuote, we can help you better understand your prescription drug plan options and save you time and potentially money. In just minutes, we can compare Medicare options available in your area to ensure you’re getting all the benefits you deserve. There’s no obligation to enroll.