From October 15th to December 7th (Annual Enrollment Period, or AEP), you may change Medicare Part D plans. How do you know if you should make changes to your Part D coverage?
If you find that the prescriptions you need are no longer available or are more expensive under your current plan, you should consider making the change. Let’s take a look at the different plan options under Medicare Part D you can change to during AEP.
Tier 1: Preferred Generic Prescription Coverage
If your plan covers preferred generic prescriptions, you will pay anywhere from $1 to $3 for the drugs you receive. This is the least expensive of the 5 tiers but, like all of the tiers, your specific prescription need may not be covered here.
Typically, however, the preferred generic tier offers essentially the same effects and benefits as regular generic (tier 2) and brand name (tier 3). Be sure to compare your current prescription for its equivalent before changing Part D plans.
Tier 2: Generic Prescription Coverage
There are some generic drugs that are not considered “preferred.” That being the case, if your plan covers generic prescriptions, you will pay $7 to $11 for the drugs you receive.
It is a bit more expensive than the first tier, but still a viable alternative to higher tiers if the prescription(s) you need are unpreferred.
Tier 3: Preferred Brand Name Drug Coverage
With a preferred brand name drug coverage plan, you will pay $38 to $42 out-of-pocket for each prescription you receive.
This is, of course, a pretty big jump in cost from the previous tiers. Brand names will always be more expensive than generic, and oftentimes, your brand name drug will have a generic equivalent. If that is the case, consider changing your tier 3 to a tier 1 or 2 Part D plan.
H4: Tier 4: Non-Preferred Drug Coverage
Sometimes, you must take the brand-name drug, and sometimes, it is not considered “preferred.” If that is the case, for a Non-Preferred Prescription plan, you will pay 45-50% of the cost for each drug you receive.
Tier 5: Specialty Drug Coverage
For specific healthcare needs, sometimes the prescriptions are simply unavailable in the lower tiers. In this case, it would be considered a specialty drug.
If your plan covers specialty drugs, you will pay the most out of any of the other types of coverage. If you no longer need this coverage, then, be sure to change your current Part D plan and disenroll from this tier. Generally, you will have to pay 25% to 33% of the retail cost for drugs in this tier.
Get Free Insurance Help From the Experts — Call Trusted Senior Specialists
Unsure if the drugs you need are covered under your plan? Need to change Part D plans but unsure of how to start? We can help — for free insurance advice, call Trusted Senior Specialists at (855) 952-1941.