Welcome to Medicare School Daily, where we help you understand Medicare, save money, avoid
mistakes, and above all else, get the most out of your Medicare benefits. Now, today's topic is
switching drug plans during the annual enrollment period. Drug plans are a very important part
of our health care coverage, especially if we're taking a lot of meds or maybe expensive meds or
even both. And so being on the right drug plan and staying on the right drug plan year to year
is very, very critical. Now, I want to remind you, as you enrolled into Medicare,
you made a choice whether you were going to go with an advantage plan or a supplemental plan.
If you chose to go that advantage plan, notice your prescription drug plan
is included, we called that an embedded plan. It's part of the package. So that advantage
plan covers your inpatient outpatient as well as prescription drugs. If you chose to stay in
original Medicare A and B as the first payer, then you have a supplemental plan as the second payer,
and then your drug coverage is totally separate. It's not part of your A and B,
and it's not part of your supplemental plans, it’s separate or what we call a stand-alone drug plan.
And so if we need to switch drug plans, whether it's included or separate, then
we have the annual enrollment period to do that. So here's the process that happens every year.
Number one, you're going to receive right around the 1st of October, certainly before October 15th,
but right around the 1st of October, the company who has you covered right now is going to send
you what we call an ANOC or an annual notice to change. And so they're required by law to let
you know what your plan is going to look like the following year. And so they'll say, here's what
you have with this this year and here's what we're gonna be changing going into the next year. And so
my most important piece of advice to you is: open the ANOC. Open it up and see what they're doing.
There's so many people that assume because they like the plan this year, they're going to like it
next year. Do not make that assumption because the plan has the right to change anything they want,
and they may make some change to the plan that could adversely affect you. All right? So here's
what we're looking for in the ANOC. Number one, have they changed my premium? Now, frankly,
most plans will change the premium, sometimes it goes up a few dollars,
sometimes even down a few dollars. Medicare sets the profit margins for these carriers,
and sometimes they actually have to lower their premium. But look to see what the premium change
is going to be. This past year, we had one plan that actually raised their premiums 150 percent.
And if so, someone didn’t open their ANOC, their annual notice of change, and were not
paying attention to the premium. What happened was when they got their premium bill in January,
then they realized “oh it went up 150 percent”, and now they want to switch, but it was too
late. And so open the packet; see what the premium is going to be for the following year.
The second thing they can do is they can change their formulary. They can add medications. They
can drop medications. So you want to be sure that your medications are covered.
All right? They have the right to make those changes. And so open it up and find out if
your meds are covered. Now, thirdly, what they can do is they can re-tier or
make tiering changes to a medication. All the plans will disclose the covered medications,
and with those covered meds, there will be a tiering number: 1, 2, 3,4, 5. The lower the tier,
the lower the copay. But the plans have the right from year to year to change the tier. And so you
may be on a medication this year that's tier two, and next year they bump it to a tier four,
or maybe it's a tier three this year and bump it to a tier five. I have seen tiering switches
when they switch those tiers. I've seen those move medication copays, literally $150 to $175 a month.
That means the same medication that you're on from one year to the next could go up in cost of $2,000
to you. All right? And so again, open the packet to make sure you know if there's been any tiering
changes, is that going to hurt you? Now, if you look these over and there's no changes that are
hurting you, and you're still happy with the plan, you don't have to do a thing because that plan,
when you do nothing, will automatically renew into the next year. We just want to make sure
if it auto renews it auto renewed because you wanted it to, not because you didn't open your
ANOC. All right? And so if you're happy to plan, you can keep the plan. Nothing at all
is required of you. But if you're unhappy with the plan, and they've made some kind of a change,
here's the process. Beginning October the 15th, all the way through December 7th,
what you need to do is you need to go to this website, Medicareschool.com/AEP,
the annual enrollment period. You can also do the same thing at Medicare.gov.
Both companies whether it’s Medicareschool.com or Medicare.gov, use the same company to manage
the websites. Now this is one that we have, that is our website and we can help you if you need
our assistance. You go to Medicare.gov, course you'll be on your own. But this particular site,
they both are very similar. If you go to this site here, what you're gonna have to do is you’ll have
to set up an account, and they're going to ask to do some basic information, your name and your
address and your date of birth and your Medicare number. And once you've set that account up, then
what we do is make sure you have your medications in there. If your account has already been set up,
then you just put your username and password in because it's all safe from year to year.
And then you can update your medications. And that means that if the doctor has changed dosage or
maybe frequency, then you need to update. Maybe a doctor has dropped a medication. You've added
one throughout the year, then you want to be sure your medication list is up to date, and then you
can choose your pharmacy. If you're happy with the pharmacy that you're on now, you'll just have to
confirm the pharmacy. But if you would like to switch pharmacies, then this is when you need
to do that as well. And after you've loaded that information in, now you're going to shop, you're
going to compare plans. And what the software is going to do is going to look at all the
plans in your particular zip code based upon your medications and the pharmacy you want to go to.
It's going to shop them all. It's going to look at all the plans in that market
and it’s going to take those; it's going to put them in order from top to bottom
looking at coverage and costs. So it's going to show you if your meds are covered and what the
cost of your copays and the cost the premiums will be. It'll put all them in order. And so we
recommend people definitely enroll in something that's at the top or at least the top three. Now,
sometimes the top three plans may only be a few dollars apart. So let's say this year, I'm on
a plan that next year is showing it's the number three. But there's just a few dollars difference.
You probably just want to stick with the plan because if you enroll into a new plan, you may
have to change pharmacies and your doctors may have to resend the meds. But if there's a drastic
difference in price, then we feel like it's well worth your time to switch plans, even if the
doctor has to resend the medications and you have to change pharmacies. All right? So that's the
process that's involved if you need to switch your drug plan during the annual enrollment period.