Listed here are tips about get your Medicare 2021 drug protection proper throughout open enrollment
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If you’re on Medicare, now is the time to make sure you don’t pay more for prescription drugs than necessary next year.
Even if you think you don’t need drug coverage or are happy with your plan, experts say it is worth evaluating your 2021 insurance options during Medicare’s open registration this fall. Doing nothing is an option, but it can also cost you more than you expected.
“We find many circumstances in which changing plans will benefit our policyholders,” said Danielle Roberts, co-founder of insurance company Boomer Benefits. “But sometimes we find that someone has the best plan for them by next year … and they can automatically renew their current plan.”
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The window to make changes to your Medicare coverage opened on October 15th and closed on December 7th. During this time, beneficiaries with traditional or basic Medicare treatment (Part A Health Insurance and Part B Outpatient Care) can add or switch a standalone Part D prescription or plan or sign up for a benefit plan (Part C). Individuals who already have a benefit plan can switch to another or drop it and return to Basic Medicare.
For 2021, the average beneficiary can choose from 30 standalone prescription drug plans under Part D or receive this coverage through a benefit plan.
The estimated average premium for a standalone Part-D plan in 2021 is $ 41, according to the Kaiser Family Foundation. Rewards range from a low of $ 5.70 for a standalone Part-D plan in Hawaii to a high of $ 205.30 for one in South Carolina.
Additionally, plans can have a deductible (up to $ 445 for 2021), and co-payments can vary between plans and specific medications.
“You should shop every year as each plan may have its own formulation – a list of medicines it covers – and some medicines will appear or be added to it every year,” said Elizabeth Gavino, Lewin & Gavino founder and independent broker and agent for Medicare -Plans.
“Or the medication may have gone up or down [in cost]”Said Gavino.
Note that beneficiaries with modest incomes and assets may be eligible for assistance with paying premiums and other co-payments through Medicare’s low-income subsidy program.
On the other hand, beneficiaries with higher incomes pay a monthly surcharge. In 2020, these fees apply to singles with an income greater than $ 87,000. It’s $ 174,000 for couples (see table below). (The exact amounts for 2021 have not yet been released by the Centers for Medicare and Medicaid Services.)
If you don’t want medication coverage because you’re not taking medication regularly, be aware that if you change your mind later, you may pay additional fees. Experts recommend getting at least some coverage to avoid late registration fees.
“Many states have plans with rewards in the $ 7-15 range so they appeal to people who are relatively healthy and sign up for Part D just so they don’t get fined,” Roberts said.
The late enrollment penalty for Part D is generally 1% for each month that you might be enrolled but do not want to (unless you otherwise have qualified coverage, e.g. through an employers plan). You would pay this fine as long as you have Part D coverage.
If you are taking insulin, you should also consider whether the plan you want is participating in a new program aimed at reducing the cost of this drug. Depending on the brand, the copay can be as low as $ 35.
“But not all plans take part because it’s voluntary,” said Gavino.
The best way to see your drug coverage options is to use the Medicare Plan Finder online. You can enter the medication you’re taking and the dosage, and the plan finder will evaluate your options.
Even if the top plan cost the slightest amount, check to see if there are any restrictions and, if so, if they are palatable to you, experts say. For example, some plans may include volume restrictions on certain medications, require pre-authorization, or step therapy (try a cheaper drug before one that costs more).