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Act Now During Open Enrollment or Pay Later

Oct 26, 2017

44.jpgYou’ve seen the news headline. A senior citizen is upset. “Last year, I paid only $25 for this medication. This year, it’s over $300. Why do the drug companies rip off old people?”

It’s probably not the drug company ripping off seniors; it’s more likely the seniors did not pay attention. During Medicare’s Open Enrollment Period, only 13% of beneficiaries actually check out changes in their coverage and other plans that are available. The other 87% could face some expensive and unpleasant surprises next year.

This year’s Open Enrollment is underway (October 15-December 7). Here are some important observations from 65 Incorporated’s initial reviews for clients that reiterate the importance of paying attention.

  • Pharmacies offering preferred retail cost-sharing can make quite a difference.
    Jane takes 12 medications. Her favorite pharmacy offers standard retail-cost sharing. Her monthly cost next year would be $281. If she were to switch to a pharmacy offering preferred cost-sharing, her out-of-pocket costs would drop to $162, a savings of $1,400 in 2018.
  • However, not all pharmacies offering preferred cost-sharing are equal.
    John has two preferred pharmacies in his neighborhood. At one, his copayments for four medications would be $62 a month and, at the other, $18. He would save over $500. 
  • The network of pharmacies can change. One plan’s network no longer includes pharmacies that offer preferred retail cost-sharing. A second plan is dropping a group of pharmacies from network.
  • Cheaper plans are out there. Even those who take no medications should check what's available. In some markets, the cheapest plans in 2018 started around $13 a month. Plus, there may be new new plans with lower premiums.
  • Those who just started with a Part D drug plan still need to pay attention. No matter how great your current plan may be, things can change. Here's a 65 Incorporated true story from last year.
    Tracey enrolled in Medicare in December. She found a good drug plan that covered all her drugs for treatment of a serious medical condition. She was satisfied with the coverage and didn’t see the need to do anything. However, once convinced to take a look, she discovered the current plan would not cover her most expensive medication that costs $20,000 a month. With help, Tracey found a plan to cover every medication and she pays $2,500 a month, an annual savings of over $200,000.

Pay attention now so you don't make headlines later. There are many resources available to help you with Open Enrollment, including 65 Incorporated's Medicare Tune-up ( 


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