Help! My Medicare Advantage plan costs have skyrocketed.
Here is a question a friend recently asked.
How can I get out of my Medicare Advantage plan? The costs have skyrocketed and I am very angry about this.
After a bit more discussion, we learned that our friend is not happy with her plan because the drug prices have skyrocketed. She was paying $35 a month for her prefilled insulin pen last year and now she pays almost $400. She thought insulin was capped at $35.
Our friend’s anger is directed at the wrong source. She should be mad at herself and not the Medicare Advantage plan. Last year, the insulin was covered by her plan but it was dropped from the formulary. Her Annual Notice of Changes would have alerted her to the change in coverage but she did not open it. If she had, she could have looked for another plan that still listed her insulin in the formulary. Instead, she is responsible for the entire cost of this medication. (Every plan determines which insulins it will cover and the $35 cap applies only to covered insulins.)
Our friend cannot consider changing plans until the Open Enrollment Period (October 15-December 7). Until then, she may need to talk with her physician about trying a different insulin or talking with the plan.
There’s one important thing our friend (and everyone with a drug plan) needs to do during the Open Enrollment Period. Check the costs of medications through every payment stage. The Medicare Plan Finder at medicare.gov can help with this.
Besides the fall Open Enrollment Period, there is another opportunity for those who have a Medicare Advantage plan to change coverage. During the Medicare Advantage Open Enrollment Period, January 1-March 31, an individual can switch to a different Advantage plan with or without drug coverage or drop the coverage and return to Original Medicare with a Part D drug plan.
Last updated: 12-05-2024