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2015 Medicare Open Enrollment: What You Need to Know - Aging Wisely

Medicare prescription drug coverage

2015 Medicare Part D open enrollment is available from October 15, 2014-December 7, 2014 for current Medicare beneficiaries.

Why should everyone review their Medicare drug plan during open enrollment?

A Florida study done a couple years ago found the great majority of their sample were not in the best (most affordable) plan for them. A plan switch can sometimes save the client thousands of dollars over the year. Sometimes your current plan is still the best, but you won’t know without comparing. And, if your plan made changes or you had medical changes, another plan may be much better for you next year.

What information do you need to compare Medicare drug plans?

  1. Medicare # and effective date for Part A (see Medicare card)
  2. List of current medications (with dosages/frequency)
  3. Preferred pharmacy(ies), if applicable

Additionally, you may want to be prepared with some information on how Medicare works and your options for receiving coverage. If you plan to stick with traditional Medicare and simple review your drug plan choices, that will be pretty straightforward. But, if you are on a Medicare Advantage Plan and want to consider switching back to traditional Medicare (or vice versa), or have other coverage (VA, retiree health insurance, etc.) and may be making changes, you should have a basic understanding of the pros and cons with different options, costs, etc. (or enlist help from one of our patient advocates). The Medicare website offers a good overview and the Center for Medicare Advocacy also provides a range of educational materials.

Medicare Part D #s for 2015

The standard Part D deductible and out-of-pocket limit will increase in 2015, while donut hole (gap) coverage will increase. Looking ahead to 2015, here are some of the changes in the standard benefit as set by CMS (Center for Medicare and Medicaid Services):

  • Initial Deductible:
    will be increased by $10 to $320 in 2015
  • Initial Coverage Limit:
    will increase from $2,850 in 2014 to $2,960 in 2015
  • Out-of-Pocket Threshold:
    will increase from $4,550 in 2014 to $4,700 in 2015
  • Coverage Gap (donut hole):
    begins once you reach your Medicare Part D plan’s initial coverage limit ($2,960 in 2015) and ends when you spend a total of $4,700 in 2015. In 2015, Part D enrollees will receive a 55% discount on the total cost of their brand-name drugs purchased while in the donut hole. The 50% discount paid by the brand-name drug manufacturer will still apply to getting out of the donut hole, however the additional 5% paid by your Medicare Part D plan will not count. Enrollees will pay a maximum of 65% co-pay on generic drugs purchased while in the coverage gap.

 Contact Aging Wisely’s patient advocacy team to learn more about how we can help with your Medicare choices!

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