Things you should look at during Medicare Open Enrollment in Prescott – Adler Insurance Discusses Part D Plans

What changes should you make during Medicare Open Enrollment this year? Unfortunately, you may be facing some premium increases or changes to covered drugs, now is the time to review your Medicare Part D coverage to head off headaches next year. Adler Insurance, your local Medicare Broker serving Prescott and the Verde Valley (Cottonwood, Camp Verde and Sedona), would like to bring you these helpful tips.

Here’s what you should review during the annual open enrollment period so you can select a new prescription drug plan if necessary.

Covered medications. Prescription drug plans can change the medications they cover each year, and it’s important to double-check that your current medications and any new prescription drugs you expect to use in the coming year will be covered. Will there be any changes next year you need to think about?

Premium prices. Your Medicare Part D monthly premium may increase, many of the popular Part D plans have seen increases in the past years, you must weigh the amount of the change in premiums versus the inconvenience of making changes. If the changes are small you should not worry.

Cost-sharing changes. Prescription drug plans may change the co-payments and coinsurance of covered drugs each year. Most plans have structured tiers for generic drugs and brand-name drugs. Medications in each tier have different out-of-pocket costs, ranging from co-payments to a percentage of the bill. Be sure to watch for this.

Deductibles. Most part D plans charge a deductible. Some companies will charge a smaller deductible, however plans that do lower or eliminate the deductible make other changes that can raise costs for people. Watch for lower deductible with higher premiums.

Preferred pharmacies. Filling your prescriptions at selected network pharmacies will help some with certain Part D plans. Higher copayments can be charged depending on the pharmacy and whether you choose a non-preferred generic form of your medication. Get a list of pharmacies before you sign up.

Medication restrictions. Speaking of non-preferred generic medications, some Part D plans require you  to get prior authorization before they will cover certain drugs. These plans may require lower-cost drug alternatives or limit the amount of medication you can buy at one time. It may be worth it to get a plan that does not have these restrictions.

There are many options to consider. There are over a thousand different plans and options possible. There are about 30 plans that fit for most people. Adler Insurance would like to help you get the best value from this year’s Medicare Open Enrollment in Prescott and the Verde Valley areas. For more information on how we can help, contact us today at 928-710-1455 or visit our website at http://www.AdlerLifeHealth.com.

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Adler Insurance provides more information on Medicare Part D Open Enrollment in Prescott

It's important to compare your options for 2017. Plans have been boosting premiums, increasing cost-sharing, imposing new hurdles before covering expensive medications, charging extra if you don’t use certain preferred pharmacies, and making other changes that could increase your out-of-pocket costs. Adler Insurance provides what you need to know when picking a Medicare Part D plan for 2017 in Prescott.


Don't stay on autopilot. The average monthly premium for Part D is increasing only slightly.  but you could still end up paying a lot more in out-of-pocket costs if your plan increases the co-payments for your drugs or drops them from its formulary (list of covered drugs).

Find out how much you'll pay for your drugs. Don't just ask if your plan covers your drugs; instead, find out how much you'll pay for your specific medications.

Find out if you can save money at a preferred pharmacy – and if the rules have changed. Most Part D plans now have preferred pharmacies, where you will pay a much lower share of the costs than you would through other pharmacies.

Shop separately from your spouse. You and your spouse might have very different needs, depending on your prescriptions. Each of you should plug your drugs and dosages into the Medicare Plan Finder to see what each of you would pay under the plans in your area.

For more information about choosing a 2017 Part D or Medicare Advantage plan during open enrollment contact us at 928-710-1455 or by visiting us at http://www.adlerlifehealth.com. 

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Prescott Medicare Part D explained by Adler Insurance

In 2006, Medicare began covering some prescription drugs taken at home.   It introduced Part D drug plans, which are actually operated by private insurance companies with oversight by Medicare.  At Adler Insurance in Prescott, we are here to answer all your questions about Medicare Part D.

The Centers for Medicare and Medicaid Services (CMS) or Medicare is responsible for the administration of the Medicare Part D prescription drug program.  There are approximately 40 to 50 Medicare Part D prescription drug plans (or PDPs) available in each state or CMS region.

In general, Medicare Part D prescription drug plans provide insurance coverage for your prescription drugs - just like other types of insurance.  If you join a Medicare Part D prescription drug plan, you will pay a monthly premium ranging from only a few dollars up to over 100 dollars.

Some Medicare Part D or Medicare Advantage plans have an initial deductible where you pay 100% of your prescription costs before your Part D prescription drug coverage or benefits begin.  Please note, that you may pay a higher monthly premium for Medicare Part D plans with no initial deductible. Also, the amount of the initial deductible can (and probably will) change each coverage year.

Make a list of the drugs the potential subscriber to the plan needs. Then check with each plan to see which drugs are included in what's called its drug formulary.  If more than one plan covers all the drugs, choose the plan that has the fewest restrictions on access to those drugs and the lowest total costs.

Medicare's website has information about Part D drug plans available where you live, including the medications currently in each plan's formulary.  Or you can contact Adler Insurance Inc., by visiting http://www.adlerlifehealth.com or give us a call at (928)710-1455.

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What is Medicare Part D

The Medicare Part D healthcare insurance drug plan is a program designed by Medicare to help all citizens with their who are eligible for Medicare benefits pay for prescription drugs. It began in January of 2006, and has been a beneficial money saving tool for seniors.

Prior to Medicare drug coverage, most seniors had to find prescription coverage through a confusing web of private insurance companies. Now there is a single source for prescription drug coverage. Although administered by private insurers, the plans offer a nice range of coverage for a reasonable cost. Adler Insurance brings you these tips to assist you with your medicare Part D plan searching.

Many Plans, One Complicated Choice

Medicare encourages competitive pricing among the private insurance companies that provide Part D coverage. This approach translates to affordable plans from household names like Humana, Aetna Medicare and Silver
script. However, it can also result in confusion for seniors as they try to pick out the best plan from a seemingly endless list.

Raising the stakes is the fact that plan enrollment runs from October 15 to December 7, with no way to opt out. Once the choice is made, one is stuck with it, for better or worse, until that date. Also, enrollees who fail to meet certain deadlines could face a financial penalty.

Given the complexity of Part D, seniors are well-advised to educate themselves before making a decision. At Adler Insurance we are happy to help you choose the right plan for your needs.

Making Sense of Drug Costs

Prescription drugs covered by Part D are divided into four price levels called tiers, with Tier 1 being the lowest and Tier 4 the highest. Some plans may only have three Tiers. Generics and inexpensive drugs are low-tier drugs; brand-name and costly drugs carry higher tier numbers.  Lack of consistency among Part D plans means that tier designations further complicate plan selection. For example, a certain drug might be labeled Tier 2 on one plan and Tier 3 on another, yet cost less under the second plan. As a general rule, tier rankings and exclusions should not dictate plan choice. The best plan is usually the one with the lowest monthly premium, deductible and prescription costs, plain and simple.

Controlling Drug Costs

Therapeutic Interchange, or "TI" as it's called in the healthcare industry, is the process of finding medications that are similar in function to the ones you are taking. Most of the time, this is done to handle some sort of allergic reaction or side effect that is caused by taking the original drug.

However, this can be used to find lower cost medications in the same class as the medications you are taking. For example the retail price of a medication  can be up to $200 per month while a therapeutic alternative, has almost identical function to the original drug but costs only $15 or less per month.

Special Assistance

For seniors who have difficulty meeting the costs of Part D, a federal financial aid program called Special Assistance is available to help. Eligible seniors may receive subsidies on monthly premiums and drug costs, or have all expenses paid for them. Recipients of state Medicaid benefits are also entitled to Part D subsidies, and most nursing home residents over age 65 are fully exempt from all prescription costs.

In conclusion Medicare Part D is an important program that provides essential prescription drug benefits for America's senior citizens. Although the plan can be confusing, education is key to understanding the plan details and how to make them work best for the individual. Seniors should makes note of the deadlines required by the plans, and work one-on-one with their Insurance agent to customize their benefit.

At Adler Insurance in Prescott, we are happy to help you find the right Medicare part D plan to fit your needs. Contact us today 928-710-1455 or visit our website: http://www.AdlerLifeHealth.com

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