The Annual Election Period for the 2021 Plan Year is approaching!

Dear Friends,

The Annual Election Period begins October 15 and runs through December 7, 2020 and is when you are allowed to change your Medicare Part D Prescription Drug Plan for the 2021 plan year or, if eligible, enroll in a plan for the first time.

We have enjoyed helping hundreds of clients during this time over the past ten years and we look forward to making our advisory service available this year as well. Our recommendations are largely dependent on the functionality and accuracy of Medicare’s online Plan Finder tool. Due to changes in the tool and the complexity of drug pricing, our analysis is more difficult and time-consuming, especially with complex drug lists. To keep our consulting fee the same ($175 per person) we ask that you complete our drug form thoroughly. To help in this regard, we’ve added an online form and the ability to pay by check or credit card. More on that below.

2021 Facts & Figures:

  • Next year there will be thirty-two plans available offered by eleven companies, same as 2020.
  • Of the two million Californians enrolled in Part D drug plans, eighty-five percent are covered by four carriers (AARP, Humana, SilverScript and WellCare).
  • Ten plans will lower their premiums and nineteen will see increases.
  • Overall, the average monthly prescription drug plan premium in CA will increase 1.45% to $45.75 per month.
  • SilverScript is introducing a new plan at $7.20 a month, the lowest premium plan available.
  • CMS has released a Part D Senior Savings Model that will cap the cost of many insulins. Recipients can expect a maximum copay of $35 for a one-month supply in those plans that participate.

If you would like to proceed with our service, which will include a plan analysis, recommendation and enrollment assistance, please complete our <<Online Drug Form>> and pay by credit card or mail a check to our new address below for $175 per person payable to OnlyHealthInsurance. If you prefer a paper form, just let us know and we’ll email or mail you one to complete and return with a check. Our last day for accepting new consultations is Friday, December 4th. Note: we do not sell or represent any Medicare Part D drug plans.

Whether you participate in our service or not, it is very important to review your plans renewal material and confirm that your current medications will be covered next year. Changes to your plan’s deductible, copays and premium will also be communicated to you in your renewal packet.

We will be supplementing information from other resources to complete our reviews and make our recommendations which are listed in the self-help section below.

Important for you do-it-yourselfers! The Medicare Plan Finder tool has a more intuitive interface and some enhancements that make it more user friendly. If you log-in or create a Medicare account, you can save your work for future use and view past drug purchases for reference. You can now enter up to five pharmacies to compare pricing and share of costs. Remember that Preferred pharmacies can provide some additional savings over Network pharmacies.

We appreciate the opportunity to assist you.

Respectfully yours,

Phil Dougherty, John Wheeler & Lois Whitley

OnlyHealthInsurance  

Self-help resources and free services:

www.medicare.gov – Using their Plan Finder tool  you can enter your medications and preferred pharmacies, review all plan options, and enroll online.

Call Medicare at 1-800-633-4227 – Medicare representatives are available 24/7 to provide free analysis, recommendations and enrollment over the phone.

www.q1medicare.com – Best private website on the subject of Medicare Part D. This site has the most information available with tools to compare plans by a number of sorting options and research drug plan formularies. You can also compare your current plan with its 2021 version. If you visit the site, be sure to choose CA from the list of states to show relevant plan options.

www.goodrx.com – A free price comparison resource for shopping prescriptions. Access coupons for discounted scripts at major pharmacies. Note: Cannot be used in conjunction with Part D plans.

 

Medicare’s New Part D Senior Savings Model

The Centers for Medicare and Medicaid Services (CMS) has released a new demonstration program that will begin on January 1, 2021. It is designed to provide Medicare enrollee’s affordable access to insulin by capping the cost of a 30-day supply to a maximum of $35. For enrollees who take insulin and enroll in a plan participating in the model, insulin prescriptions will not be subject to a plan’s deductible or see any coverage gap cost increases. CMS states that beneficiaries should save an average of $446 in annual out of pocket costs for insulin. With the Medicare Part D Election Period approaching (Oct 15- Dec 7) when members of Part D drug plans can make plan changes for the next year, it will be especially important for diabetics to review their plan’s renewal information as well as look at other plan options. For more on the Medicare Part D Senior Savings Model, visit this CMS web page: https://innovation.cms.gov/innovation-models/part-d-savings-model.

Correction to recent post: Medicare Prescription Drug Plan Annual Open Enrollment 2020

Correction: it was an acquisition of Aetna by WellCare.

The Medicare Prescription Drug Plan (Part D) Annual Open Enrollment begins October 15 and runs through December 7, 2019. This is the period when you are allowed to change your Medicare Prescription Drug Plan for the 2020 plan year or, if eligible, enroll in a plan for the first time.

2020 Update: Next year there will be thirty-two plans available, two more plans than this year. The recent accusation acquisition of Aetna drug plans by WellCare will result in some plan name changes. The trend is for additional lower premium plans; six more plans will be priced under $25 a month. However, the number of plans with deductibles will increase too. Next year only five plans will have a $0 deductible, the cheapest being $74.20. Ten plans will see premium decreases with seventeen having increases. The parameters within the Part D plan benchmark design will increase slightly (deductible, initial coverage, donut-hole and catastrophic level) resulting in a potentially higher out-of-pocket.

It is very important to review your plans renewal material and confirm that your current medications will be covered next year. Changes to your plan’s deductible, copays and premium will also be communicated to you in the renewal packet.

If you would like our assistance in evaluating all plans, we again will be offering our advisory services. For our evaluation, recommendation and enrollment assistance, we charge a $175 fee per evaluation. (Note: we do not sell market or represent any Part D drug plans).

If you would like our assistance, please request our Prescription Drug form and we’ll send you one. Once you have completed the form, mail it to the address below along with a check for $175 payable to OnlyHealthInsurance. We will then contact you with results, a recommendation, and assist with enrollment as necessary.

Important for you do-it-yourselfers! It will be important to get an early start this year. Medicare has changed their Plan Finder tool significantly. It offers a much more user friendly experience however some key information and functionality have been removed. We will be supplementing information from other resources (some are listed in the self-help section below), to complete our reviews and make our recommendations.

We appreciate the opportunity to assist you.

Medicare offers free resources to assist you in evaluating plans and enrollment:

  • www.medicare.gov – Using their Plan Finder (www.medicare.gov/find-a-plan) you can enter your medications and preferred pharmacies, review all plan options, and enroll online.
  • Call 1-800-633-4227 – Medicare representatives are available 24/7 to provide free analysis, recommendations and enrollment over the phone.
  • www.q1medicare.com – Best private website on the subject of Medicare Part D. This site has the most information available with tools to compare plans, search the drug formulary of any plan and review star ratings.

Medicare Prescription Drug Plan Annual Open Enrollment for 2020 Plan Year

The Medicare Prescription Drug Plan (Part D) Annual Open Enrollment begins October 15 and runs through December 7, 2019. This is the period when you are allowed to change your Medicare Prescription Drug Plan for the 2020 plan year or, if eligible, enroll in a plan for the first time.

2020 Update: Next year there will be thirty-two plans available, two more plans than this year. The recent accusation of Aetna drug plans by WellCare will result in some plan name changes. The trend is for additional lower premium plans; six more plans will be priced under $25 a month. However, the number of plans with deductibles will increase too. Next year only five plans will have a $0 deductible, the cheapest being $74.20. Ten plans will see premium decreases with seventeen having increases. The parameters within the Part D plan benchmark design will increase slightly (deductible, initial coverage, donut-hole and catastrophic level) resulting in a potentially higher out-of-pocket.

It is very important to review your plans renewal material and confirm that your current medications will be covered next year. Changes to your plan’s deductible, copays and premium will also be communicated to you in the renewal packet.

If you would like our assistance in evaluating all plans, we again will be offering our advisory services. For our evaluation, recommendation and enrollment assistance, we charge a $175 fee per evaluation. (Note: we do not sell market or represent any Part D drug plans).

If you would like our assistance, please request our Prescription Drug form and we’ll send you one. Once you have completed the form, mail it to the address below along with a check for $175 payable to OnlyHealthInsurance. We will then contact you with results, a recommendation, and assist with enrollment as necessary.

Important for you do-it-yourselfers! It will be important to get an early start this year. Medicare has changed their Plan Finder tool significantly. It offers a much more user friendly experience however some key information and functionality have been removed. We will be supplementing information from other resources (some are listed in the self-help section below), to complete our reviews and make our recommendations.

We appreciate the opportunity to assist you.

Medicare offers free resources to assist you in evaluating plans and enrollment:

  • www.medicare.gov – Using their Plan Finder (www.medicare.gov/find-a-plan) you can enter your medications and preferred pharmacies, review all plan options, and enroll online.
  • Call 1-800-633-4227 – Medicare representatives are available 24/7 to provide free analysis, recommendations and enrollment over the phone.
  • www.q1medicare.com – Best private website on the subject of Medicare Part D. This site has the most information available with tools to compare plans, search the drug formulary of any plan and review star ratings.

Medicare Prescription Drug Plan Annual Open Enrollment for 2019 Plan Year

The Medicare Prescription Drug Plan (Part D) Annual Open Enrollment begins October 15 and runs through December 7, 2018. This is the period when you are allowed to change your Medicare Prescription Drug Plan for the 2019 plan year or, if eligible, enroll in a plan for the first time.

2019 Update: Overall the news is good. Five additional plans will be offered next year for a total of thirty plans. There will be twice as many plans under $25 (6) and eight plans with rate decreases. Five plans will see rate increases with a weighted average of $5.90. Also, the Coverage Gap or “donut-hole” parameters will improve ahead of schedule. By 2020, beneficiaries were expected to only pay 25% of their brand name drug costs while in the donut hole. But that change is coming a year early. Next year, the discounts provided by drug manufacturers and plans for brand-name drugs will increase to 75% thereby closing the gap.

It is very important to review your plans renewal material and confirm that your current medications will be covered next year. Changes to your plan’s deductible, copays and premium will also be communicated to you in the renewal packet.

If you would like our assistance in evaluating all plans, we again will be offering our advisory services. For our evaluation, recommendation and enrollment assistance, we charge a $175 fee per evaluation. (Note: we do not sell market or represent any Part D drug plans).

If you would like our assistance, please print our Prescription Drug form. Once you have completed the form, mail it to the address below along with a check for $175 payable to OnlyHealthInsurance. We will then contact you with results, a recommendation, and assist with enrollment as necessary. For those of you wanting to review plans on your own, there are self-help resources available which I have listed below.

Medicare offers free resources to assist you in evaluating plans and enrollment:

  • www.medicare.gov – Using their Plan Finder (www.medicare.gov/find-a-plan) you can enter your medications and preferred pharmacies, review all plan options, and enroll online. Medicare also has a new demonstration video to walk you through the process step by step. See the video link on the Medicare home page.
  • Call 1-800-633-4227 – Medicare representatives are available 24/7 to provide free analysis, recommendations and enrollment over the phone.
  • www.q1medicare.com – Best private website on the subject of Medicare Part D. This site has the most information available with tools to compare plans and enroll online.

 

If you have friends and family entering Medicare, be sure to pass along our information. We love and appreciate your referrals!