By Cheryl Field
January is a month that brings a fresh start to so many of us. As an expert in senior care, January means you might have questions on payments for your prescription medications. Now that the New Year is here, I thought I would outline some considerations for your Part D Prescription drug plan you will need to pay attention to.
Starting January 1, each year you will pay 100 percent of your prescription medication until you reach your copayment limit which is $545 in 2024 This is Phase 1 of the plan. After this point, you will enter what’s called the “initial coverage” phase - the Phase 2. Most of you will stay in this phase all year. You pay copayments and coinsurance, and your health plan pays the rest of the prescription costs until the total cost of your prescriptions reaches $5030 in 2024.
MOST Americans over 65 will stay in Phase 2 until January 1 of the next year. For some with very high costs of medications you might enter the third phase called the “coverage gap”, also called the donut hole. In this phase, you are paying 25 percent of brand name drug costs until the total costs of medications total $8000 in 2024. Again, this occurs for about 10 percentof Americans over age 65.
The fourth phase is called catastrophic, where you pay 5 percent of coinsurance costs until December 31st. Then January 1 arrives you go back to Phase 1. Now is a good time to check your medications. Plan ahead financially for later in the year should you think you might enter the less-than-palatable “donut hole”. For more questions on Medicare and Managed Care follow me on Facebook Tuesday nights for an open question-and-answer session. Visit my website, join my newsletter, submit your questions, and let me know how I can help you. Tips for Considerations for Medicare Part D
Review Medications. Check if your prescriptions are covered and at what cost.
Compare Plans. Explore various Part D plans to find the most suitable one.
Consider Premiums and Deductibles. Assess the overall cost of each plan.
Network Pharmacies. Confirm if your preferred pharmacies are included.
Coverage Gap ("Donut Hole"). Understand how this phase impacts your costs- email me if you need a one-page handout you can understand and refer to.
Formulary Changes. Check for any medication list modifications in the new plan.
Star Ratings. Consider plans with higher ratings for better quality coverage.
Seek Extra Help. Determine eligibility for assistance in covering Part D costs. www.cherylfield.com www.linkedin.com/in/cherylfield1621 www.facebook.com/cheryl.field.18 @cefield50 info@cherylfield.com
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