Most Medicare beneficiaries don’t compare plans during open enrollment season, and may be paying more, or accepting more restrictions, than they should.
Ed note: Medicare insurance choice is impossibly confusing. If you need help, please contact https://www.shiphelp.org/ — the State Health Insurance Assistance Program. They can help sort out the programs and costs available to you for Medicare. If your medications are still too expensive, consider a Canadian pharmacy such as https://www.pharmstore.com/ for mail order delivery at a fraction of U.S. prices.
By Paula SpanOct. 30, 2021
One morning last month, Eunice Korsah, a retired nurse in Burke, Va., spent about half an hour on the phone being guided through the complexities of various plans for Medicare Part D, which covers prescription drugs.
Her current drug plan was being discontinued and the insurer wanted to move her into one with sharply higher premiums. “I decided, ‘No way,’” she said. But what to replace it with? She looked at the Medicare website for Part D plans available in Fairfax County and found 23, with monthly premiums ranging from $7.10 to $97.30. “There are so many choices, so I wanted someone to clarify them for me,” she said.
Jack Hoadley, a health policy researcher at Georgetown University, was on the other end of the call with Ms. Korsah. He has for two years volunteered with the State Health Insurance Assistance Program, or SHIP, the federally funded, free counseling service that helps Medicare beneficiaries find the coverage that’s best for them.
“Some very smart people just don’t know how Medicare works and get confused,” Dr. Hoadley said. For example, “it can make a $1,000-a-year difference if you’re willing to try several different pharmacies.”
Ms. Korsah, 74, and her son had already compiled a list of her eight medications — for blood pressure, cholesterol, acid reflux and glaucoma — and their doses. Using the online Medicare Plan Finder, Dr. Hoadley narrowed the field to three suitable selections.
With the cheapest plan, from Wellcare, Ms. Korsah’s estimated total yearly drug and premium costs (“the magic number,” he said) would be $301 a year if she used a CVS or Giant pharmacy — but $1,125 if she took the same prescriptions to a Walmart. Conversely, a Humana plan would cost $525 a year through a Walmart pharmacy, but more than twice that at CVS. With a Cigna plan, the best deal involved a mail-order pharmacy.