770-449-7369 / Fax: 770-449-1093 info@cdainc.net

The start of the Medicare Open Enrollment period is a scant two weeks away, so it is time for us to line up our pill bottles and prepare for our annual prescription review. Open enrollment for those of us under age 65 is a scant month away.

Each year prescription formularies change for all carriers and we have a chance to prepare ourselves thus limiting the unpleasant surprises we may have to face. Drugs may be moved from one copay level to another, they may be applied to a deductible where they did not before, we may have new prescription deductible levels or our drugs may fall of the approved list entirely.

Those of us who are Medicare eligible have the opportunity to select different plans each year, but the decisions and enrollment must be completed by December 7 for the January 1 effective date. If we have worked with brokers in the past we need to reach out to them for the fact gathering form being used to update our information at www.Medicare.gov . From there the plan analysis can be completed and the appropriate consult can be had rather easily.

If we are in the habit of doing this research ourselves now is the time to prepare for the visit to the Medicare website, but it may be best to wait until a few days after the start of Open Enrollment to avoid some of the initial mad rush.

If we are under 65 and the open enrollment for our group plan is soon we need to ask for a copy of the new formulary as soon as it is available. If we need to chat with our doctors about changing drugs to stay on the list sooner is always better than later.

Why go through this exercise? Those who are Medicare eligible can select a different plan each year, but it can only be effective January 1. If we end up in the wrong plan because we did not do the proper research or failed to address this issue entirely, twelve months can be a very long time to have a drug plan that does not fit our needs. Let’s not find out that our plan does not pay the way we expect it to when we are at the pharmacy renewing our prescriptions for the first time in the new year.

Those of us who are not Medicare eligible can look at drug lists for individual coverage and make plan selections based on what we find, but this is also a once a year decision. Those of us who have group coverage may have the ability to select between plans and this may be a major consideration in that decision. Those of us who only have one plan to enroll in need to make provisions for having prescriptions covered as favorably as possible and that may require a few conversations with our providers or experimenting with alternative options that ARE covered.

All in all, a little time invested now can save a lot of expense later. Drug formularies can still change during the calendar year, but we can at least make the best decision possible when we have the opportunity enroll in a plan.

For help making sense of it all, contact us at Czajkowski Dumpel & Associates, Inc. – we are here to help!