You may be feeling the post-summer blues, but don't let the doldrums keep you from making money-saving
It's an especially good time to consider changes. Drug prices are rising and provider networks for Advantage and individual plans are narrowing. Also, about 30 percent of beneficiaries of traditional
Be sure to review the notice that you received in September from your Part D or Advantage plan. The notice explains changes in coverage and costs. Even a small change, such as a new cost-sharing level for one of your drugs, can substantially raise your out-of-pocket costs. "For a specific person with particular needs, a plan could get markedly better or worse," says
PART D DRUG PLAN
First, make sure your drugs are included in the plan you're considering. Insurers are paring their formularies and dropping coverage of some expensive options. "They're getting more aggressive with drugs on their formulary exclusion list," says
Although the average premium for Part D is expected to remain at about
Look at the share of the costs you will have to pay for each drug. Insurers are charging consumers as much as 30 percent to 50 percent of the cost for specialty drugs. For example, before you even reach the Part D "doughnut hole" coverage gap, you may have to pay
Most insurers have also increased cost sharing for drugs in the nonpreferred and preferred brand-name drug categories -- rising to a median of
Insurers are also imposing more restrictions on the use of brand-name drugs, such as requiring prior authorization from your doctor or requiring you to try lower-cost drugs first (known as step therapy). Before switching plans, find out if there are any hurdles before the insurer will cover your brand-name drugs.
Ask your doctor if you can switch to a generic drug or other lower-cost option before you pick a plan for 2016. "The cost sharing for preferred generic drugs has actually gone down," Neuman says. The median cost of a 30-day supply is
You'll need to pay a larger portion of the price for your drugs when you hit the doughnut hole. In 2016, your Part D plan will provide coverage until your drug expenses reach
You can compare plans available in your area with the Medicare Plan Finder at www.medicare.gov/find-a-plan. Type in your drugs and dosages, and you'll see the premiums and total out-of-pocket costs for your specific drugs over the year, including a monthly breakdown of your costs.
Also see if you can save money by using a plan's preferred pharmacies. "There has been an explosion of preferred pharmacy networks over the past four years," says
The difference can add up, even for generic drugs. If you use two common generic drugs (such as Lisinopril for high blood pressure and Metformin for Type 2 diabetes), you'd pay
ADVANTAGE PLANS
Instead of getting a Part D plan and a Medigap supplemental insurance policy (more on Medigap later), you can get both medical and drug coverage through a private
The costs, coverage and networks can change from year to year. "It's easy to focus on premium, but it's hugely important to make sure you have access to the doctors you want to see, and the drugs and pharmacy you use," says Avalere's Shannon. Cost sharing also varies from plan to plan.
As with Part D plans, it's essential to check the costs of drugs in Advantage plans. Cost sharing for brand-name drugs increased by about 70 percent for Advantage plans from 2006 to 2014, with the median co-payment at
To compare costs for all of the plans in your area, use the Medicare Plan Finder. After you list your drugs and dosages, you'll be taken to another page. On the left panel, you can refine your search by your health status (excellent, good and poor), for example. Then click on "Medicare Health Plans with drug coverage."
Compare premiums as well as deductibles for your drugs and various medical services. You can also compare cost-sharing for services and supplies that you use, such as podiatry and mental health care. Also compare the out-of-pocket maximum.
Check out the plan's star ratings, which measure customer service and access to care. Very few plans have the top 5-star rating, but plans with 4 and 4 stars are usually good, too.
In addition to using the Plan Finder, you can review analyses of plans offering best values in your area for good, fair and poor health levels at MedicareNewsWatch.com.
Find out if your key doctors and hospitals are included in the plan's network. Plans can change provider networks every year, so don't assume that your doctors in your current plan will be included in 2016.
Also ask what happens if you go out of network. Some HMO plans don't let you use non-network providers except for emergencies. Some preferred-provider plans (PPOs) let you go out of network, but charge much larger out-of-pocket costs.
Supplemental insurance. You may be able to save money by reassessing your Medigap plan, which fills in many of traditional
Medigap plans are sold by private insurance companies in 10 standardized benefit designs, named A through N. Premiums can vary enormously from company to company, even though each letter plan has the same coverage. A 65-year-old
You may also be able to cut your premiums by switching to a plan with more cost sharing. "The Medigap policies that cover everything can be very attractive, but a person could be overinsured and paying more than they need to for their premiums," says
Plan F also has a high-deductible version, where you pay
Also consider Plan N, which offers low premiums in return for some cost sharing. The coverage is similar to Plan F, but you have to pay the
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Kimberly Lankford is a Contributing Editor at Kiplinger's Personal Finance magazine. .