Patients who have Medicare Part D prescription drug plans most likely will see an increase in the cost of their medications next year.
According to a recent article in the AARP Bulletin, premiums for Medicare Part D prescription drug plans will increase next year by an average of 4.6%. Experts say you should look beyond what you’re paying for premiums and pay closer attention to the copays you’ll be charged for medications. One plan that charged $7 permonth for a generic drug will charge $352 permonth for the same drug. The AARP analysis also found enormous differences in copayments charged for a 30-day supply of the same drug. One example is Advair, a bronchodilator used to prevent asthma attacks and COPD flare-ups. In the state of California, the lowest copay for 30 days is $21 with the highest being $170, which is a huge difference.
You should have received your plan’s notice of change in September. It describes the plan’s tier structure, coinsurance (a percentage of the full cost of the drug, not to be confused with copays, which are flat rates) and premium increases. Read your notice carefully.
DONUT HOLE: After your initial coverage limit of $3,700 (minus your deductible) has been reached you are in the “donut hole.” For 2017, Medicare Part D will pay 49% of your generic meds cost and the Brand-Name manufacturer will pay 60% of brand-name drugs, even if your plan’s coverage says “No Gap Coverage” while in the donut hole. When you’ve reached $4,950, you are now in what’s called “catastrophic coverage” and will have a copay of 5%.
It will pay to shop around as there are 40 to 50 Medicare Part D drug plans in each state. Find more information at: medicare.gov/find-a-plan/questions/home.aspx or call Medicare at 800-633-4227. Please don’t call us at Breathe PA as you will have to contact your provider for answers. Good luck!