It’s Open Enrollment time for Medicare Part D. Senior citizens are checking their prescription drug plans (PDPs) to see if they can save money by switching to a different plan.

Open Enrollment started Oct. 15 and runs through Dec. 7 for the 60-plus million Americans who are Medicare beneficiaries. Any changes made now go into effect on Jan. 1, 2023.

In most cases, anyone who has Medicare Part D – which covers prescription medications – will not be able to change their plan outside of this timeframe.

Donna Krug at the Cottonwood Extension Office in Great Bend is one of several volunteers trained to help people explore their options. Those who want to do it themselves can go online to Medicare.gov and click on “Find health & drug plans.”

Krug and her husband John took the training to become SHICKs – Senior Health Insurance Counselors for Kansas. The service they offer is free. Many K-State Extension offices offer the service. To schedule an appointment call the Extension office, 620-793-1910.

Linn Hogg at Volunteers in Action/RSVP is also a SHICK, along with two of her staff, Melissa Nech and Krista Smith. Appointments can be scheduled at their office by calling 620-792-1614. They did an outreach this week at Claflin and they’ll be in Hoisington Nov. 9-10.

The ABC’s and D

Medicare is available at age 65 and consists of several “parts.” People really do need all of them, Krug said.

A and B are the original Medicare offered by the federal government – covering hospital bills and 80 percent of most medical expenses. Part C, or supplemental insurance, is offered through private insurance companies to pick up some of what A-B won’t pay, and Part D for prescriptions is offered through private insurance companies as well. 

Buyer beware of Advantage Plans

“There are also Medicare Advantage plans,” Krug said. These are different from supplemental plans and are heavily advertised this time of year. Krug said people in the more rural areas of Kansas may find that the benefits touted by the Advantage Plans aren’t all available here. Plans that say they cover things like dental and vision may work better in Wichita than in Great Bend because not all health-care providers participate in them.

“My advice is to do your homework and go to your own provider that you use all the time and say, ‘This is a plan I’m looking at switching to; would my visits be covered in your office?’”

Hogg cautions seniors not to purchase an Advantage Plan based on a television ad or a telephone call.

“Some of these plans just don’t work in rural Kansas,” she said. When in doubt, check with a SHICK.

Marry your supplemental plan; date your prescription plan.

While SHICKs field questions of this nature all year, the Open Enrollment period is when they look at PDP, the Part D Prescription Drug Plans.

It’s usually not a good idea to change supplemental plans, Krug said. That’s because companies are reluctant to pick up the tab for expensive conditions that were covered under a previous plan. But drug plans can and should be reviewed every year, or every two years at the most, because people’s medications change and so do the prices charged under different plans. That is why she says, “Marry your supplemental plan; date your prescription plan.”

It is possible to compare the costs of plans, based on the drugs used and the pharmacies used, at the Medicare.gov website.

Whether doing it themselves or making an appointment with a SHICK, it’s something that should be done regularly, Hogg said.

“It is important to check (Part D) every single year. Medications and price ranges change,” she said.  

Some people like to go online themselves but then meet with a SHICK later.

“People appreciate having another set of eyes to check over something,” Krug said. “If we can save someone $500 to $800, that’s grocery money; it’s significant. So if we can help we are happy to do that.

“I helped a lady yesterday; it took all of 10 minutes because she had a short drug list,” Krug said. After entering the information into the website, it showed her current plan was still the best option.

But when Krug helped a couple in Hays who were considering switching to a pharmacy closer to their home, the search showed the pharmacy was “out of network” for their prescription plan. Instead of hundreds of dollars a year, their drugs would cost thousands.

“We also explain to people that if they are given a new medicine, it’s always important to ask the doctor to give you a generic brand rather than the brand name.” Usually, but not always, the generic brand costs less. “You just have to be really diligent and run the numbers,” Krug said.

Things to consider

Some people put off adding a drug plan at age 65 because they don’t need it. But those who wait will be charged a penalty later when they do enroll, Krug said. The penalty increases for every month the person delays. Krug recalls a couple that waited 10 years before needing a drug plan. Eventually, they had medical issues and needed a plan. Their penalty was close to $50 a month, and it would continue from that point forward. “But during the period of 10 years, they saved money.”

That brings up another point, which is that Krug and other volunteers don’t tell people what to do. “We just tell people what the options are. We want it to be their decision.”

Krug also cautions people not to make their insurance decisions based on what their friends and neighbors are doing. “It depends on your meds and your dosages. It could be totally different for you,” she said. It’s not unusual for a husband and wife to end up with different Part D plans, because they take different medications.