Annual Medicare Plan Review and Your Prescription Drug Coverage

If there is one thing certain in our lifetimes, it’s change. Medicare understands your needs and budget can change during the year, so you have the opportunity to address your medical needs and budget during the Annual Enrollment Period, which happens each year from October 15th through December 7th. In our experience, the Medicare Part D drug coverage is the part of Medicare that typically has the most change, so annually reviewing your Part D benefits can help you maintain benefits and control your out-of-pocket costs.

Managing Your Prescriptions and Your Medicare Drug Coverage

Maintaining an updated list of current prescription medications is vitally important so you can confirm that your Medicare Part D plan provides the proper drug coverage benefits. When you consider that numerous Medicare beneficiaries experience changes in their health that alter their dosage or type of prescription medications throughout the course of the year, it’s even more important to be sure they are covered under your Medicare plan. At times, covered drugs can be added to or removed from the formulary or changed in the assigned tiers of coverage. When that happens, a well-kept record will help inform your coverage decision when it comes time for your annual Medicare plan review.

Tracking all of your prescriptions against your Medicare plan formulary is not just a once a year task before the Annual Enrollment Period (AEP). Your prescription drug plan’s formulary, the list of both generic and brand-name prescription medications that are covered under your plan, can change during the year too in rare cases. If this happens, your plan will send written notice 60 days in advance of making these changes. (If a doctor determines you need the specific prescription that is no longer covered, you can make a written exception request.) If the plan is making changes that go into effect the upcoming plan year, they’ll send a letter detailing the formulary changes called the Annual Notice of Change (ANOC) in September before AEP begins on October 15th.

The Benefits of an Annual Medicare Plan Review

With prescription or formulary changes, beneficiaries may find they need a more suitable Medicare plan that better meets their prescription drug needs. At times, we even see a plan sponsor discontinuing a plan. The primary benefits of reviewing your plan is to help you prevent such changes from negatively affecting you. If you’re impacted by a change or loss of prescription drug coverage, this requires immediate action or you could be left without coverage or costlier coverage. It’s best to stay up-to-date on any coverage changes, check your plan’s formulary online and then research plans based on your current and anticipated prescription drug needs for the next year. An annual Medicare plan review before AEP is often the best way to prepare.

It’s a good idea to seek out plan review assistance from a licensed Medicare agent when AEP approaches. These professionals offer free, tailored guidance with extensive knowledge about local plan options, coverage changes and anticipated costs – information you need to make an informed prescription drug coverage decision. They also offer free lifetime assistance to you and all other Medicare beneficiaries so you can continue to make independent choices best suited to your needs.

During your annual review, you can:

  • Review your current plan to see if it will continue to provide access at the lowest out-of-pocket costs.
  • Explore and consider coverage that meets your prescription drug needs.
    • If your plan is not meeting your standards or you had a prescription change during the year, evaluating other options will be worth the time invested.
  • Lower out-of-pocket costs for next year with suitable prescription drug coverage.
    • After the review process, you will have confidence that you can continue to get your medications at the pharmacy of your choice at the lowest out-of-pocket costs for the upcoming year.

It’s important to stay on top of your prescriptions and ensure your Medicare plan choice offers the most suitable prescription drug coverage for your needs. An annual plan review is essential to helping ensure you have the optimal coverage and determining the best alternatives before the Annual Enrollment Period. Contact Medicare Portal for one-on-one assistance with your free annual Medicare plan review today.

Scroll to Top