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TIP #1: CHECK WHAT HAS CHANGED IN YOUR PLAN:
Here's what can happen if you don't:
"Plan went from 47.93 per month to 82.10 per month -- and also droppedbrand name drugs from the doughnut hole -- Classic Bait and Switch!!!" -- Readreview here: http://www.medicaredrugplans.com/Ratings.aspx?PlanId=407E0C3D-B3FF-4420-ABB5-A1E016497E2B (*)
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"I didn't realize they use full cost of prescriptions to add towarddoughnut hole. I've reached it early in year and will not be using this plannext year." -- Read review here:http://www.medicaredrugplans.com/Ratings.aspx?PlanId=00D32196-08D0-4F27-BD9F-8F1064ACE92F (*)
Related Fact: It's the full cost of the drug (that is, what you pay andwhat your plan pays) that moves you toward the coverage gap or "doughnuthole." If you are among the millions of seniors with annual drug costsexceeding $2,510 a year, you will end up in the gap until drug spendingreaches $5,726, at which point the plans cover 95% of drug costs. If youenter the gap but don't expect to spend enough to reach the other side, try toget your medications for the lowest possible cost - which might mean goingoutside of your plan. Canadian online pharmacies often offer the lowest brandname prescription drug prices, while US pharmacies have the lowest prices ongeneric drugs. Compare drug prices for free at www.pharmacychecker.com.
TIP 3#: FIND OUT NOW WHAT'S COVERED IN THE GAP
Don't rely on what you are told. Check plan formularies and read thematerials carefully -- as these people learned:"Telephone representatives lack knowledge. For example, they were unable toexplain the coverage gap on several calls." -- Read review here:http://www.medicaredrugplans.com/Ratings.aspx?PlanId=DE16EDC1-000B-4E8E-B4A9-24BACC9096AD (*)
"I selected [the plan] based on GAP coverage and now discover that my medsare non-formulary, contrary to what I researched in December 2006. High costand few meds in formulary. Bringing my costs to unaffordable levels."
-- Read review here:http://www.medicaredrugplans.com/Ratings.aspx?PlanId=4E933638-92B1-4253-9A34-65A37441BB64 http://www.medicaredrugplans.com/Ratings.aspx?PlanId=4E933638-92B1-4253-9A34-65A37441BB64 (*)
Related Fact: Like last year, about 71% of plans don't provide anycoverage during the gap. Worse, about half of those plans that covered allgenerics last year are covering only some generics this year.
TIP #4: KEEP IN MIND THAT PLANS CAN CHANGE DURING THE YEAR
This person learned the hard way:
"My most expensive prescription was on their list on their website, intheir info packet and Walgreens print out. But when I went to fill theprescription, it was not covered. They say they can change their formularylist any time ... " -- Read review here:http://www.medicaredrugplans.com/Ratings.aspx?PlanId=4CE495D1-4EC7-44D9-B33C-E1C2AA7477D8 (*)
Related Fact: A plan can change its formulary during the year and is onlyrequired to notify you sixty days in advance. Unfortunately, you can't changeplans until the end of the year except under special circumstances, such as ifyou move to a new area or enter a nursing home.
TIP #5: UNDERSTAND WHICH DRUGS REQUIRE APPROVAL AND IF YOU'RE LIKELY TOGET YOUR REQUEST APPROVED
Some plans make it very hard to get certain drugs:
"When I looked at drug plans I ask[ed] ... if they covered Aciphex. Theytold me yes all I needed was a referal from my doctor. My Doctor hasrepeatedly tried to get Aciphex for me." --Read review here:http://www.medicaredrugplans.com/Ratings.aspx?PlanId=65
