Medicare Part D Open Enrollment: Oct 15 – Dec 7
October 27, 2015
BROOKINGS, S.D. – South Dakotans have until Dec. 7, 2015 to review or make changes to their current plan during Medicare Part D annual enrollment period, which opened Oct. 15.
The new plan will take effect on January 1, 2016.
Prior to Sept. 30, 2015 Medicare recipients should have received an annual notice of change and evidence of coverage documents from their current plan provider.
"Make sure to review these documents very carefully as they outline the plan changes made for the 2016 year," said Carrie Johnson, Assistant Professor & SDSU Extension Family Resource Management Specialist.
She outlines items to double check:
* Look to see if the monthly premium and/or deductible have changed.
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* Check your new co-payments for the drugs have been modified.
* Make sure the medications you are on have not been removed from the insurer's formulary.
* If you have had a change in your health since reviewing last year, make sure that your new medications are covered.
* Confirm that your medications are on the same drug tier for the year ahead. If not, you may have a lower or higher co-payment during the year.
* Make sure your pharmacy still intends to accept your plan.
To check all of these items, visit the Medicare website. Once your personal information is entered, the site it will give you the best options for your situation.
"It doesn't hurt to just run the numbers to see if making a change can save you money in the long run. If you decide not to make any changes, you can just keep your current plan and do nothing," Johnson said.
Changes for 2016 include:
* The initial deductible will increase by $40 to $360
* The initial coverage limit will increase from $2,960 to $3,310
* The out-of-pocket threshold will increase from $4,700 to $4,850
* During the coverage gap, beneficiaries will receive a 55 percent discount on the total cost of their brand-name drugs purchased while in the donut hole. The 50 percent discount paid by the brand-name drug manufacturer will still apply to getting out of the donut hole; however the additional 5 percent paid by your Medicare Part D plan will not count toward your TrOOP. Enrollees will pay a maximum of 58 percent co-pay on generic drugs purchased while in the coverage gap.
* Minimum cost-sharing in the Catastrophic Coverage Portion of the benefit will increase to greater of 5 percent or $2.95 for generic or preferred drug that is a multi-source drug and the greater of 5 percent or $7.40 for all other drugs.
* Maximum co-payments below the out-of-pocket threshold for certain low income full subsidy eligible enrollees will increase to $2.95 for generic or preferred drug that is a multi-source drug and $7.40 for all other drugs.
For assistance with finding the right plan in South Dakota, contact Senior Health Information & Insurance Education (SHIINE), http://www.shiine.net/:
* Eastern SD: 1-605-333-3314 or 1-800-536-8179
* Central SD: 1-605-224-3212 or 1-877-331-4834
* Western SD: 1-605-342-8635 or 1-877-286-9072