Be Prepared for Quicksand and Hidden Traps
For several years now I’ve wanted to do a deep dive into Medicare Part D prescription drug costs. I had run various scenarios from time to time to illustrate some examples. But had not carved out time to put on my scuba gear and go for a dive. What are our seniors dealing with when shopping for their prescriptions? And, what’s in store for us Boomers as we get ready to enter Medicare?
I’ll get to the punch line right here: I was shocked and disillusioned.
First, the Bottom Line
After spending upwards of 80 hours using the Medicare “find plans” tool, I came away wrung out, disappointed, and mad. Most people are not going to spend this kind of time analyzing their prescription drugs from every angle.
But the facts were glaring. You can go wrong in so many ways. There are no warnings quicksand is ahead. The premiums of the Part D prescription drug plans are generally reasonable. But the costs of the drugs can be astronomical. This is beyond unacceptable for American seniors.
I think you know I contribute to Retirement Daily on The Street each month. I cover something retirement-related or something I think readers will be interested in. As part of my focus on Medicare this year, I did a small analysis on Rx costs. I say small, but that’s only because I could only cover one zip code. I researched seven different zip codes. But we have tens of thousands of them in the US. And, every Medicare option is based on your personal zip.
The bottom line is my hair was on fire as I dug into Medicare Part D prescription drug costs. And it’s still singed and smoldering.
A Series of Simple Questions
I was simply looking for basic information that anyone on Medicare is expected to do each year. Just looking for the lowest cost option for Part D prescription drugs. I explored a number of questions I figured were pretty common for retirees:
- How much would it cost someone taking two generic blood pressure medications?
- What happens if a “designer drug” is added to the mix?
- With diabetes on the rise, how much does the management drug, Metformin, cost?
- What about costs for a brand-name drug and its twin generic option?
- There are so many specialty drugs heavily advertised. How much do they cost?
At the end of the analysis, I ended up with not one, not two, but three separate articles for Retirement Daily! There were simply way too many gotcha’s to include in just one article.
Direct Links to the Medicare Part D Prescription Drug Costs Articles
You can find the articles, called Medicare Part D Prescription Drug Cost Analysis: Shocked and Disillusioned here:
Part 1 explores the basics of generic drugs. The article highlights how what should be so easy is fraught with peril for the unsuspecting. <click here for the article>
Part 2 shows the high cost of a specialty drug, Dupixent. And how dramatically the generic drug prices change. <click here for the article>
Part 3 covers the insanely high costs of those “specialty” drugs. They are heavily advertised on TV and in virtually every magazine. <click here for the article>
At the end of many days immersed in the cost analysis, I wrote,
“Of all the issues older American run into when dealing with Medicare, none may be as shocking, frustrating, and downright egregious as choosing a Part D prescription drug plan.”
Some Tips for Getting Started with Your Part D Research
Even if you only take one generic medication, you will want to spend some time exploring your options. Simply assuming you’ll buy your drug at the same pharmacy you do today is likely a costly mistake.
Here are several pointers for getting started with your Medicare Part D prescription drug costs. Most important tip of all? Do not delay!
- Get very familiar with the “find plans” tool on Medicare.gov. You can use it without logging in to start exploring how your drug coverage will work.
- Set aside plenty of time to do your research. Especially if you are diabetic and on insulin. Many new cost and delivery programs are in test-mode. It may take more time to explore the choices you have in your zip code and county.
- Print the results as you go through each iteration. The information quickly becomes overwhelming, especially as you test out more than 5 pharmacies. (You can only get 5 sets of results at a time.)
- Pay very close attention to the pharmacy status. You’ll usually find the lowest cost drugs in the “preferred, in-network,” but not always. Other pharmacy status categories are “standard, in-network” and “out-of-network.” The status for each pharmacy changes by insurance company.
- When you first get started, you’ll see all the insurance companies that sell Part D plans in your local area. Use the “compare” option at the overview level to review some topline results. I always compare the lowest cost plan vs. the highest cost plan and choose one in the middle.
You won’t know what you’re looking for at first. But keep digging and eventually you’ll surface from the quicksand you’re in. It’s at that point you’ll get a better handle on your costs for Part D prescription drugs.
You may think it’s not worth your time to explore the Part D plans in your area. You might only take one prescription drug, and it’s a generic. Or you’re busy now. I get it. However, I urge you to start anyway.
Choosing a Part D plan is not a one-time thing as you enter retirement. In fact, it will become an annual item on your retiree checklist. Just like tax day is April 15th every year, November 1st will become your Find Part D Plans day. Read more about that in my blog post: Re-shop your Medicare Part D Plans.