If you had a Part D prescription drug plan in 2015, you likely received a letter from the insurance company indicating a substantial increase in premium for 2016. The national average was ~13% increase in premium.
This is your one opportunity each year to review and change your Part D Medicare Prescription drug coverage. We highly recommend you take advantage of this opportunity, if you have not done so already. Read more or watch our videos explaining how to review and select a drug plan.
Also there was a great article in the Wall Street Journal on Tuesday regarding the costs of Prescription Drugs in the United States compared to other countries. This article was specific to Medicare Part B drug costs, but the inference is that the U.S. pays more for Part D drugs as well.
What drugs are covered under Part B of Medicare?
Here is the language from CMS regarding drugs covered by Part B:
"Generally, Part B covers drugs that usually aren’t self-administered. These drugs can be furnished in a physician’s office as part of a doctor’s service. In a hospital outpatient department, coverage generally is limited to drugs that are given by infusion or injection. If the injection usually is self-administered or isn’t given as part of a doctor’s service, Part B generally won’t cover it, but a person’s Medicare drug Plan (Part D) may cover these drugs under certain circumstances."
The article from the Wall Street Journal provides a list of over 50 drugs that are covered by Part B and how much each drug costs. The majority of these drugs cost well over $1,000 per vial/dosage. An example of three drugs is in the image below.
Why are Part B drug costs important to me?
Most Medigap Plans will pay the full 20% of costs not covered by Medicare Part B. This is generally used for Medical/Outpatient expenses, but it also applies to the list of drugs that are covered by Part B of Medicare. So, if you have one of these Medicare Supplement plans, you will be fully covered for these Part B drugs and will not have to pay anything out-of-pocket.
However, if you have a Medicare Advantage Plan, you will likely have to pay the 20% of these Part B drug costs up to $6,700 per year. In the examples above, this 20% would amount to over $1,000 per vial. At this rate, you would likely hit the out of pocket maximum of $6,700 in just a few short months. This is another key reason that we generally prefer Medicare Supplements over Medicare Advantage Plans.
If you currently have a Medicare Advantage Plan and you do not currently have any serious medical conditions, you may want to inquire about switching to a Medicare Supplement. Please call us now 1-856-866-8900 (Moorestown Office) or 1-908-272-1970 (Cranford Office).
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