Is Your Prescription Drug Plan Working for You? We Can Help.

If you have Part D Medicare or a Medicare Advantage plan, it’s a good idea to review your drug coverage to make sure you’re getting the best bang for your buck – and your health.

Open Enrollment, from Oct 15-Dec. 7, is the period of the year when you can switch your plans.

Certified counselors from the Medicare Medicaid Assistance Program (MMAP) at AgeWays are taking appointments to help review your plan, and if necessary, will enroll you in one that may work better for you. The counseling is free and unbiased.

“We saved Medicare beneficiaries $7 million last year,’’ says Shari Smith, MMAP program manager. “It’s worth seeing if you can save money and get a plan that works best for you.”

Smith talks here about the benefits of reviewing your plan during Open Enrollment.

Q: What is Open Enrollment?

It is the one time of year that you can make changes to your Part D Plan. During Open Enrollment, you can also switch from Original Medicare to a Medicare Advantage Plan (Part C), switch from one Medicare Advantage Plan to another, or switch from a Medicare Advantage plan to Original Medicare. Changes will take effect January 1, 2023.

Q: What is Medicare Advantage?

Medicare Advantage (MA) plans combine Original Medicare – Parts A and B – and generally Part C. They are sold as HMOs and PPOs by private companies. With these plans, you have to go to a health care provider who is in your network. If you have an HMO, you are required to get a referral to see a specialist. One benefit of MA is that you might get vision, hearing and dental benefits with your plan.

Q: If someone is already enrolled in Medicare, do they need to do anything during Open Enrollment?

If you currently have a Part D (the Medicare prescription drug) plan or a Part C (Medicare Advantage) plan, you’ll receive an Annual Notice of Change in September that lists any changes for 2023.

You might be satisfied with your current plan, but we still recommend that you do a “benefits checkup” during Open Enrollment every year. Even a small change in a plan’s drug prices or changes to the drugs included in the plan’s prescription formulary can impact price, so it’s worth taking a fresh look.

Q: What kinds of things can impact costs with Medicare?

Lots of factors can have an impact on costs: changes in drug prices, going to a doctor who does not take Medicare, brand name drugs versus generic drugs, differences in price between one pharmacy and another and, of course, your medical needs. Taking the time during Open Enrollment to review your plan options is smart. If you have a Medicare Advantage Plan, taking the time to become familiar with how your plan works is also critical, as some plans charge more for seeing out-of-network doctors or require referrals before seeing specialists.

If you have a Medicare Advantage plan, you can also switch to another between Jan. 1 and March 31, 2023.

Q: The Inflation Reduction Act that was just passed by Congress allows the government to negotiate drug prices with pharmaceutical companies. How will that affect Part D and Medicare Advantage plans?

Insulin is now capped at $35 per month, permanently. Diabetics no longer have to worry or make uncomfortable choices because they can’t afford their insulin. I’m hopeful in the future we’re going to see drug prices coming down, especially for the more expensive drugs people need.

[The Inflation Reduction Act enables Medicare to negotiate the price of 100 drugs over the next decade and requires drug companies, beginning in 2023, to rebate price increases higher than inflation to Medicare. Lower drug prices will go into effect in 2026.]

 

Q: Do I need to make an appointment for an Open Enrollment review?

Yes. Call 1-800-803-7174 to schedule a one-on-one, on-site session with a MMAP counselor (see schedule). We can also do a review by phone or Zoom. We are also available year-round to offer free, unbiased counseling and help people understand and access their benefits.

Please check our schedule of appointments here:

Livingston, Monroe and Washtenaw counties: Zoom appointments ONLY, Monday-Thursday. Call (800) 803-7174.

Macomb County:

  • Sterling Heights Senior Center, 40200 Utica Road: 10 am-4 pm Tues., Oct.18; Tues., Nov. 15; Wed., Dec. 7
  • Clinton Macomb Library – South, 35679 Gratiot Ave., Clinton Township: 10 am-4:30 pm Tues., Oct. 18; Tues., Nov.15
  • St. Clair Shores Senior Activity Center, 20100 Stephens Road: 10 am-4 pm Fri., Oct. 21; Mon., Dec. 5
  • Shelby Township Senior Center, 14975 21 Mile Road: 10 am-4 pm Mon., Oct. 24; Mon., Nov. 14; Mon., Nov. 28
  • Clinton Township Senior Center, 40730 Romeo Plank: 10 am-4 pm Wed., Oct. 26; Wed., Nov. 30
  • St. Michael Church, 40501 Hayes Rd., Sterling Heights: 9:30 am-2 pm Fri., Oct. 28; Fri., Nov. 18
  • Henry Ford Health Center Richmond, 67267 Main Street, Richmond: 9 am-3 pm Thurs., Nov. 3; Thurs., Dec. 1
  • Harrison Township Public Library, 38255 L’Anse Creuse St.: 10 am-3 pm Thurs., Nov. 10

Oakland County:

  • Troy Community Center, 3179 Livernois: 10 am-3 pm Tues., Oct. 18; Tues., Nov. 1; Tues., Nov. 15
  • Farmington Community Library, 32737 W. 12 Mile Road: 10 am-3 pm Thurs., Oct. 20; Thurs., Nov 10; Wed., Nov. 30; Tues., Dec. 6
  • Jewish Community Center, 6600 Maple Road, West Bloomfield: 10 am-3 pm Mon., Oct. 24
  • Barton Towers, 333 N. Troy, Royal Oak (for residents only): 10 am-2 pm Wed., Oct 26
  • Independence Township Hall, 6483 Walden Ctr. Dr., Clarkston: 10 am-3 pm Fri., Oct. 28. Call 248-625-8231 to schedule an appointment.
  • Dublin Senior Center, 685 Union Lake Road, White Lake: 10 am-3 pm Thurs., Nov. 3
  • Bloomfield Township Senior Center, 4315 Andover Road, Bloomfield Hills (township residents only): 10 am-3 pm Thurs., Nov. 17. Call 248-723-3500 for appointments.

St. Clair County:

  • McLaren Hospital, 1221 Pine Grove Ave., Port Huron: 10 am-4 pm Tues., Nov. 1; Mon., Nov. 21. Call 800-228-1484 for appointments.

We will ask you questions about your current plan and the medications you take, so you’ll want to have that information handy.