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Just one more week to choose Medicare drug plans

Consumer Reports News: December 01, 2011 01:08 PM


Medicare’s annual open enrollment period ends Dec. 7, so you have only one more week to decide whether to keep your current Medicare Advantage or Part D plan, or switch to a new one.

We recommend you check your options every year, because the plans’ preferred drug lists can and do change from year to year—and so can your mix of prescriptions. Not choosing wisely could cost you big.

Consider, for instance, a recent analysis from Avalere Health, a Washington-based consulting firm, of plan coverage of the 2,306 different medications covered by at least one 2012 Part D plan. Among the 10 biggest national standalone prescription plans, the percentage of those drugs on plan formularies ranged from a high of 79 percent on the Humana Enhanced plan, to a low of 47 percent on WellCare Classic.

What’s more, your out-of-pocket payment for the same drug could vary many-fold depending on what plan you choose, according to a recent report from AARP. For instance, someone in one of those top-10 drug plans could pay anywhere from $38 to more than $90 a month for the blood thinner Plavix.

If you take Lipitor, you should definitely check your plan if you haven’t already. The drug just went generic, and Pfizer, its manufacturer, is cutting deals with many plans. However, some are apparently dropping it from their formulary completely.

There’s no way to find out what your plan is up to except to check its 2012 formulary. You can do this by going to and clicking on “Compare drug and health plans.” Follow the online instructions to find out how plans in your area cover your personal list of drugs.

“Don’t just search by premium,” advises Leigh Purvis, AARP’s Part D expert. “Find out if they have utilization management on the drugs your taking. Do they have pharmacies nearby? Do they have co-pays at your pharmacy? Can you buy your drugs by mail order?”

For details, see our tips on how to choose the right Medicare plan for you.

New Analysis Reveals Number of Medicare Part D Drugs Covered by Prescription Drug Plans Varies Widely [Avalere Health]

Increasing Plan Complexity Highlights Need for Careful Evaluation

Nancy Metcalf

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