Showing posts with label open enrollment. Show all posts
Showing posts with label open enrollment. Show all posts

Monday, October 24, 2016

2017 Brings Cuts in Covered Medications!


Open Enrollment is the one time of year when you may make changes to your health insurance plan (aside from a qualifying event). As you’re researching your options, there’s some important information about your drug coverage that you’ll want to know. In the coming year, many previously covered prescription drugs will be excluded by insurance companies. If any of your prescriptions are on the list of excluded drugs, this change will directly affect your wallet, leaving you to pay full price at the pharmacy.

There are two reasons that this is happening: Hyperinflation of prices and the availability of “biosimilars” — not identical but similar medications to an expensive drug. Hyperinflation is a term for drugs that have had massive price hikes. When a biosimilar alternative exists, these carriers refuse to cover the hyperinflated drug to force drug companies to lower their prices, which can ultimately save us, the consumer, significantly.

This isn’t the first time popular drugs have been dropped from coverage. Just this year, Qsymia, Abilify, Viagra, and others were dropped coverage. In 2017, several expensive cancer drugs and hepatitis C medications will also be dropped. Adjustments to the list of covered drugs are likely to occur annually.

As a result, it’s important to take the time to make sure you’re ready for the coming changes:
  • Review the list of drugs being dropped from each company’s formularies for 2017.
  • Consider switching insurance providers if you require a specific prescription that will no longer be covered. 
  • If you’re blindsided by a drug no longer being covered, it is possible to appeal the coverage decision with your insurance provider. To get your drug covered through the exceptions process, see the requirements here
  • Some insurance companies will provide a one-time refill for your medication after you first enroll. Ask your insurance company if they offer a one-time refill until you can discuss next steps with your doctor.
While coverage is changing, one thing you can continue to count on is the FamilyWize Prescription Savings Card, which is available to you at no cost, and can save you an average of 43% off the cost of your medications.

If you don’t already have one, you can download a free card online today or request a card by calling 1-800-222-2818. You can also get the free FamilyWize app, available for both Android at the Google Play Store and Apple Devices (iPhone and iPad) at the App Store.




Monday, October 17, 2016

Medicare Open Enrollment Tips



Are you ready for Medicare Open Enrollment? If not, you need to get ready! Open Enrollment is only October 15 through December 7, and there are penalties for missing the window; it’s worth a few minutes of your time today to prepare yourself. Open Enrollment can be confusing, so we’re sharing seven tips to help you understand what your Medicare options and requirements are.

Open Enrollment Tip 1 — Don’t Just Re-Up but Re-Evaluate

Even if you’re already enrolled in a Medicare health plan, it’s important to understand that the Open Enrollment period is largely about reevaluating your current Medicare Advantage or Part D plan, or both.

The big question you should be asking yourself is, “Do I need to change my plan or should I stay with my current plan?” The answer to that question begins with finding the answers to these related questions:
  • Has anything changed in my life?
  • Has anything changed in the plan I’m on? 
  • Has anything changed in the other plans available to me?
If nothing has changed significantly in any of those three areas, then your best strategy might be to stay with your current plan. Odds are though that at least one of these three things has changed. Take the time to go through the plans, looking for the option that best meets your needs.

Open Enrollment Tip 2 — Check Your Health

When you previously selected Medicare coverage, your health was a major factor. If you experienced a change in health status during the past 12 months, you’ve likely put your insurance plan to use, giving you a chance to evaluate the out-of-pocket costs and the quality of care you received. If it was not satisfactory, you should look for a plan that would offer improvements.

Open Enrollment Tip 3 — Evaluate Cost vs. Benefit

Oftentimes a more expensive plan comes with a wider range of benefits. This may have been appealing if you were thinking, “Better safe than sorry.” But that plan’s monthly payments may have proven to be more of a cost burden than you expected, especially if any of your other expenses have increased. Or, maybe you selected a lower-cost plan and now feel you’re feeling burdened by co-pays. In either case, a plan change may be exactly what you need.

Open Enrollment Tip 4 — Verify That Your Plan Features Match Your Lifestyle

There are measurable cost differences between Original Medicare and Medicare Advantage plans. Medicare Advantage plans (also known as Part C plans) are more affordable, but come with more restrictions, such as being more geographically localized to your home area. If you plan to spend a lot of time away from home (think snowbirds), you may be better off with Original Medicare rather than a Medicare Advantage plan.

Open Enrollment Tip 5 — Look at Prescription Drug Coverage

Many factors influence your choice for prescription drug coverage. These include:
  • Choosing no insurance because you feel you can cover the cost of your prescription drugs on your own
  • Enrolling in a Part D drug plan 
  • Choosing a Medicare Advantage plan that already includes drug coverage 
  • Getting your coverage through an employer or via your VA benefits 
  • Using a state-based Prescription Assistance Program, if available in your state
Keep in mind that you’re a year older now than when you last evaluated your options. As we age, the likelihood of needing prescription drugs goes up, and often substantially if, for instance, you develop a chronic condition that requires ongoing medication. So, if you are not already covered adequately to meet a changing medical status, use Open Enrollment to fix that.

Open Enrollment Tip 6 — Take a 1-Minute Quiz

Are you still feeling unsure and overwhelmed? Before making any decisions about switching your coverage during Open Enrollment, take this short Medicare Questionnaire, created by The National Council on Aging (NCOA), one of our partners. It gives you advice about how to choose the best plan for your needs, and about whether to change your Medicare plan during Open Enrollment.

Open Enrollment Tip 7 — Beware the Donut Hole!

The “donut hole” is a coverage gap in certain Medicare Prescription Drug Plans that begins after you reach a certain dollar amount for covered drug purchases in a calendar year. This gap can significantly affect your prescription costs. But you can lessen its impact on your wallet by using the FamilyWize Prescription Savings Card. It’s free and anyone can use the card – insured or not. There are no qualifications to use the card, and it can save you an average of 43% off the cost of your prescription medications.

All you have to do is show the FamilyWize card (or app) to your pharmacist the next time you pick up a prescription and ask them to compare the discount offered by the card to the price you would pay otherwise. In many cases, the FamilyWize price proves to be the better deal.

And don’t forget to comparison shop. You can check the price for your prescription at all participating pharmacies in a selected region using our Drug Price Lookup Tool, available on our website or through our app (just search "FamilyWize" in your smartphone's app store). Then you can fill your prescription at the most affordable location.

With a little bit of effort, you can confidently manage your Medicare plan and prescription coverage. Take the time to do your research and prepare – especially during Open Enrollment!

Tuesday, November 24, 2015

Your Complete Guide to Medicare Open Enrollment

Choosing your own health plan can be an intimidating and often confusing process, particularly for those who are already enrolled in Medicare but are interested in how other plans on the market compare with Medicare Advantage or Medicare Part D.

With Open Enrollment season ending December 7th, time is running out to select the plan that fits your needs along with your budget. Fortunately, our friends at My Medicare Matters have developed a guide to help you through it.



The Complete Guide to Medicare Open Enrollment gives you an overview of the essential facts of the Open Enrollment period, including when it starts and ends, which parts of your Medicare plan you can change, and when your new coverage will begin. It also lets you know who should consider changing their coverage during this period; for example, certain people may find plans that offer better prescription drug coverage than their current plan, while others may need to switch in order to keep their doctor in-network. You can also sign up for reminders by email to learn more about when Open Enrollment starts and ends.

Not sure how your current Medicare plan stacks up? Use My Medicare Matters’ short Medicare Questionnaire. By answering a few simple questions, you will be provided with an online price comparison tool that will allow you to do your own research and find the plan that is right for you.



We’ve partnered with My Medicare Matters because like us, they are dedicated to offering free, easy ways to help people save money on their health. Together with our free Prescription Savings Card, which saved an average of 42% off the retail cost of prescription medication in 2014, there are more options than ever to help people, insured or uninsured, save on the rising cost of proper healthcare.