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Medicare 2016: A step-by-step guide to using the Plan Finder

Taking time to review your options can cut drug costs.

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Taking time to review your options can cut drug costs.

Federal health officials recently announced that Medicare Advantage premiums would remain stable in 2016, and that the average Part D premium wouldn't change much either.

But that doesn't mean individual plans won't change.

Premiums can rise or fall from one year to the next. The same with deductibles. Plans can also change which drugs are covered, or which doctors are in their networks.

This special LifeTimes section contains several charts to help people choose their plans for 2016. But those are only a general guide. By far, the best way to choose your coverage is by consulting Medicare's online Plan Finder.

It estimates out-of-pocket costs based on the specific drugs you take. It grades plans by performance. It also lets you explore possible pharmacies in your neighborhood.

A good search takes about an hour. If you are not comfortable with computers, try to find someone who is, such as a friend or family member, or Florida's SHINE volunteers. (You can call toll-free at 1-800-963-5337).

Here are step-by-step suggestions for working through it:

1 Make a list of all your prescription drugs, along with the dosage and how often you refill them.

TIP: Do not include over-the-counter drugs because Medicare does not cover them.

2 Go to medicare.gov/find-a-plan, enter your ZIP code and click on Find Plans.

3 Answer two questions about your Medicare coverage and click Continue to Plan Results.

4 Enter your prescription drugs one at a time. The computer will invite you to switch from brand-name drugs to generic equivalents to minimize your cost. This can result in huge savings. In one search, the difference between brand name Lipitor and the generic Atorvastatin saved $1,300 a year because many plans will not cover Lipitor on their formulary. Always consult your doctor before switching to any generic drugs. Use the Plan Finder to identify the savings, consult your doctor, then sign up for the plan you like best.

TIP: The right side of the drug list screen lists an ID number and password date under "Retrieve My Saved Drug List." If you have to leave your search and come back to it later, this ID and password date will pull up your drug list automatically and save time.

When you are done, click on "My Drug List Is Complete."

5 Select two nearby pharmacies you might like to use. If you don't see any you like, a drop-down box at the top allows you to widen the distance from your ZIP code and see more. You can pick two pharmacies at a time, but sometimes a third or fourth pharmacy might save you money. We will tell you later how to repeat this step if you want to check out more than two pharmacies.

TIP: This page sometimes measures distance in a quirky fashion. It is possible that a pharmacy just a few blocks from your house will not show up on the list if it lies in a different ZIP code. If you want to use that pharmacy, keep widening the geographic search until you find it.

After you pick two pharmacies, click on "Continue to Plan Results.''

6 "Refine Your Plan Results.'' This lets you research Prescription Drug Plans, which accompany original Medicare, as well as Medicare Health Plans, which are privately managed care companies with networks. If you do not know which type of plan you prefer, you can check both boxes and see both types of results.

Also, check out the "Change Health Status'' filter at bottom left. It is preset for people in "good" health. If you are either in poor health or excellent health, make that change.

The filter for "Select Special Needs Plans'' is only for people with certain chronic diseases like diabetes or COPD, people in nursing homes or people who also qualify for Medicaid.

TIP: In general, it is a good idea to avoid filters, because they can skew results and lead you to a more expensive plan.

Click on "Continue to Plan Results."

7 View "Your Plan Results" page. It estimates the cost of various plans tailored to your particular prescription drugs, your health condition and the two pharmacies you picked. Prescription Drug Plans are ranked only on your estimated drug costs, because drugs are all they cover. The cost is listed in the first column. Health plans are ranked by total projected costs, listed in the sixth column. These include premiums, drugs, doctors, hospitals and all other expenses.

TIP: The Plan Results page lists only 10 plans of each type. If you want to see more, click on a blue link under the heading that allows you to "View 20" or "View ALL."

TIP TWO: Unfortunately, this list can be deceptive. It may not actually list the cheapest plan first, depending on how you buy drugs. That's because the list is ranked only by retail drug cost. Some plans offer big savings if you order your drugs by mail, but this Plan Results page may not reflect that. We will help you find mail-order costs, but you will need to dig a bit deeper.

8 Once you set up the Plan Results page to view the number of plans you want to consider, print it out. A hard-copy list provides a good place for taking notes and is essential for a thorough search.

9 (Optional) If you want to see if there is a better pharmacy for you, return now to the pharmacy page and pick two new pharmacies you think might offer discounts, then work your way back to the Plan Results page. Sometimes, your third or fourth favorite pharmacy will have a special relationship with one of the plans and that can generate savings. But you will never find out about these savings unless you work through the Plan Finder again, checking out four different pharmacies instead of two. After your second swing through the Plan Finder, see if the Plan Results page reveals a cheaper plan than the first search did. This step is not necessary, just beneficial. If you want to stick with just two possible pharmacies, proceed to Step 10.

10 Check retail versus mail order. The Plan Finder can sometimes miss the cheapest plan because the Plan Results list defaults to retail purchase of 30-day supplies. Some plans offer big savings if you buy a 90-day supply via mail order. Once you have printed out the initial Plan Results page, look for the "Sort Results By" function at the top of each plan list. Using the drop-down arrow, order the list based on Lowest Estimated Annual Mail Order Drug Costs. Now compare these costs to the Retail Cost list to see if you can save money by using a mail-order option.

11 Analyze plans. Go now to the accompanying story titled "What to Look For in Plans." When you finish analyzing individual plans that interest you, come back to Step 12.

12 Time to choose. You can enroll directly in a Prescription Drug Plan or a Medicare Advantage health plan by calling the plan directly. Or you can also enroll by calling Medicare toll-free at 1-800-633-4227. The deadline is Dec. 7.

TIP: Before you pick a health plan, remember to first make sure your current doctors are in the network.

Contact Kathleen McGrory at kmcgrory@tampabay.com or (727) 893-8330. Follow @kmcgrory.

Medicare 2016: A step-by-step guide to using the Plan Finder 10/14/15 [Last modified: Wednesday, October 14, 2015 11:44am]
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