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AEP Celena

Countdown To The End of Annual Enrollment Period (AEP)

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A Quick Review of Annual Enrollment Period (AEP)

If you have been on Medicare for more than 1 year, you have gone through an Annual Enrollment Period (AEP).  For those new to Medicare, it can seem like a "wild and crazy" time.  There will be mailers, tv commercials, internet ads, Facebook ads, and even people dropping by your house unannounced (this is illegal).  There are a number of misleading advertisements on TV with famous personalities promoting plans that are "too good to be true."

Don't Panic....we are here to help you through this each and every AEP.  Below is all the information you will need to know about AEP.  

STEP 1

Time Table for AEP

October 1st - October 14th: This is the "window shopping" period for your Part D or Medicare Advantage plan. Medicare releases the 2023 data to the public on the first of October.  It allows you to see what plans are available for next year, but you cannot change plans yet.

October 15th - December 7th: This is officially the Annual Enrollment Period (AEP). This is when you can change your Part D plan.  You can change as many times as you would like during AEP, however the last application in the system on December 7th will be your plan for 2023.  After December 7th, AEP is over and you can no longer switch Part D plans without a special enrollment period.  If you switched Part D plans during AEP, your new plan will start January 1st and your old Part D plan will be cancelled behind the scenes by Medicare.


January 1st, 2023: If you did make a change to your Medicare Part D coverage during AEP, the new Part D plan will start on January 1st.  Your previous Medicare Part D plan will be cancelled automatically by Medicare.  This happens behind the scenes when the new company notifies Medicare that you have enrolled with them.

STEP 2

A Quick Warning On the "Wild Wild West" of Medicare

Unfortunately there will be tons of calls coming in and many will be made illegally.  Some brokers/agents are ignoring the "Do Not Call" list by using call centers from overseas and faking (spoofing) the caller id to avoid being caught.  It is really out of control.  Some are even saying they are with Medicare (that's illegal!!) and they want to stop by and review your coverage.  I would recommend ignoring any of these calls and anyone who shows up at your door.  You can remind them that what they are doing is illegal under Medicare (CMS) regulations. Even the insurance companies will call you and try to move your coverage so they can remove me as your agent (sad but true).  The video below will help educate you on some of these ads that will be airing.

Good News, Medicare (CMS) has started to crack down on these Medicare ads you see on TV.  Here is a link to a Memo published on October 8th.  Basically Medicare is concerned these ads are misleading Medicare beneficiaries.  LINK
STEP 3

How to Use Our Part D Comparison Tool

  1. Watch the Video Below
  2. Gather your current medicines
  3. Click the button below this video to get started!  (Remember, you can only change Part D plans between October 15th and December 7th)

(Remember, you can only change Part D plans between October 15th and December 7th.  
There will be no "Add To Cart" button until after October 15th.)

Additional REsources

Below is a table of the changes Medicare has made to the limits and phases of the Medicare Part D plans for 2023.

Changes to Part D

2022

2023

Deductible*

$480

$505

Initial Coverage Level

$4,430

$4,660

Coverage Gap (Donut Hole)

$7,050

$7,400

Catastrophic Level

$10,012.50

$10,516.25

*For many 2023 Part D plans, the deductible will only apply to Tier 3, Tier 4, and Tier 5.  
Tier 1 and Tier 2 medicines typically do NOT count towards a deductible, so you only pay a small copay.

Inflation Reduction Act impact on Medicare

The Inflation Reduction Act was passed this year.  It will have impact on Medicare moving forward.  Some of those impacts will start soon, while others will be phased in over the next few years.  For more detail about this law, please see this link to kff.org article.  It is important to know this is what is in place to happen in the future, but when politics gets involved, anything can change.

Image from kff.org article

Want More (way more) Detail on the Structure of Part D Plans?

Each year, the National Council of Aging (NOCA) publishes a detailed breakdown of the Part D plan levels/phases.  This goes into much greater detail and could be too much information, but for those who are interested, click this LINK.  This chart shows how much the Medicare beneficiary, Medicare, and the Drug Manufacturer spend during each phase of the coverage.

Additional Ways to Save on Your Medicines

GoodRx or SingleCare
Use www.GoodRx.com or www.Singlecare.com to save on many of your generic prescriptions.  These are great tools to have your toolbox. Just because you have a prescription plan doesn’t mean you have to get all your medications through it.  Some common medications that you can sometimes get cheaper with these discount programs than through drug plans:

  • Albuterol HFA
  • Celecoxib
  • Ezetimibe
  • Fenofibrate
  • Rabeprazole
  • Raloxifene

There are many more medicines that you can save on. Bottom line is it never hurts to check and see. 

IMPORTANT NOTE FOR GOODRX - It is FREE...just know they have recently partnered with a large call center to market you Medicare Advantage plans (story here).  If you have used Goodrx in the past, expect to get calls from these call centers pushing their Medicare Advantage plans.

Patient Assistance Program
If you have high costs medications and are having trouble paying for them then you may want to see if you qualify for assistance through the Patient Assistance Program.

An additional site that I have found that puts detailed information together for you is www.needymeds.com

Synthroid
A client let us know this was available.  If you have to take the brand name Synthroid and can’t use the generic version you may be able to get this cheaper through www.eaglepharmacy.com. This is an online retail wholesaler of Synthroid and they will mail you 90 day supply for $75.

Eliquis
I have noticed that for 2023 on all the lower priced Part D plans (Under $50/mo) Eliquis is now listed as a Tier 4 medication.  This will GREATLY increase your costs on this medication as you typically pay coinsurance between 40-50% of retail price rather than a set copay amount like in the past.  This means that Eliquis, once the deductible is met, will cost around $250+ per month for a 30 day supply.  

My recommendation would be to look in to the Patient Assistance Program...you can get all the information you need at www.needymeds.com.  

Another source for this, which I have NO affiliation with, is The Canadian Medstore.  According to some clients they are getting Eliquis through them for around $70/mo. Contact them for pricing and information about their offerings.  Attached is a brochure for them....CLICK HERE FOR BROCHURE or visit their site at www.canadianmedstore.com

Part D Senior Savings Model (Insulin Savings)

For those using insulin, this medicine has always been expensive on Medicare Part D.  This program was released last year and some Part D plans participate in this program.  You will notice that a $35/month copay will show up as the price in the first 3 phases of the Medicare Part D analysis using the comparison software.

FAQs (frequently asked questions) about the Part D Senior Savings Model - LINK

List of Insulins Covered by the Part D Senior Savings Model for 2023 - LINK

Link to Medicare.gov Pharmaceutical Assistance Program - LINK

The Annual Notice of Change (ANOC) Letter

What is it? Your Part D carrier will send you a “Plan Annual Notice of Change” (ANOC) each year in September. The ANOC includes any changes in coverage, costs, or service areas that will be effective in January.

What to look for in the ANOC:

  • What medications have been added or removed from the plan
  • Are the drugs you currently take listed on the formulary?
  • Have any of your medications been assigned to a different tier on the formulary? (this may affect your costs)
  • Is the plan premium changing?
  • What other costs are changing...deductibles, copays, coinsurance?

How important is the ANOC?
The ANOC is basically good information to review. However, during the AEP is the time to review your Part D options (the reason why you are on this page). If you follow the video on how to review your Part D plan we have outlined it will tell you whether or not the current plan you are on is the right one for next year or if you should make a change.