Part D Prescription Coverage

There seems to be a lot of confusion about the names of Part D prescription plans. 

Just the other day I had a client, Jan, come in for a second opinion on her Medicare options.  She was talking to a broker who found her an inexpensive plan which had “Wal-Mart” in the title.  But the broker told her that meant she could only use it a Wal-Mart”. I’m glad she came to us for a second opinion, because not only did we clarify what “Wal-Mart” meant in the title, we also saved her over $1,000 this year.

The truth is, the name of your Medicare Part D prescription plan isn’t as important as you think.

In 2010, Humana partnered with Wal-Mart and introduced one of the first “co-branded” Medicare Part D prescription plans. Those who chose to use the plan at Wal-Mart and Sam’s Club pharmacies received steep discounts on generic medications, and their deductible was often waived.

What many people don’t realize is that the Humana Wal-Mart plan is widely accepted, even at competitive pharmacies.

Since Humana joined forces with Wal-Mart several other co-branded plans have joined the Medicare Part D prescription plan scene. United Healthcare has created a plan encompassing AARP and Walgreens; CVS/Caremark has worked with both Aetna and SilverScript in the past.

Choosing a co-branded plan does not restrict you to using the pharmacy listed; nor does it obligate you to any other entity. The AARP Medicare Rx Walgreens plan causes particular confusion; the plan is sold by United Healthcare, you do not have to be a member of AARP to be enrolled (and being a member does not offer any extra benefits), and the plan is widely accepted at other pharmacies.

After enrolling in a Part D plan you should receive a comprehensive packet of information, included in that is a list of pharmacies that accept your plan. You should contact your plan directly if have concerns about any aspect of your coverage.

Medicare Part D plans are allowed to change their network of pharmacies each year. Beneficiaries should take the opportunity during Medicare’s Open Enrollment to ensure their pharmacy is in-network.

So when you are picking your Part D prescription plan, make sure you understand what you are paying for your medications and what pharmacies accept your insurance.  Knowing this from the beginning can save you money.

Also keep in mind that these plans change every year during Open Enrollment (October 15th) so it’s crucial you review your plan.  People who don’t review their Part D plan every year usually end up with costly surprises.

Email me at larry@mymedicarecoach.com If you want to know more about how to review your Part D plan during Open Enrollment to save money (just the other year we saved a client $52,000 by changing his Part D plan)