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Will I save money if I enroll in a 2013 Medicare Part D plan that has a $0 initial deductible or a really low monthly premium?

Category: Selecting your Medicare plan
Published: Nov, 25 2012 07:11:05


Maybe.  We usually suggest that people enroll in Medicare Part D prescription drug plan that provides the most affordable overall annual cost (monthly premiums + deductible + covered drug costs).


In the past, some people have mistakenly thought that plans with no initial deductible or a low monthly premium were always less expensive on an annual basis.  But this is often not the case. People usually find that their annual drug costs really depend on their own personal health needs.

For instance, people who use only low-cost generic medications, and choose a Medicare Part D plan with a low monthly premium and standard initial deductible, may find that they never get any cost-sharing benefits -- because they must first satisfy the initial $325 deductible before their low-cost generics are covered by their plan.  However, people using higher-cost brand-name medications may go through an initial deductible in the first month and benefit from the lower monthly premiums.

As an example, in the Medicare Part D plan with the lowest monthly premium is the AARP MedicareRx Saver Plus Plan with a premium of $15.00 and a $325 deductible.  The Texas Part D plan with the next lowest premium is the Humana Walmart-Preferred Rx Plan with a premium of $18.50 and a $325 deductible.  The Medicare Part D plan in Texas with the lowest premium and a $0 initial deductible is the SilverScript Choice plan, with a $29.10 monthly premium.  Please notice that the HealthSpring Prescription Drug Plan with a higher monthly premium ($33.00) and a $325 deductible has the lowest total annual costs because it covers two of the medications not covered by the other lower cost plans.

Medicare Part D Plan Name

Monthly
Premium

Initial
Deductible

Total Annual Cost*

Number of Drugs on Formulary

Cost-Sharing of Lipitor®

Cost-Sharing of Plavix®

Cost-Sharing of Nexium®

AARP MedicareRx Saver Plus

$15.00

$325

$5,251

3,090

Not on Formulary

($140)

Not on Formulary

($224)

$25 - $35 **

Humana Walmart-Preferred Rx

$18.50

$325

$7,180

3,044

Not on Formulary ($139)

Not on Formulary ($223)

Not on Formulary ($217)

SilverScript Choice

$29.10

$0

$7,333

2,875

Not on Formulary ($140)

Not on Formulary ($224)

Not on Formulary ($218)

HealthSpring Prescription Drug Plan

$33.00

$325

$3,886

2,857

Not on Formulary ($139)

25%

($51)

25%

($48)



* Total annual projected costs includes the monthly premium and the medication

** low value is cost-sharing at preferred network pharmacies and high value is cost-sharing at regular network pharmacies.

Please note in the table above that the HealthSpring Prescription Drug Plan (even with its higher monthly premium) has the lowest cost-sharing for these three popular brand-name medications. 

The HealthSpring Prescription Drug Plan also has the lowest total annual costs (retail) for someone who is using only the three example brand-name drugs (Lipitor®, Plavix®, and Nexium®).

When we switch to the generic form of Lipitor® and Plavix®, our most economical plan choice changes drastically (using Walmart as the chosen pharmacy).

Medicare Part D Plan Name

Monthly
Premium

Initial
Deductible

Total Annual Cost*

Number of Drugs on Formulary

Cost-Sharing of Atorvastatin

Cost-Sharing of Clopidogrel

Cost-Sharing of Nexium®

First Health Part D Value Plus

$31.10

$0

$793

2,975

$0 - $7 **

$0 - $7 **

$35-$45 **

AARP MedicareRx Saver Plus

$15.00

$325

$990

3,090

$2 - $5 **

$2 - $5 **

$25-$35 **

Cigna Medicare Rx Plan One

$31.80

$325

$1,128

3,290

$0

$8

$31



*Annual Cost Estimates from Medicare.gov Plan Finder 11/25/2012.

Bottom Line:  Be sure to look at your total annual medication costs and consider monthly premiums, drug coverage, drug cost-sharing, and initial deductibles.  And when in doubt, telephone a Medicare representative at 1-800-633-4227 and ask for assistance.







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