When it comes to preparing for Medicare Annual Enrollment, which runs from Oct. 15 to Dec. 7, your pharmacist can be a great resource on Medicare Part D prescription drug coverage questions.
Check out some of the most common questions that come up when talking with local pharmacists about Medicare.
What is the Difference Between PDP and MAPD?
First off, let’s clarify what PDP and MAPD mean as it is a common question people have when they start making Medicare decisions. PDP refers to a prescription drug plan. MAPD refers to a Medicare Advantage plan with prescription drug coverage.
PDP plans are stand-alone Part D plans provided by private insurance companies. These are stand-alone plans that only provide prescription drug coverage.
An MAPD plan is a Medicare Advantage plan that includes prescription drug coverage along with coverage for Medicare Part A, Part B as well as other extra benefits such as dental or vision. MAPD plans are also offered by private insurance companies.
How Do Medicare Plan Changes Impact My Drug Costs?
Medicare plans can change the drugs they cover and the plan’s drug costs every year. Prescriptions covered under a plan one year might not be covered the same way the following year, or they may not be covered at all.
Your costs can increase or decrease depending on what drugs the plan chooses to cover, what formulary tier the plan puts the drug under, and how much the plan’s premium, copays, deductibles and coinsurance are.
If your plan has different costs based on how and where you get your drugs, that can impact how much you pay too. For example, costs could be different with a pharmacy that’s in-network versus out-of-network, or if it’s mail-order versus local pickup.
Pharmacists Can Help People Manage Medications and Avoid Potential Problems
As people get older, they may take more medications. Pharmacists can help with this in a few ways.
- Identify possible drug interactions
- Answer questions about medicines you’re taking
- Warn you about potential side effects and expected outcomes
- Provide guidance on the best time(s) to take your medication
- Offer tips to help you remember to take your medication and how to make getting refills easier
- Act as a resource in case you forget a drug’s instructions
- Recommend a less expensive drug option – such as a generic substitute or alternate brand-name drug
In addition, if you’re shopping around for Medicare Part D or Medicare Advantage plans with drug coverage, a pharmacist could help you look at the drug formularies and make recommendations on which may be better.
Tips to Help Save Money on Prescription Drugs
Saving money on your prescriptions is a great way to bring down your overall health care costs. Fortunately, there are ways to do that.
- Ask your pharmacist or doctor about generic or other low-cost substitutes for any expensive medications you’re taking. (Drugs that are on the lower tiers of your plan’s drug formulary often cost less than those in higher tiers and may work as well as their high-cost counterparts.)
- Consider getting 90-day refills when offered as they usually cost less per dose than 30-day supplies.
- Check if your plan has a preferred pharmacy network. Your copay is usually less when you fill prescriptions at the plan’s preferred pharmacies.
Pharmacists are local, easy to reach and ready to answer questions and offer tips on what to expect from medications and how to maximize their results. Take advantage of using your local pharmacy when making decisions about your Medicare prescription drug coverage.