Medicare Part D Plan Comparison - Find the RIGHT plan for you

While choosing the right Medicare Part D plan can save you money, the process of comparing plans can be a bit confusing and time-consuming. That’s why Kinney is pleased to offer a FREE Medicare Part D plan comparison report.

EZ Medicare PlanAdvisor is a comprehensive Medicare Part D plan comparison tool that provides the information you need to make an informed choice when it comes to prescription drug coverage. Our Pharmacists simply input your particular prescriptions and generate a personalized plan comparison report which will show you:

Your projected out-of-pocket expenses including premiums, deductibles and copays for the entire year.
When you can expect to enter the "donut hole".
What plans will cover your medications, and which won’t.
What drugs require prior authorization from your physician or have other restrictions, such as quantity limits.

Ask your Kinney pharmacist for your FREE personalized report.

Not a Kinney customer? No problem! Just bring in your medication list, and your Kinney Pharmacist will take care of the rest.

Types of Medicare Plans

Medicare is a federal program that provides varying degrees of health insurance to people over the age of 65, or those with Medicare-qualifying disabilities to cover services that are medically necessary to treat a disease or medical condition. Enrollment is voluntary and you cannot be denied coverage for any health reasons.

When you enroll with Medicare you automatically receive Part A; however, there are three additional Parts you may choose to add depending on your needs: Part B, Part C and Part D. Below is a general overview of the benefits associated with each Part.

Medicare Part A:

Covers medical expenses related to hospital care, nursing home care, and/or hospice.

Medicare Part B:

Covers services or supplies needed to diagnose, treat, or prevent a medical condition such as inpatient/outpatient doctor visits. Kinney Drugs accepts Medicare Part B to cover diabetes testing supplies and vaccinations such as influenza and pneumonia.

Medicare Part C:

Provides enhanced benefits compared to Part A and B alone. This part is typically referred to as a Medicare Advantage (MA) plan and is offered through a private health insurance plan. Some plans (MA-PDs) may include drug coverage as well. If you sign up for Part C, you will incur some out-of-pocket costs for premiums and/or deductibles for the added coverage.

Medicare Part D:

Provides drug coverage only to help lower your out-of-pocket expenses for medications. It is partially subsidized by Medicare and is offered through a private health insurance plan. Many plans in each state are available and your costs (monthly premiums, yearly deductibles and copays) will vary based on the plan you choose. Also, the plan you choose may impact the pharmacy that you can use.

Kinney Drugs accepts most Medicare Part C and D plans. Our Pharmacists can help you to find the plan that’s right for you.

Choosing to Enroll in Medicare Part C and/or D

Anyone over the age of 65, and those younger with certain disabilities, are eligible for enrollment. The first step is deciding if you need additional medical coverage either with or without drug coverage (Part C), or drug coverage only (Part D). If you are already enrolled with Medicaid you will be automatically enrolled in a joint plan if you are Medicare-eligible.

Choosing a Plan

The next step is to compare plans to ensure the plan will cover the healthcare providers and pharmacy that you use while keeping your out-of-pocket costs as low as possible. A plan comparison should include the following:

Premiums - A monthly charge to maintain coverage by the plan.

Deductibles - An upfront amount each year that you must pay before your plan begins paying for their share of the costs.

Copays - The amount of money you pay for each service, such as a doctor visit or prescription. Your prescription copays will vary depending on the drugs you use and whether they are branded or generic.

CMS Star Ratings - All plans are evaluated by Medicare to determine how well they offer care. The Star Ratings are out of 5; the higher the rating, the better the plan.

Do It Yourself

You can comparing prescription plans yourself by following these steps:

Step 1: Make a list of all your prescriptions, including specific dosages and quantities. If you are already a Kinney patient, your Kinney Drugs Pharmacist can easily provide a printout of all your prescriptions.

Step 2: Go to www.medicare.gov/find-a-plan and follow the steps to create your personal Part D Plan comparison.

Step 3: The plan comparison will outline the differences in costs and features of all the Part D plans available in your area. Use this information to make a decision about which plan is best for you.

Step 4: If you decide to enroll in a new plan, you can go to www.medicare.gov or call the plan phone number on your plan comparison.

If you have questions about your plan comparison, or need assistance obtaining a print copy, talk with your Kinney pharmacist.

Determining Eligibility for Extra Help with Out-Of-Pocket Costs

If you have limited income and resources you may qualify for a program called Extra Help through Social Security. This program will help you pay for your monthly premiums, yearly deductibles and copays. To determine if you are eligible you can contact your local Social Security office or visit http://www.ssa.gov/medicare/prescriptionhelp/. You can apply at any time, and there’s no risk to submitting an application.

Enrollment in a Medicare Part D Plan

If you are new to Medicare you can begin to enroll three months before to three months after your 65th birthday. If you are already enrolled in Medicare and wish to add Part D, you may do so during the open enrollment period, October 15 to December 7. If you enroll outside of this window you will be faced with an incremental late fee penalty that is added each month to your premium. The amount of the penalty depends on how far outside of your eligibility period you are enrolling. If you are late because you are switching from a private insurance carrier, such as a plan from a former employer, or if you qualify for Extra Help, the late fee will not apply to you.

Once enrolled you will be locked into your chosen plan for one year. Each year during open enrollment you have the opportunity to review all available plans and select the best plan for you.

Your Medicare Part D Plan and the Coverage Gap

Most Medicare Part D plans have a gap in coverage often referred to as the donut hole. This means the plan will cover up to a certain amount for covered drugs, then coverage will be put on hold until you spend a certain amount out-of-pocket. The amount which triggers the coverage gap may change yearly. If you are also enrolled in Medicaid or Extra Help you will be exempt from entering the coverage gap.

Once you enter coverage gap you will receive 45% discount for brand name medications but 95% of the cost of the medication will count towards the amount to get you out of the gap.