Ever since Medicare Part D began covering prescription drugs in 2006, beneficiaries have been frustrated by surprise costs. Well, to be fair, folks were SO glad to finally have prescription drug coverage at first that there was more happiness than frustration. Up until that point, most Medicare beneficiaries had to pay out of pocket for all their medications. So Part D coverage was a huge step forward.
But over the nearly two decades since, costs have become problematic. Some of it comes from the fact that many more people are on many more meds. And many more meds are extremely expensive compared to 20 years ago. But much of the frustration stems from the complexity of plan benefits. Deductibles, co-pays, tiers, the (now defunct) "donut hole".
Things got easier this year for three reasons. First, the "donut hole" was eliminated. Now there's just the deductible period (first few months of the year), then the regular ("initial") coverage period, and finally "castrophic coverage". Catastrophic coverage kicks in after you've spent a total of $2000 out of pocket (not including premiums), and after that you only pay for your monthly premium..
The second reason is that everyone's out of pocket maximum is now $2,000. That doesn't count premiums, but it does count deductibles and copays. It also doesn't count any meds you purchase outside of the insurance coverage (more about that in a minute).
The third reason you may not have heard about is the Medicare Prescription Payment Plan (MPPP). All Medicare Part D insurers now offer payment plans that can make your monthly drug costs more predictable. If you have a deductible, instead of paying the whole thing during the first months of the year, you can even it out over the entire year. Or if you know your drug costs will go over $2,000, you can choose to pay that amount over 12 months instead of six or eight.
Who is most likely to benefit from the MPPP?
If you have a plan with a deductible that always seems to take you by surprise, you might have more peace of mind using the MPPP. Same if your yearly medication costs are quite high. Your overall drug costs for the year won't be any lower (or any higher for that matter). But they'll be a bit more predictable month to month.
Keep in mind that if you sometimes choose to purchase your medications without using your insurance, those costs won't be counted in your "out of pocket" maximum of $2,000. That may or may not change the way you decide to purchase your prescriptions.
How does the MPPP work?
I cannot tell a lie -- the formula used to figure the monthly amount is a bit complicated. And the monthly bill will vary from month to month -- it won't be exactly the same for the whole year. But if you're used to a large deductible, or huge co-pays during part of the year, it's likely that this new program will be more predictable.
The other interesting difference is how you'll pay for your prescriptions. Instead of paying for your prescriptions at the pharmacy, you'll get a bill from your insurance company every month. The insurance company, in turn, will reimburse the pharmacy that filled your prescriptions.
Signing up for the MPPP
In order to get signed up, you'll need to contact your insurance company. Look for the phone number in your handbook, or on the back of your insurance card. The MPPP won't charge extra for this service. It's just a convenient way of spreading out the cost of your prescriptions more evenly throughout the year.
You can sign up for this new program anytime during the year. It's already April and you may have spent a fair amount of money on deductibles and copays. But if you look at your costs and believe you could still benefit from evening out payments over the rest of the year, you can still sign up at any time.
Getting help with unaffordable healthcare costs
Any time you have trouble paying your Medicare bills, whether it's doctor visit copays, Medicare part B premiums, supplemental insurance premiums, or prescription drug costs, you can use this link to see if you're eligible for programs that might help. Many people who are eligible for extra help with healthcare costs don't know help is out there. If you, or someone you know, might be in that situation, check it out!
Take a look at this new payment option!
If you've already signed up for it and have feedback, please comment in the section below. You can ask questions there, too, and I'll try to answer them. Or contact us directly at Better My Meds -- we love hearing from you!
