Prescription Drug Plans May Change In New Year

Question: What happens now that my prescription drug plan will not be offered in 2021?

Answer: This year there are only three plans that will not be offered in 2021. The three monthly plans are Magellan Rx Medicare Basic, $35.80, Journey Rx Standard, $32.80, and Journey Rx Value, $26.10. These plans haven’t been the most popular plans.

It sounds like you have Original Medicare, a Medicare Supplement Plan (Medigap) and a standalone drug plan.

The plan that changes the most year to year is your prescription drug plan (PDP). This PDP change each year in the monthly premiums, the coverage the plan gives you on your medication, and the pharmacies considered to be “in-network”.

There are 27 PDPs available in 2020. In 2021 there will be 28 PDPs available. Since I said three plans will no longer be offered, that means there are four new plans. There are also plans that changed names. Some plans have increased their premiums and some have lowered their monthly premiums. The cost of your medications will also change. The way your medications are placed in tiers, and what those tiers cost you during each phase of coverage may change. If you take very little medication or no medication, there may be a cheaper option this year. But review your choices available using some of the tools out there.

The information on the new 2021 plans are available via the medicare.gov website, as well as (800) 633-4227. These are both available 24-hours-a-day, seven-days-a-week between Thursday and Dec. 7.

You also have agencies and programs that are available locally to help you find new insurance. There is Office For the Aging 753-4582 staff available to help with insurance questions throughout the year. Southwestern Independent Living Center 661-3070 also has staff available to help with insurance issues. There is also Senior Life Matters, 720-9797 that can help work through these insurance issues. The insurance companies also have staff available, brokers and insurance agents, to help you make your decisions. Remember that a broker can only talk about the products he sells.

The average premium for all the plans in New York state is $42.27 per month. The minimum coverage allows for a $445 deductible. Next is the initial coverage stage. The initial coverage period ends, and the coverage gap begins at $4,130 in total drug costs which means not only what you pay but what the medication costs according to your insurance and your pharmacy. At $4,130 in total drug cost, you enter the coverage gap, where your cost for 2021 is 25% of the retail cost of your medications. Lastly is catastrophic coverage which is 5% of the cost. Most people do not take enough medication to get to the coverage gap or even close to catastrophic coverage.

If your plan is no longer available in 2021, then you must evaluate the alternatives and enroll in a new plan by Jan. 1, 2021

If your plan is no longer available you actually have some extra time make your new choice, but if you wait and make a choice after Jan. 1, 2021, your coverage will be delayed to the first day of the following month.

Senior Life Matters is a community based program sponsored by Lutheran Jamestown. For questions, concerns or to reach Janell Sluga, GCMC, call 720-9797 or e-mail slm@lutheran-jamestown.org.


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