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Medicare Part D Information

By Lourdes Cross posted 11-25-2020 08:21

  

Medicare Part D Information
Eileen D. Ward, PharmD, BCACP, TTS
Presbyterian College School of Pharmacy

I am sure many of us working to assist in diabetes care can agree that a common frustration is how difficult it can be for some people to access or afford beneficial medications, particularly insulin. Luckily, there are some Medicare Part D changes coming in 2021 that may make some affordability issues a little easier. For starters, there are some select plans that will offer insulin for $35 or less per month. This can provide a huge cost savings for some individuals. Additionally, there will no longer be a "donut hole" or "coverage gap" in 2021 for any Part D enrollees.  The donut hole was where participants were responsible for 100% of drug costs out of pocket.  In 2021, enrollees will pay 25% of medication costs out of pocket during the gap coverage phase until they reach the "catastrophic coverage phase" which is once $6,550 has been spent on medications throughout the year.   These two updates can go a long way in saving Medicare Part D enrollees a significant amount of money on drug costs.  But enrollees need to hurry if they want to take advantage of choosing a new Part D plan with the insulin savings! The open enrollment period ends on December 7th.  

Below are a few links to considerations when selecting a Medicare Part D plan along with a summary of changes in Medicare coverage for 2021. Also, please see the additional document outlining the process for using the medicare.gov website in identifying Medicare coverage options, including Part D plans that offer the insulin savings plan.   


We can help identify which factors to consider in choosing a plan, but be mindful and allow the final plan selection to ultimately be the patient's choice.  Once a plan is identified, the patient can reach out to a representative of that plan for assistance signing up. Avoid the temptation to assist with this final step to avoid the perception a plan was selected for your or your company's/employer's benefit and not patient choice. Helping eligible patients with diabetes find a Medicare Part D plan that best suits their financial and medication needs is just another way diabetes care and education specialists can positively impact patient care.

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