In 2024, Georgia has 20 different standalone Medicare Prescription Drug plans (Part D) to choose from. Metro Atlanta alone has over 100 Medicare Advantage plans that offer prescription drug coverage to choose from. Each plan has a different monthly premium, annual deductible, per prescription copay/coinsurance, different formularies (list of drugs the cover), and pharmacy networks. Considering an average of 35% of Medicare beneficiaries regularly take 5 or more medications, it can get overwhelming and frustrating very quickly. Choosing the wrong plan can cost them hundreds.

The do-it-yourselfer will go to Medicare.gov every fall and enter their current medications, along with their preferred pharmacy. They click on the “most cost effective” plan and enroll, thinking there’s not much more to it. That’s where mistakes are made. One of my most often used phrases in the office is, “Prescription drugs in the Medicare world is like a scavenger hunt”. There are SO many things to consider in plan selection that most don’t think of. That’s my specialty!

• That generic medication you’re taking but paying a brand tier price for? Yeah, we can likely get that knocked down to a generic tier (Tiering exception).
• Your plan wants to charge $47 per refill of a cream that treats rosacea? I found it on Goodrx for $13.
• CostPlusDrugs.com has that medication you were paying $100 per month for at CVS, for $24 for a 90-day supply.
• When you hit the “donut hole”, let me know. There are likely Patient Assistance Programs available that will help with the cost increase.

These are all things that I take into consideration when helping my clients choose their plan. Sure, Medicare.gov can give them a good starting point, but knowing the ins and outs of the Medicare Part D world and knowing how to play the game with insurance companies can save hundreds. It’s one of my absolutely favorite games to play and I’m the MVP.