If you have End-Stage Renal Disease (ESRD) and are enrolled in Medicare, you most likely have Original Medicare Part A and Part B. Part A covers hospital insurance and Part B covers medical insurance. Most people with ESRD are not currently able to get Medicare Part C, also known as Medicare Advantage, which combines Parts A and B (and sometimes Part D). Part D is a prescription drug plan. It is a separate plan that people with ESRD can purchase to help pay for outpatient prescription drugs.
If you have Original Medicare Part A and Part B, you do not have to do anything during the Medicare open enrollment period. However, if you have Part D, you will want to review your plan to see what changes are being made for 2018, if all your drugs are still covered, and compare its value to that of other Part D plans. You may be able to lower your costs by shopping among the various Part D plans available in your area. To change your Medicare Part D policy, you will need to do so between October 15 and December 7, 2017. Otherwise, you will have to wait another year to make any changes.
You may find the tool, Medicare Plan Finder, helpful in choosing a Medicare Part D plan. It enables you to view and compare the drug options in your area, which plans cover your drugs, what the costs of your medicine will be at your specific pharmacy, and what the 5 -Star ratings for the plans are.
To use the Medicare Plan Finder, you can go to Medicare.gov, then click on “Find health & drug plans” or click on the tab “Sign Up/Change Plans” and select “Find health & drug plans” from the drop-down menu or go to Medicare.gov/find-a-plan. The Medicare Plan Finder is also available in Spanish. Or you can call Medicare at 1-800-MEDICARE (1-800-633-4227)/ TTY: 1-877-486-2048.
In addition, you can contact your local State Health Insurance Assistance Program (SHIP) which is a free health insurance counseling program for people with Medicare and their families. Your dialysis social worker also can be helpful to you and/or direct you to the appropriate person or resources for your Medicare questions. Once you decide which Medicare Part D plan is the best for your prescription medicine needs, you may want to contact the company directly to further answer any questions.
Additional resources:
4 Ways to Help Lower your Medicare Prescription Drug Costs
Information Patients Can Use On: Open Payments
Medicare and Other Health Benefits: Your Guide to Who Pays First
Medicare Rights Center: 2017 Guide to Fall Open Enrollment
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