The Popel Insurance Group Blog
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Do Medicare Part D plans cover the shingles vaccine? SPECIFICALLY Shingrix®?
Yes. Medicare Part D prescription drug plans do cover the shingles vaccine (stand-alone Medicare Part D plans and Medicare Advantage plans that include drug coverage). However, coverage (and cost) of the vaccine can vary depending on your chosen Medicare prescription drug plan, vaccine, and the pharmacy where you have the vaccine administered.
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Many people living with diabetes struggle to afford their insulin. In response to this problem, Lilly has launched a nationwide grassroots campaign called Insulin Affordability: Learn. Act. Share. to drive awareness of their insulin affordability solutions and help people better understand the options available through the Lilly Diabetes Solution Center and other programs. This is the most recent effort to drive awareness to available options and encourage people to act – especially during the Medicare Part D open enrollment period – to lower the amount they pay for their insulin at the pharmacy.
1. Your plan is changing unfavorably
Just because your Part D plan offered certain coverage this year doesn't mean that will hold true going into 2021. All Part D plans have a formulary that groups different prescriptions into different tiers. The lower a tier your prescriptions fall into, the less money you pay for them. But Part D plan formularies can change from year to year, so it could be the case that the prescriptions you take will move from one tier to another, costing you more money. And if that's the case right now, then it could certainly pay to get yourself a different plan. Each year, your Part D plan is required to issue a notice of change, which you should have by now. Read it thoroughly and see what's happening with your plan. If your prescriptions are being bumped into a higher tier, start looking at alternatives. You might be familiar with the acronym CMS, Centers for Medicare & Medicaid Services. CMS is the federal agency that administers Medicare. Annually, they revise the parameters for the standard drug Medicare Advantage and Part D plans to account for increased prescription drug costs. The parameters include the four phases of a Medicare drug plan- deductible, initial coverage phase, coverage gap (or donut hole), and catastrophic coverage. Depending on what medications a Medicare beneficiary is prescribed will depend on how many phases one might enter, varying the costs of prescriptions throughout the year.
Part D changes for 2021 are:
1. While reviewing your options, look at the multiple factors which can affect your plan’s overall costs. While a lower premium might save you money upfront, these plans can have much higher copayments, which over time can make it more expensive.
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