Blog

The Best 2021 Medicare Part D Drug Plans in Decatur, IL

The Best 2021 Medicare Part D Drug Plans in Decatur, IL

Medicare’s Annual Enrollment Period (AEP) starts on October 15, which is generally the only time during the year you can switch Part D drug plans.

The AEP lasts from October 15-December 7, so if you haven’t had your drug plan reviewed yet, make sure you contact us as soon as possible!

In this article, we'll share why everyone should review their drug plan annually, some Part D updates for 2021, ​​and our recommendations for the most competitive Part D carriers.

→ Get the 2021 Medicare Enrollment Period To-Do List

Note: Originally published October 14, 2019. Updated October 6, 2020 to include new drug plans for the 2021 contract year.

Why You Should Review Your Part D Drug Plan

Before we offer up our recommendations for the most competitive 2021 Medicare Part D drug plans in Decatur, IL, you might be wondering – is it really necessary to review my plan?

Even if you love your drug plan, the unfortunate reality is that drug plans change every single year.

For example, those with a 2020 Mutual of Omaha drug plan will experience a $50.90 premium increase in 2021 unless they change plans between October 15-December 7!

Benefits and prices can and do change every year, not to mention that the prescriptions you take might have changed as well.

Drug plans have formularies, and you want to make sure that the drugs you take are in your plan’s formulary. If not, you’ll pay much more than you need to on prescription drug prices.

Changes You Can Make to Your Medicare Drug Plan

From October 15-December 7, you can make the following changes to your Medicare drug plan:

  • Enroll in a stand-alone Medicare Part D plan
  • Switch from one stand-alone Medicare Part D plan to another one
  • Drop your prescription drug coverage

This is the only time of year in which you can make these changes, so it’s in your best interest to at least shop the options.

If you don’t make adjustments to your Part D plan during this special time period, your options for making changes later are very limited.

You’d have to qualify for a special enrollment period, which includes situations like getting kicked off of your employer’s group plan or your Medicare Advantage plan getting terminated. If you don’t qualify for a special enrollment period, you just have to wait until October 15 of next year to make changes.

Take advantage of the Medicare AEP while you can! You have nothing to lose, but hopefully, you have some money to save.

Medicare Part D 2021 Updates

There are a few changes this year as we enroll in 2021 Medicare Part D plans.

Insulin savings

The first change is the new initiative to bring down insulin costs for diabetics. This initiative is called the Part D Senior Savings Model – it was announced by President Trump on May 26, 2020 and takes effect January 1, 2021.

The "Model," as it's often called, caps the cost of a 30-day insulin supply for most insulins to a maximum of $35. If you choose a Part D drug plan that participates, your insulin prescription will not be subject to a deductible or any coverage gap cost increases.

Read more at American Diabetes Association or CMS

For our existing clients, there's nothing you need to do – we will enter in your current prescriptions and will find you the lowest cost plan. If you choose to run your own drug comparisons, be sure to filter the plan options by clicking "Filter Plans" and checking the "Insulin savings" box.

Drug deductible is now $445

Most stand-alone Medicare Part D drug plans will have a $445 deductible for 2021. It was slightly less last year at $435, but the change isn't very significant.

Compare costs from up to five pharmacies

The final change is we can now compare costs for up to five pharmacies at a time.

In previous years, the comparison limit was three.

Again, for our existing clients, there's nothing you need to do. We'll run your drug comparison with your favorite pharmacy. However, if you want to compare costs for other pharmacies, just let us know!

Most Competitive Medicare Part D Plans in Decatur, IL

Each year, the most competitive drug plans change, because the plan benefits and premiums also change.

This year, the most popular Part D carriers in Decatur, IL are going to be SilverScript, WellCare, and Mutual of Omaha. These are the three companies we’ll be recommending the most when we run drug comparisons for our clients.

Our recommendation is always tied to the drug comparison you can run on Medicare.gov. SilverScript has a plan with a great, low premium, WellCare has three stand-out plans, and Mutual of Omaha is great for those who prefer local pharmacies over chains.

Using the recently updated drug comparison tool on Medicare's website, you can enter the exact prescriptions you take, and the system will show you the plan options in your zip code. Simply sort plans by 'lowest drug + premium cost', and your least expensive option will sort to the top!

Rest assured you don't have to do this on your own – your agent will assist with running your Part D drug plan and will either walk you through the enrollment process or complete the enrollment for you.

If you're not currently a Sams/Hockaday client, give us a call at 217-423-8000 to request an appointment!

Drug Comparison Example for Decatur, IL Seniors

Here are several examples showing you theoretical drug comparisons and the best 2021 plan options here in Macon County.

Example 1: I take Lisinopril and Simvastatin

We do this day in and day out, and there’s no doubt that Linisopril, a blood pressure medication, and Simvastatin, a cholesterol pill, are the two most common prescriptions we see.

Since these generic drugs are so common, let’s use them in a drug comparison example.

After running these prescriptions through Medicare’s updated Plan Finder tool, SilverScript SmartRx is the lowest cost option with a total annual cost of $87.60. That's if you pick up your drugs at CVS, and that's premiums and copays at the pharmacy combined.

In fact, copays at CVS in this example are $0.

Keep in mind the pharmacy you go to is very important. This same drug plan would cost you $2,193.12 if you went to Walgreens for your prescriptions. (And these are generics!)

The bottom line is make sure you understand which pharmacy "plays nice" with your drug plan. That will help you lower your total out-of-pocket costs for the year. If you have a favorite pharmacy, let your agent know, and we will find a drug plan that works well with it.

Example 2: I take NovoLog

To showcase how the Insulin savings filter works, let's say you take NovoLog with a 100unit/ml solution pen injector.

By checking the "Insulin savings" box, we see the nine Medicare Part D drug plans in Macon County that are a part of Medicare's Senior Savings Model. These plans cover several types of insulin at a maximum $35 copay for a 30-day supply in the deductible, initial coverage, and coverage gap phases of the Part D benefit.

The most competitively priced drug plan in this example is WellCare Wellness Rx, with a total annual cost of $596.40 if you fill your prescriptions at Walmart, CVS, or Walgreens. (This plan is considerably more expensive if you use a local pharmacy or mail order.)

Example 3: I prefer a local pharmacy

If you'd rather support local pharmacies than shop at a chain, Mutual of Omaha's Rx Premier at $23 per month looks like a great choice.

Most of the local pharmacies like Dale's, Colee's, and Sav-Mor are preferred in-network pharmacies.

What If I Don’t Take Medications?

You have the option to refuse Part D drug coverage, but there are some penalties attached to that.

Each month you go without creditable drug coverage, you’re penalized 1% of the national base beneficiary premium, and the final sum is added to your monthly Part D premium.

Read more: Penalties For Not Signing Up For Medicare Part D: What Is the Part D Penalty?

If you want to avoid penalties and like the idea of having a drug plan just in case, the lowest premium plan in Macon County is $7.30 from SilverScript. This is the lowest premium drug plan we've seen in a very long time.

If you need help with your drug plan, please contact us at 217-423-8000! We are your local, trusted Medicare agents and will go above and beyond to make sure you have the best coverage for the lowest price.

Get a Prescription Drug Plan Comparison

Whether your premiums change or not, there's a good chance that the medications covered by your plan change yearly. Let us help you choose the best plan.

Get Started
Get a Prescription Drug Plan Comparison

Here's what our clients say…