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Medicare Open Enrollment Ends 12/7/14 -- Tool to Assist Beneficiaries with 2015 Medication Needs Shows Wide Disparity in Projected Costs

By Lorianne Maria Sainsbury-Wong posted Fri November 21,2014 02:23 PM

A recent, excerpted MBA article -- Prescription Drugs Price Variation and the ‘Cost Reduction’ Feature in 2015 Medicare Part D Plans ( – applies now to lawyers who assist elderly individuals in need of Medicare coverage and prescriptive medications.  Medicare beneficiaries are presently engaged in the annual open enrollment process, which began October 15th and will continue through December 7th.  

Although under limited circumstances a Medicare beneficiary may be eligible to change prescription drug plans, for most Medicare beneficiaries the open enrollment period is the only opportunity to change plans or to enroll a new Medicare Part D plan.  Medicare has an online Part D [Prescription Drug Coverage] Plan Finder,, which allows individuals to conduct cost comparisons and benefits analysis, assess different plans available geographically, and enroll in a prescription drug plan for 2015.  The Medicare Part D Plan Finder seems most useful to individuals who do not anticipate changes in current medication needs and who can reasonably rely on known prescriptions and dosages as 2015 input data.  It would also make sense for these individuals to consult with their providers and pharmacists who may better understand and/or project their 2015 medication needs and identify therapeutically equivalent generics, if applicable.   

The MBA article identifies the broad range of cost sharing, tiered networks, and medication types that Medicare beneficiaries may experience in searching the available, online Medicare prescription drug plans and benefits. The data identified in Figure 1 of the article, for example, shows disparities in cost, such as approx. $3,500 to $14,000 in projected 2015 costs, depending on the pharmacy and drug plan selected.

[Special thanks to the MBA Publications Staff, who posted an excerpt from this timely article in the 11-20-14 Lawyers e-Journal.  The complete article will appear in the Health Law Section Review of the Massachusetts Lawyers Journal, scheduled for December 2014.]

Lorianne M. Sainsbury-Wong
MBA Health Law Section, Chair

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