Content below updated October 29, 2013

Money saving improvements noticed in 2014 choices

While working with people interested in saving money on their 2014 prescription drug plans, we have noticed innovative changes introduced in our choices.  We are seeing plans where tier 1 (generic) and tier 2 (non-preferred generic) medications are exempt from the 2014 $310 deductible.  This can mean attractive savings for beneficiaries that take mostly generic medications.  Some mail order plans have zero dollar cost for tier 1 and 2 generic med’s at the 90-day order level.

We have noticed generic med’s being placed in all five tiers too.   The message here is do not assume that the generic med’s you take will always be in your plan’s tier 1 or 2 formulary.

Beneficiaries using Spiriva, a medication frequently used to treat COPD, may have noticed a lower cost alternative that was FDA approved in 2012.  You can learn more about Tudorza Pressair here.   Other popular brand named medications that will have newly available generics are noted below.  If you know people that take any of these medications, you might bring this to their attention; they should check with their doctor and see if these lower cost alternatives will work for them.     These are:

        Aciphex                Comtan              Exforge          Niaspan              Zomig

        Actonel                 Cymbalta          Lidoderm       Opana                 

        Advicor                Detrol La           Lovaza           Rapamune  

        Antara                  Evista                 Lumigan        Renvela

        Atacand               Exalgo                Micardis        Viracept

        Celebrex               Exelon                Nexium         Vivelle Dot


If you are an Idaho resident and have not had your prescription drug plan compared to the alternatives in a while (this includes people with MAPD plans too), you may be leaving money on the table.  Contact us if you would like help reviewing your alternatives.


Content below updated October 11, 2013

Idaho Prescription Drug Plan Changes for 2014

Mining the CMS data about 2014 Prescription drug plans available to Idaho residents produced the information below.

Number of plans available to Idaho Residents:   32

Number of plans with a zero dollar deductible: 14

Lowest cost plan available:  $12.60

Highest cost plan available: $138.80

Number of plans with Gap coverage: 6

Number of plans with a premium decrease:  9

Number of plans with a premium increase: 16

If you have experienced an uncomfortable increase in your monthly premium for your 2014 prescription drug plan and would like help analyzing your alternatives, contact us. We will help you explore your options and if a more cost effective plan is available, help you enroll in that plan.

Content below updated September 26, 2013


It’s official; the July 30, 2013 press release from HHS regarding Prescription Drug Plan changes for 2014 is below.  The original is available here.  Note that “the average premium for a basic prescription drug plan in 2014 is projected to remain stable, at an estimated $31 per month”.  If your PDP plan’s monthly premium increased by an uncomfortable amount without corresponding savings in copays, deductibles, help in the coverage gap or formulary updates,  contact us; we will compare your current plan with others available for 2014.  Remember, if you want to make a plan change, you have to do it between October 15th and December 7th of 2013.




July 30, 2013
Contact: HHS Press Office
(202) 690-6343

Medicare drug premiums remain stable four years in a row

On the 48th anniversary of the signing of Medicare and Medicaid into law, the Department of Health and Human Services (HHS) released data showing that the average premium for a basic prescription drug plan in 2014 is projected to remain stable, at an estimated $31 per month.

This news comes as seniors and people with disabilities continue to save money on out of pocket drug costs. Yesterday, HHS announced that more than 6.6 million people with Medicare have saved over $7 billion on prescription drugs as a result of the Affordable Care Act, an average of $1,061 per beneficiary. The Affordable Care Act closes the donut hole over time.

“Seniors are benefiting from improved benefits and low premiums, thanks to a competitive and transparent marketplace for Medicare drug plans,” said HHS Secretary Kathleen Sebelius.

For the fourth straight year, the average Medicare Part D monthly premium will remain steady, and is projected to be $31. For the last three years – for plan years 2011, 2012, and 2013 – the average premium was projected to be $30. Today’s projection for the average premium for 2014 is based on bids submitted by drug and health plans for basic drug coverage during the 2014 benefit year, and calculated by the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary.

CMS has already announced that key parameters for Part D will actually be lower in 2014 than in 2013.  For example, the Part D deductible will fall from $325 to $310, producing additional savings for enrollees.

The upcoming annual open enrollment period – which begins October 15 and ends December 7 – allows people with Medicare, working with their families and their caregivers, to choose their plans for next year by comparing their current coverage and quality ratings to other plan offerings. New benefit choices are effective Jan. 1, 2014.

To learn more about the Affordable Care Act, go to


Content below updated 8/30/2013

The prescription drug plan changes for 2014 are noted below.  They will become effective January 1, 2014 and will be implemented in all prescription drug plans available to you.  This means if you currently have a standalone prescription drug plan or have prescription drugs covered in your Medicare Advantage plan, you will see these changes.   If you want help understanding how your out of pocket costs will change next year based on these (or the changes your insurance company may make to your current plan), feel free to contact us.   We will review your current drug plan, out of pocket costs, and your options for next year (changing plans).  If any of these changes will save you money and you want to change plans, we will help you do so.  Changing plans takes 30 – 60 minutes.  Your new plan will be effective January 1, of next year.   Here are the highlights for the CMS defined Standard Benefit Plan changes from this year to next. This “Standard Benefit Plan” is the minimum allowable plan to be offered.

  • Initial Deductible: will be decreased by $15 to $310 in 2014
  • Initial Coverage Limit: will decrease from $2,970 in 2013 to $2,850 in 2014
  • Out-of-Pocket Threshold: will decrease from $4,750 to $4,550 in 2014
  • Coverage Gap: begins once you reach your Medicare Part D plan’s initial coverage limit ($2,850 in 2014) and ends when you spend a total of $4,550 in 2014. In 2014, Part D enrollees will continue to receive a 52.5% discount on the total cost of their brand-name drugs while in the coverage gap.  The 50% discount paid by the brand-name drug manufacturer will still apply to getting out of the donut hole; however the additional 2.5% paid by your Medicare Part D plan will not count toward your TrOOP. Enrollees will pay a maximum of 72% co-pay on generic drugs while in the coverage gap.
  • Minimum Cost-sharing in the Catastrophic Coverage Portion of the Benefit**: will increase to greater of 5% or $2.55 for generic or preferred drug that is a multi-source drug and the greater of 5% or $6.35 for all other drugs in 2014
  • Maximum Co-payments below the Out-of-Pocket Threshold for certain Low Income Full Subsidy Eligible Enrollees:  will increase to $2.55 for generic or preferred drug that is a    multi-source drug and $6.35 for all other drugs in 2014


Content below updated July 25, 2013

Will Your Out of Pocket Costs for Medications Change Next Year?

Probably.  Remember, insurance companies can change their plans annually; these changes can easily be reflected in both your out of pocket cost and convenience in having your prescriptions filled.  Not all plans have the same copays, deductibles, formulary, drug tiers, pharmacy networks, and have the same medications under ‘plan management’.

If your medication costs for this year went up, it makes sense for you to shop for a new plan between October 15th and December 7th (your Annual Election Period for Medicare Advantage and Prescription Drug Plans).   Doing so could save you both money and convenience in having your prescriptions filled.  If you have an MAPD plan and are concerned about seeing the same doctor or having access to the same hospitals, etc. we suggest you work with an independent insurance agent that specializes in Medicare AND one that carries all of the MAPD plans available in your area.

If you are an Idaho resident and would like help,  contact us. 


This page was last modified on Feb 16, 2014 @ 7:57 PM