Making the Most of Medicare: How the Right Plan Can Save You Money

Each fall, Medicare’s Annual Open Enrollment period offers an important opportunity to review and update your health and prescription drug coverage. From October 15 through December 7, anyone with Medicare can compare plans and make changes for coverage that begins January 1.

For residents and their families, this can feel overwhelming. Costs, coverage rules, and even which pharmacies or doctors are included in a plan can change from year to year. Staying in a plan that no longer fits your needs may leave you paying more than necessary.

The good news? With the right support, choosing a plan doesn’t have to be confusing.

Why Reviewing Your Plan Matters

Many residents in senior living or long-term care take multiple prescriptions every day—often a dozen or more. Medication costs add up quickly, and the way your benefit plan coordinates with your pharmacy can make a big difference in your monthly bill.

Even if you’re satisfied with your current coverage, reviewing your plan each year can uncover potential savings. Research shows that people who shop among plans annually often find lower costs, better drug coverage, or fewer restrictions. For example, one Guardian resident with TRICARE for Life was paying $74 a month in drug copays. After enrolling in a $0-premium Medicare Part D plan, his copays dropped to zero, saving nearly $900 each year.

Stories like these aren’t unusual. On average, residents who compared and switched plans saved over $778 a year.

Understanding Your Options 

Medicare has several parts, and it’s important to know the basics:

• Original Medicare (Parts A & B): Offered through the federal government, covering hospital and medical services. Generally pays about 80% of healthcare costs.
• Medicare Advantage (Part C): Private plans that bundle Parts A and B, often including prescription drug coverage. Many also offer dental, vision, hearing, or even long-term care pharmacy benefits.
• Prescription Drug Plans (Part D): Standalone plans that add drug coverage to Original Medicare. These plans vary widely in cost, coverage, and which pharmacies they work with.

For those with additional coverage, such as TRICARE, the right Medicare plan can coordinate benefits in a way that reduces or even eliminates copays.

How Guardian Can Help 

Guardian Pharmacy’s local teams know that residents and families want peace of mind when it comes to medication costs. That’s why we offer Medicare Benefits Reviews during Open Enrollment. These reviews:

• Compare multiple plans side by side
• Take your current prescriptions into account
• Provide an estimate of monthly and yearly costs
• Highlight changes in formularies, deductibles, or provider networks

Our trained billing specialists and Benefits Navigators also coordinate directly with insurance companies and prescribers to make sure medications are covered, and our experienced senior care pharmacists can assist with finding alternatives when they aren’t.

For families and community leadership, this means fewer billing surprises, less stress on care staff, and residents who feel supported in making informed choices about their care.

Take action before December 7

If your current plan still meets your needs, no action is required. But if your health, medications, or financial circumstances have changed, or if your plan’s coverage is changing, it’s worth exploring your options.

Enrollment ends December 7, and new coverage begins January 1. A short conversation with a Benefits Navigator could make a big difference in your costs for the year ahead.

Final Thoughts

Prescription drug coverage isn’t one-size-fits-all. Each resident’s needs are unique, and the right Medicare plan can help reduce financial strain, ensure access to necessary medications, and ease the burden on caregivers.

Guardian is here to help you make sense of your options, so you can focus on what matters most—health, comfort, and peace of mind.

👉 To learn more or connect with a Guardian Benefits Navigator, visit guardianpharmacy.com/medicareoptions.

Walt Rowland, Director, Medicare Plan Optimization and Services

Guardian Pharmacy Services