The Ins and Outs of Medicare D

Medicare Part D Drug Program Explained

Who Should Enroll?

There are several factors that go into making the decision to enroll in the Medicare Part D program.  For Seniors who have no drug coverage and high drug costs, it is an extremely valuable program.  Even people who are partially covered by a retirement plan or a secondary insurance plan with drug benefits should look into the coverage provided by the Part D program.  Medicare prescription drug coverage provides greater peace of mind by protecting you from expected and unexpected drug expenses. Even if you don't use a lot of prescription drugs now, you should still consider joining. As we age, there is a good chance we will need prescription drugs to stay healthy. For most people, joining now means protection from unexpected prescription drug bills in the future, and the cost of the insurance is relatively low.

When Does One Sign Up?

October 15 to December 7 is the period for enrolling in Medicare D Drug Program for those already on Medicare, and the time to switch plans, should there be a need, for those already enrolled.  You may sign up when you first become eligible for Medicare (three months before the month you turn age 65 until three months after you turn age 65). If you don't sign up when you are first eligible, you may sign up in any subsequent year during that same November 15 to December 31 period mentioned above.  The catch is that, if you wait, you will pay a penalty which will be added to your monthly premium.  However, the penalty is not overly burdensome.

How to Enroll?

The most difficult part of enrolling is deciding which is the right plan for you.  Fortunately, Medicare will literally walk you through the process.
Begin with a list of all prescription drugs you use, the dosage you take and the frequency of use.
Then, go to www.medicare.gov or call 1-800-Medicare, and follow the steps to compare insurance plans. Whether on line or on the phone, you will be able to put together a list of the plans that cover the greatest number of the drugs you use with a comparison of the cost of premiums and drugs.
Once you have a list of the top plans recommended by Medicare, use the contact information provided by Medicare to call the companies.  Read off the drugs on your list to the representative who should then be able to tell you what the annual combined cost of premium, co-pays, deductibles and your share of the drug cost will be.
You can compare companies’ costs, ask questions and get a feel for the quality of service you will get from each particular insurance company.
Now you make your choice and enroll in your preferred plan.
Once you have enrolled, received your Medicare D number and given it to your pharmacy, the ongoing process is very easy.  We encourage our clients, whenever possible to use their local independent pharmacy where they can develop a one-on-one relationship with the pharmacist.  There might be some savings in using a chain, but the personal attention of a private pharmacy, and their sensitivity to the constantly changing rules, may be worth the additional cost.

Medicare D to the Rescue - A Client's Story

When Rebecca was first hired by George and Joan 18 years ago, George was an investment banker who traveled overseas with his family for extended periods of time. Eventually George retired and his company assisted with the paperwork to get him Medicare.  He also got a secondary insurance policy that covered his prescription medicine.  George had had Parkinson’s disease for as long as Rebecca had known him, but his medication kept the disease in check.  Coverage for his medicine was a critical part of his insurance.  Unfortunately, on closer examination, Rebecca discovered that the premium for the pharmacy coverage was greater than the benefits.  Since they were now on a diminished income, Joan, in an attempt to trim the co-payments on George’s medicine and stretch the coverage benefits, tried using the secondary insurance’s mail-in pharmacy.  She found it confusing, unreliable, and too bureaucratic.  Next she tried ordering drugs from Canada through a broker.  That too proved unreliable.  Fortunately, the Medicare D plan was introduced and Rebecca helped Joan research the insurance companies to find the one which would include George’s prescription drugs.  George was now able to use his local independent pharmacy and get the kind of individualized attention he appreciated.  At that point, Rebecca and Joan happily called the secondary insurance company and changed to a plan without pharmacy coverage that cost considerably less in premiums.

October 2008 - FEATURE
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