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South Texas Living


How to pick the best Medicare prescription drug plan for you




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Jim Miller
The Savvy Senior
October 12, 2011 | 2,520 views | Post a comment

Dear Savvy Senior,

I recently received a letter from my Medicare “Part D” prescription drug plan provider notifying me that my premiums and co-pays will be increasing next year, and they are dropping coverage on one of the drugs that I take. How can I find a better drug plan?

Frustrated Senior

Dear Frustrated,

Because Medicare’s prescription drug plans can change their costs and benefits from year-to-year, comparing Part D plans every year during the open enrollment season (which is now Oct. 15 -- Dec. 7) is always a smart idea. Here are some tips and resources to help you find the best drug coverage at the lowest price.

• Do it yourself

If you have a home computer and Internet access, comparing your current Medicare drug plan with the many other plans that are available, and enrolling in one, is something you can do yourself.

Just go to Medicare’s online Plan Finder Tool at www.medicare.gov/find-a-plan, and type in your zip code or your personal information, the drugs you take and their dosages, and select the pharmacies you use and you’ll get a cost comparison breakdown for each plan available in your area. This tool also provides a five-star rating system that evaluates each plan based on past customer service records, and suggests generics or older brand name drugs that can reduce your costs.

When comparing drug plans don’t judge a plan strictly by its monthly premium cost. Low-premium plans are often associated with higher prescription co-payments and may end up being more expensive. So take a look at the whole pricing package, including premiums, deductibles, and co-pays. Also, be sure the plan you’re considering covers all of the drugs you take with no restrictions. Some plans may require you to get permission or try a number of cheaper drugs before they will cover certain prescriptions.

• Need help

If you need some help with this or if you don’t have Internet access to compare drug plans, you can call Medicare at 800-633-4227 and they will do the comparing for you over the phone for free, and enroll you in a new plan when you’re ready.

Some other great resources that can help you are the Medicare Rights Center (medicarerights.org), a nonprofit consumer service organization that maintains a hotline at 800-333-4114 to help answer your Medicare questions. And, your State Health Insurance Assistance Program (SHIP), which provides free one-on-one Medicare counseling in person or over the phone. To find a local SHIP counselor visit shiptalk.org, or call 800-677-1116.

If you want even more help, consider Allsup Inc. (866-521-7655, medicare.allsup.com). This is a national fee-based company that offers a Medicare Advisor Part D plan selection service that takes your information over the phone or online and does the comparing and analyzing for you, and then helps you choose and enroll in a plan that best meets your needs and budget. The fee for this service is $75.

• Shrinking donut hole

You also need to know that Medicare’s “donut-hole” coverage gap will shrink a little more next year. Thanks to health-care reform, Medicare Part D beneficiaries that hit the coverage gap in 2012 will again receive a 50-percent discount on brand-name drugs, and an increased 14-percent discount on generic medications.

For 2012, the coverage gap begins if your total drug cost exceeds $2,930 (that includes your share and the insurer’s share of the costs) and ends when your total costs reach $6,657.50. After that, your Part D plan usually covers around 95 percent of your remaining drug costs for the year.

Savvy Tip: If your income is under $16,335 a year (or $22,065 for married couples) and your assets are below $12,640 (or $25,260 for married couples), you may be eligible for “Extra Help” in paying for Medicare prescription drug coverage. For more information, call 800-772-1213 or visit www.ssa.gov/prescriptionhelp.

Jim Miller is a contributor to the NBC “Today” show and author of The Savvy Senior book. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit http://SavvySenior.org.
 

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