Check federal site annually for best Medicare drug plan
TERRY SAVAGE firstname.lastname@example.org Nov 18, 2010
Medicare recipients should go through the entire process annually, during the period from Nov. 15 through Dec. 31, when you are allowed to change plans because you could save a lot of money.
Updated: May 3, 2013 12:14PM
I'm a senior, and for the last couple of years I've had the same Medicare Part D drug plan. I've been seeing a lot of advertisements. Do I have to go through the whole process of finding a new plan and signing up, or should I just stick with the plan I already have?
A. I'm always astounded at the hoops seniors have to jump through to deal with Medicare, and supplements, and now the Part D drug plan. Maybe they think all seniors are retired and have nothing better to do! Since there are 40 million seniors and disabled individuals eligible for Part D, this adds up to a lot of time spent on the process, but it will be well worth it.
So, yes, you should go through the entire process annually, during the period from Nov. 15 through Dec. 31 , when you are allowed to change plans. Doing so could save you a lot of money for several reasons.
First, you could be taking different medicines or dosages. Second, the drug plan that you now have could be changing its prices in January for the drugs you take. And there is some new competition among those who offer these plans -- most notably Wal-Mart's entry as a partner with Humana to create a program that promises total savings of as much as 30 percent for the average senior's total cost.
Also, if you take a lot of medicines, you already know about the "doughnut hole" -- the point where you have to pay for your drugs before the catastrophic coverage provided by the government kicks in. This year, as part of the health reform bill, if you fall into that doughnut hole category, you'll receive a discount on branded drugs. Again, that makes it important to figure out which plan has the lowest overall cost.
If you can't remember how it worked last year -- and for those new to Part D -- here are some basics you should know.
Signup for Part D is required: You must sign up for Medicare Part D -- even if you don't take prescription medicines. If you don't sign up, then when you do need coverage you'll always pay higher premiums. The only exceptions to the need to sign up are those seniors with "equivalent" or "creditable" drug coverage from an employer's health care plan or retiree health plan. (Your employer will give you a letter attesting to that coverage.) Also, those many who receive medical benefits from the VA can get equivalent coverage.
Two ways to get Part D: You can buy Part D coverage from the private Prescription Drug Plan that is the least expensive based on the drugs you take. Each of these plans has its own monthly premium, deductible and co-pay per prescriptions (above the deductible level). That's why you need to use the tool at Medicare.gov to figure out which plan is overall the least expensive for your situation.
Or you can sign up for a Medicare HMO, known as Medicare Advantage. Then you won't need a separate Part D plan because all of your drugs will be covered by your HMO. Of the 27.7 million people enrolled in Medicare Part D drug plans, one-third are covered by Medicare Advantage plans.
Assistance for low-income beneficiaries: If your income is below $16,245 and you have few other assets, you qualify for assistance. If you know someone who would qualify, be sure to pass on this information, since it could make a life-or-death difference.Easier than you think
The only way to find the best -- cheapest -- plan for you is to use the "planfinder tool" at www.Medicare.gov -- or call for help at (800) Medicare. All you need is your Medicare number -- and the names and dosages of all your prescriptions. You'll enter that information, and the computer will generate a list of PDPs that are available in your neighborhood, with the least expensive on top -- based on the drugs you're currently taking. You'll want to compare not only the monthly premium but the overall cost for the year before making a choice.
A final note about the Humana/Wal-Mart RX plan: Two giants in the industry have gotten together to make a potent competitive entry into the Part D program. They're so proud of their deal, expected to average $450 a year in savings, that you can access the Medicare tool right from the Wal-Mart website.
If you're an adult child or grandchild -- or neighbor -- of a senior, take the time to sit down with him or her and go through the process while you're waiting for the turkey to cook next week. It will make them very thankful. And that's The Savage Truth.
Terry Savage is a registered investment adviser.HOW YOU CAN PICK TERRY'S BRAIN
In this column, I'll respond to your most frequently asked questions regularly. Of course, you always can submit individual questions on my Sun-Times blog, reached on the home page at www.TerrySavage.com.