MEDICARE
PART D SPECIAL ALERT
By Dana
E. Bookbinder. Esquire
Homework
is Key for Medicare Part D
By now,
we have all been introduced to the new Medicare
Prescription Drug Plan, also
called Medicare Part D. Regardless of how much time
you have spent trying to understand the new
program, you have probably discerned one primary fact: it’s
complicated. Now that the program
has begun with the new year, a worthy resolution would be to
make sense of it – and then sign up.
For those who do not have an alternate equal or better
prescription plan, the deadline to sign
up for a Medicare D plan under the program without
penalty is May 15, 2006. It is important that
you select a plan that covers the prescription medications
that you take and is accepted by the
pharmacy where you purchase them. Those are the first things
you must verify.
Each plan
requires a monthly premium that you must pay and, in
addition, each may require
an annual deductible of up to $250 be satisfied before the
discounts kick in. Details on the standard
plan were included in Begley and Bookbinder’s September 30,
2005 Alert. If all the plans stuck to
the standard formula, signing up would be easy; an
individual would simply select any plan offered
by his pharmacy that includes his particular medications.
However, it’s not that simple, because of
the large number of plans and because each offers its own
variation of the standard plan. To
provide help, the government maintains a Help line,
(1-800-medicare) and also an internet website
(www.medicare.gov).
Approximately 19 companies offer Medicare approved
prescription drug plans in New Jersey, and some offer as
many as 3 options for a total of about 45 choices. The
government Help line assists you in comparing three plans.
Those of you with Internet access may want to see the plans
for yourself. I found the Internet to be not user friendly
because for each prescription that is entered, and for each
dosage, the user must switch between web pages. Be prepared
to spend substantial time online, especially the first time.
Those with high speed access will get quicker results.
The website gives you the option of entering your specific
pharmacy or of simply requesting the best prices in your
area. The website will display all the plans available to
you. For each plan, it will give you a phone number to call
for further information and to enroll (it is also possible
to enroll directly via the website). It also gives the
monthly premium, the deductible, your monthly out-of-pocket
25% cost share, and your total annual estimated cost;
including the premium, taking into account the deductible
and the coverage gap. It also gives you the option of
selecting cost details for any one plan at a time. That
option provides the user the cost of each medication, both
the 25% discounted price and the full retail price.
Plans that eliminate the deductible are not necessarily the
least expensive. They may make
up the difference by charging a higher premium or a higher
price for the drugs. Also, it is
extremely important that you check with your pharmacy before
you commit to a plan. It is possible
that the website information will not be the most current
with regard to whether a pharmacy accepts
a particular plan.
Be aware that the estimated out of pocket costs of
particular medications could vary widely
from plan to plan. The total cost between the least and most
expensive plans for six medications
that I entered into the computer varied by almost $2000.
Therefore, to find the cheapest plan that
carries your medications and is accepted by your pharmacy,
you must do your homework.
Once signed up in a plan, you are committed to that plan for
a year. Keep in mind that you
may change or add to your prescriptions, and the insurance
companies may make changes to the list
of prescriptions drugs they cover and their costs during the
year. The next opportunity to re-enroll
will be next November 15. |
