Post by norbert1 on Jul 5, 2006 9:14:10 GMT -5
My local alzheimer’s association had an education program on this and has another one scheduled. In my state, the insurance department has set up an 800 number to help people figure this out.
This program was set up this way so that it could be run by the “Private sector” instead of the government. They were hoping competition would create the cheapest/best program for consumers. Yes it is confusing.
In any area/state, several companies should be offering medicare part D. Each company is required to offer at least 2 meds from each drug class. (Since dementia doc’s have to switch around from one med to another to find the one that works, I think this could be a problem if you get a company with a limited drug list "formulary").
What you have to do, is use a program compare program at medicare.gov. List the meds the person is on, and it will tell you what each program in your area will cost you (premiums and co-pay) (I haven’t been able to use this yet for my MIL because the program requires personal information I don’t have yet. )
The government is providing a $600 subsidy to private drug plans. Some existing plans will continue to offer meds to their existing members. Others (like the one my MIL has) are deciding to drop the drug portion and telling people to shop around and subscribe to a Medicare part D plan.
Enrollment is open until May 15, 2006 (but you will be missing out on benefits if you wait that long.) After that time, you will have to wait for the next enrollment period (at the end of the year) there is a penalty of 1% of premium per month for delayed enrollment (wait to the end of 2006 to enroll, and there will be 7% added to the premium.)
You can switch plans once per year with out penalty (at the end of the year.) You can switch onto part D without penalty if you are dropped from another QUALIFIED drug plan, or if your plan folds. (if the plan offered "creditable coverage").
The minimum benefits a drug plan must provide---
There is a monthly premium
There is a yearly deductable of $250 (may be less in some plans)
For drug costs from $250 to $2250, copay is 25%
On basic plans, you must may 100% for costs from $2251 to $5100 (The gap or doughnut hole. Some companies will offer supplemental coverage for this gap for an increased premium)
For drug expenses above $5,100, Medicare Part D then kicks in again and provides all beneficiaries with a "catastrophic benefit" that covers 95 percent of all drug expenses until the end of the calendar year. The benefit then is $2 per prescription for generic drugs, $5 for brand-name drugs or 5 percent of the cost of each prescription, whichever is higher.
Social security will offer premium assistance for low income seniors.
---------------------------------------
I found a good article that explains medicare part D
www.bankrate.com/brm/news/insurance/20051115a1.asp
----------------------
from the web
A crucial part of deciding which drug plan to join involves knowing which prescription drugs are covered by the different plans. The only easy way to compare drug plans is on the Internet. Unfortunately, many senior adults do not have access to this important tool. That is why senior centers in Southern Illinois have been equipped with a high speed Internet connection in order to help senior adults make their decision about Medicare’s approved prescription drug plans.
The Medicare website has a “Compare Medicare Prescription Drug Plans” and “Enroll in a Medicare Prescription Drug Plan” links which anyone can use to find out which drug plan best fits their needs and pocketbook. This comparison tool is needed since not all drug plans cover every drug, and the monthly premium and deductible varies depending on the plan chosen.
---------------------
Recent information from a talk by the Ohio Insurance Dept
on January 4, 2006
Most Medicare HMO programs include drug coverage.
The average cost of drug programs was $32 per month.
All the programs were better than the minimums set up by medicare. Most reduced or eliminated the $250 deductable and most closed the "doughnut hole" gap in coverage.
I tried to get acquainted with the medicare program for choosing a plan. The animated demo takes 10 minutes showing you all the places that have to be clicked and information that needs to be entered.
Wallgreens drug store is now running adds that they will run the program comparisons and prepare a report for people.
Some nursing homes are running the analysis for their residents, but many are not. (It makes sense to me that the NH should do it since they have to make arrangements and have a working relationship with the drug companies they use.)
Residents usually obtain drugs from a pharmacy(s) chosen by the facility.
It is very important that medicare and medicaid recipients are enrolled in a plan that is "creditable" (participates in the Medicare program) - otherwise they will be hit with premium penalties when they enroll later.
The old medicare supliment plans - H, I and J are not creditable.
Your current drug plan should have sent you a letter telling you whether it is "creditable". If not, call your plan and find out.
---------------------
My aunt had a drug bill of $500 per month. She definitely would have saved money with this plan.
Norbert
This program was set up this way so that it could be run by the “Private sector” instead of the government. They were hoping competition would create the cheapest/best program for consumers. Yes it is confusing.
In any area/state, several companies should be offering medicare part D. Each company is required to offer at least 2 meds from each drug class. (Since dementia doc’s have to switch around from one med to another to find the one that works, I think this could be a problem if you get a company with a limited drug list "formulary").
What you have to do, is use a program compare program at medicare.gov. List the meds the person is on, and it will tell you what each program in your area will cost you (premiums and co-pay) (I haven’t been able to use this yet for my MIL because the program requires personal information I don’t have yet. )
The government is providing a $600 subsidy to private drug plans. Some existing plans will continue to offer meds to their existing members. Others (like the one my MIL has) are deciding to drop the drug portion and telling people to shop around and subscribe to a Medicare part D plan.
Enrollment is open until May 15, 2006 (but you will be missing out on benefits if you wait that long.) After that time, you will have to wait for the next enrollment period (at the end of the year) there is a penalty of 1% of premium per month for delayed enrollment (wait to the end of 2006 to enroll, and there will be 7% added to the premium.)
You can switch plans once per year with out penalty (at the end of the year.) You can switch onto part D without penalty if you are dropped from another QUALIFIED drug plan, or if your plan folds. (if the plan offered "creditable coverage").
The minimum benefits a drug plan must provide---
There is a monthly premium
There is a yearly deductable of $250 (may be less in some plans)
For drug costs from $250 to $2250, copay is 25%
On basic plans, you must may 100% for costs from $2251 to $5100 (The gap or doughnut hole. Some companies will offer supplemental coverage for this gap for an increased premium)
For drug expenses above $5,100, Medicare Part D then kicks in again and provides all beneficiaries with a "catastrophic benefit" that covers 95 percent of all drug expenses until the end of the calendar year. The benefit then is $2 per prescription for generic drugs, $5 for brand-name drugs or 5 percent of the cost of each prescription, whichever is higher.
Social security will offer premium assistance for low income seniors.
---------------------------------------
I found a good article that explains medicare part D
www.bankrate.com/brm/news/insurance/20051115a1.asp
----------------------
from the web
A crucial part of deciding which drug plan to join involves knowing which prescription drugs are covered by the different plans. The only easy way to compare drug plans is on the Internet. Unfortunately, many senior adults do not have access to this important tool. That is why senior centers in Southern Illinois have been equipped with a high speed Internet connection in order to help senior adults make their decision about Medicare’s approved prescription drug plans.
The Medicare website has a “Compare Medicare Prescription Drug Plans” and “Enroll in a Medicare Prescription Drug Plan” links which anyone can use to find out which drug plan best fits their needs and pocketbook. This comparison tool is needed since not all drug plans cover every drug, and the monthly premium and deductible varies depending on the plan chosen.
---------------------
Recent information from a talk by the Ohio Insurance Dept
on January 4, 2006
Most Medicare HMO programs include drug coverage.
The average cost of drug programs was $32 per month.
All the programs were better than the minimums set up by medicare. Most reduced or eliminated the $250 deductable and most closed the "doughnut hole" gap in coverage.
I tried to get acquainted with the medicare program for choosing a plan. The animated demo takes 10 minutes showing you all the places that have to be clicked and information that needs to be entered.
Wallgreens drug store is now running adds that they will run the program comparisons and prepare a report for people.
Some nursing homes are running the analysis for their residents, but many are not. (It makes sense to me that the NH should do it since they have to make arrangements and have a working relationship with the drug companies they use.)
Residents usually obtain drugs from a pharmacy(s) chosen by the facility.
It is very important that medicare and medicaid recipients are enrolled in a plan that is "creditable" (participates in the Medicare program) - otherwise they will be hit with premium penalties when they enroll later.
The old medicare supliment plans - H, I and J are not creditable.
Your current drug plan should have sent you a letter telling you whether it is "creditable". If not, call your plan and find out.
---------------------
My aunt had a drug bill of $500 per month. She definitely would have saved money with this plan.
Norbert