Are you or a Relative New to Medicare? Learn from a pro about Part D planning

Learn from the Experts: Part D Overview
By: Rich Allen, Allen Associates
 
As HealthyHive.com gets its start in NH (and the US), we want to provide guest bloggers to bolster our consumer education initiatives.  Rich Allen has provided Medicare expertise for over 38 years.  Rich’s wife Linda & their son John operate Allen Associates in Manchester New Hampshire.  Rich & Linda have consulted seniors on their Medicare insurance planning for over 38 years.  They specialize in Medicare Supplemental Plans, Part “D” Rx plans, Senior Life insurance, and Long Term Care planning.
Rich’s post below is intended to inform you of some of the most common pitfalls for those learning the Medicare Part D ropes for the first time.  If you have any ideas of future guest bloggers please email us at info@hiveaway.com

 
The first challenge: Part Medicare Part “D” Prescriptions
Consumers are eligible to enroll for a Part “D” RX plan within 3 months of signing up for Medicare Part “B” benefits. You will pay a permanent penalty to Medicare if you don’t and the penalty increases every year you wait to obtain a RX plan. The penalty is waived if you continue your current Group coverage or VA Veterans health plan as long as it is defined as “as good as or better than the Medicare Part D plans”. (A creditable plan)
You can change your RX plan every year from October 15 and December 7.
Do not buy a plan just because you recognize the company name from a TV AD, or you got a flyer in the mail.
It might be the best plan in the world for your neighbor but not for you.
The (vital) key to this decision is comparing your actual list of drugs to the dozens of plan formularies available in your state so you can arrive at the lowest actual out-of-pocket cost to you for the year.  A wrong decision here could cost you thousands of dollars.

• Each plan insurer usually has 3 options with various deductibles and co-pays
• Most of these plans have an agreement with one or more of the major pharmacy chains. These are called “Preferred Pharmacies”. This can mean much lower co-pays for you if use the “preferred” drug store, or sometimes even lower cost if you use the mail order option
• There are five tiers your drugs can fall into. Each tier has different co-pays
• Your drugs could be in a different tier from plan to plan
• The first tier is for preferred Generic drugs.  In some plans there is zero co-pay for generic drugs.  In the other tiers you will pay a percentage of the cost instead of a co-pay.
• All Part “D” plans have a formulary (list) of drugs they will cover. If your drugs are not in the formulary, you will pay the full cost
• Some plans will move a drug from one tier to a higher cost tier from year to year leaving you with a higher out of pocket cost for the same plan you had the year before
• If you want to be sure getting the most for your money, you must review your drug plan yearly with a competent broker who is certified to understand these constant changes by the drug plans that could cost you unnecessary expense

Summary
Today I have covered the most important Parts of the Medicare Part “D” stand-alone drug plans.  There are many other Medicare planning components I will discuss in future blogs.  Questions to address will include:

1. How will my medications be paid for?
2. Should I keep the health plan I have if I am still working?
3. Can I keep my current doctors and use the same hospital?
4. Will I have access to the best hospitals anywhere in the country?
5. How would I pay for a long-term illness?
6. Can I get help paying my premium (if I can’t afford it?)
7. How will I be covered for medical care if I travel around the U.S. or out of the county?
8. Are there penalties if I don’t sign up for Medicare Part “B” and Part “D”?
9. Who is qualified to help me make these decisions?

Rich Allen can be reached by phone or email if you have any questions or need help choosing the right Plan to suit your individual circumstances.
Rich Allen
Allen Associates of Manchester
Phone: 603-625-2266 or 1-800-323-0203
Email: rich@richallen.com or rich@allenassociatesnh.com
www.allenassociatesnh.com