Illustration by Christoph Niemann
|
Medicare Rx Sign-Up Tips
By Karen Westerberg Reyes, March & April 2006
Five tactics for cutting through the confusion
|
The deadline for choosing a Medicare Part D prescription-drug plan is just around the corner (May 15, 2006). If you're helping a parent, older relative, or friend to make that decision, here are a few things you need to consider to aid them in making their choice.
1. Narrow the field
There are hundreds of Part D plans, but beneficiaries will be able to choose only from the ones offered in their part of the country. To zero in on the best one, look at the three C's: cost, coverage, and convenience. Be sure to isolate the total cost of the plan, not, say, just the monthly premium. Instead, add up the premium, deductible, and your co-pay amounts, plus the expected outlays that might be needed to fill gaps in coverage, if any. Then compare plans using that number. Another key factor in the real cost of any plan is its formulary, the list of the drugs it covers. Consider: Are needed medications on the formulary? Also, are the drugstores that honor the plan convenient? Or, if you prefer mail order, make sure that's an option.
2. Price the medicine
We mentioned formularies above—the plan's list of covered medications. However, not all formularies are created equal. Ask about tiered formularies that require higher co-pays for certain drugs, usually the more expensive ones. Finally, if the plan doesn't cover all the prescriptions the beneficiary takes, make sure it covers the most expensive ones. And remember, a doctor can appeal if a specific drug is needed that isn't covered.
3. Save the mail
If your parent, relative, or friend is receiving prescription-drug benefits from a current or former employer, a union, or the military, he or she should have received a letter by now saying whether or not it'll continue its prescription benefits. If notification was not received, call the plan's administrator right away. If the plan does keep its drug coverage, it should have also sent verification that its drug plan is certified as creditable by Medicare. Save this important piece of paper. If the beneficiary elects to change plans later, or the current benefits are discontinued, he or she will then be able to sign up for another Part D plan without paying a late-enrollment penalty. If the plan isn't creditable, the beneficiary should look into enrolling in a Part D plan.
4. Look to the future
If the person takes only a few prescriptions now, and drug costs are low, it's still a good idea to consider signing up for a less expensive plan as insurance now against a time when prescription needs might increase. Reason: Those who don't enroll in some plan by May 15, 2006, or don't have creditable coverage, will pay a penalty for every month they delay in signing up after that. And the penalty amount will be added to their Part D premium for the rest of their lives. Once they're enrolled, beneficiaries are allowed to change plans once a year during open enrollment.
5. Go to the source
AARP offers three free publications explaining Medicare Part D: "Medicare Drug Coverage: The Basics" (#D18444), "The New Medicare Prescription Drug Coverage: What You Need to Know" (#D18350, #D18352 Spanish), and "Extra Help for People with Limited Incomes" (#D18351, #D18353 Spanish). To order, call 888-687-2277 or go to www.aarp.org/medicarerx. To see a comparison of all the plans, enroll, or ask questions, call Medicare at 800-633-4227 or go to www.medicare.gov.
Buy The AARP Guide to Pills.
|
