December Newsletter 2008

How Much Can the Right PDP Actually Save You?

Once people enroll in a prescription drug plan, they often forget to check to see if they are still in the most economical plan when the annual enrollment period rolls around each year. Each year plans can raise their premiums and they can also change the drugs they cover. Additionally, each year the drugs you are taking may change as well due to changes in your health. Consequently, the best plan for your circumstances last year may not be the best plan for you this year.

How much can the wrong plan cost you in a year? Data from the PlanPrescriber tool used by CVS/pharmacy revealed that the average person in the data analyzed would have saved $250 a year if the person enrolled in the optimal plan for their personal medication usage. For some people, the savings were over $1,000 per year.

Remaining in the wrong plan can be very costly to you. If you are taking a medication that is not covered by your current drug plan, not only do you pay full price for the uncovered medication but your out-of-pocket expenses DO NOT count towards the government’s catastrophic coverage threshold that protects seniors with excessive prescription drug expenses.

Statistically, we tend to take more medicines as we grow older. Medicare Part D plans can change their features such as premiums, pharmacy network, and drug coverage from year-to-year. Given the fact the tools like www.planprescriber.com are free and help seniors find the optimal Medicare Part D drug coverage, there’s no excuse not to investigate your drug coverage options every annual enrollment period to make certain you are in the lowest cost plan. If you don’t have internet access or would prefer speaking to a representative, you can call us at 1-800-819-6906.

No More Confusion & Frustration! Annual Enrollment Versus Open Enrollment

One of the biggest complaints seniors have about Medicare Part D concerns enrollment periods. Most seniors know that they can change prescription drug plans from November 15th through December 31st of each year. However, seniors are also told about “open enrollment” from January 1st through March 31st of each year. Because most seniors are in the dark regarding the differences between annual enrollment and open enrollment, PlanPrescriber.com has provided some basic guidance below.

Is Open Enrollment the same thing as Annual Enrollment? No. Annual enrollment applies to both prescription drug plans and Medicare Advantage plans with prescription drug coverage. Open enrollment only applies to Medicare Advantage plans.

Can I sign up for a stand-alone prescription drug plan during open enrollment? No. You may enroll in a prescription drug plan each year from November 15th through December 31st. Seniors turning 65 years old are given the ability to enroll up to two months before their 65th birthday through two-months after their 65th birthday.

If I enrolled in a Medicare Advantage plan during annual enrollment, can I still change plans during open enrollment? Yes. Even if you enrolled December 31st, open enrollment gives you the option of changing Medicare Advantage plans from January 1st to March 31st. However, there are some rules regarding what kind of changes you can make.

• During Open Enrollment Period, you may enroll in, dis-enroll from, or change a Medicare Advantage plan.
• If you have a Medicare Advantage plan with drug coverage you may change to another Medicare Advantage plan with drug coverage OR Original Medicare (i.e. Medicare Part A and Medicare Part B) with a stand-alone prescription drug plan
• If you have Original Medicare and a stand-alone prescription drug plan, you may enroll in a Medicare Advantage plan with prescription drug coverage
• If you have a Medicare Advantage plan without drug coverage you may enroll in another Medicare Advantage plan without drug coverage or return to Original Medicare
• If you have Original Medicare, you may enroll in a Medicare Advantage plan without drug coverage

Still confused? You can speak to a customer service representative at 1-800-819-6906 or visit www.planprescriber.com.

Do You Really Understand the “Donut Hole”?

There are a lot of rules and complication around Medicare Part D. One of the most commonly misunderstood issues is the period after initial Medicare Part D drug coverage ends, otherwise known as “the donut hole.”

How did this coverage gap become known as the donut hole? There’s actually a good reason. After satisfying your deductible, Medicare Part D covers 75% of expenses until the total cost of your drugs has reached $2,700 in a calendar year. After that limit is reached, you pay 100% of your drug costs for the rest of the year. However, if you out-of-pocket expenses for drugs reach $4,350 during a single year, the government provides additional “catastrophic drug coverage” that will help with covered drug costs for the remainder of the calendar year.

Since there is drug coverage below $2,700 in drug costs and above $4,350 in out-of-pocket drug costs but no coverage between, that in-between period is called the donut hole. It is effectively a hole in drug coverage.

Still confused? You can speak to a customer service representative at 1-800-819-6906 or visit www.planprescriber.com.