October 2008 PlanPrescriber Newsletter

The Medicare Annual Enrollment Period (Nov. 15th-Dec. 31st) will soon be here! We have assembled a series of articles to help you evaluate the changes coming in the 2009 plan year, to help you get the most from your Medicare benefit.

3 Things You Should Know About 2009 Medicare Prescription Drug Plans

Written by: Ross Blair

Whether you have a stand-alone Prescription Drug Plan or one bundled within a Medicare Advantage Plan, here’s what’s coming in 2009 and some solid advice about what you should do about it.

1. Many of the leading plans are increasing their premiums in 2009. Avalere Health reports: “the average beneficiary will see a 24% increase in their monthly premiums”. That’s the average. Some plans will see no increase in premium, but some will see increases of 30% or more.
   
    
2. The premium levels aren’t the only thing changing. More plans will offer gap coverage which is a good thing to have, but more plans will require a deductible. Most plans will change the drugs they cover, co-pay amounts or coverage limitations, so you need to do your homework, even if you are happy with your current plan. There could be an alternative plan out there that can save you more.
   
    
3. There are 135 fewer plans being offered in 2009 compared to 2008. If your plan has been discontinued you may be granted special enrollment privileges like guaranteed issue on a Medicare Supplement plan.

Sound complicated? Unfortunately it is. Kerry Weems, the acting administrator of the U.S. Centers for Medicare & Medicaid Services (CMS) said, “We are encouraging all beneficiaries to review how their plans are changing and what other options are available to determine which plan best meets their needs.” The good news is we can help and the 2009 plan information will be available soon. Call us today at 1-800-838-0346 or use our tool online at www.PlanPrescriber.com.

What If My Drug Isn’t Covered?

Written by: Kev Coleman

When choosing a prescription drug plan, ALWAYS look for a plan that covers all the medications you are prescribed. This will both reduce your out-of-pocket expenses and also ensure that your medication expenditures count towards the threshold for people who have extremely high annual drug expenditures (catastrophic coverage). However, despite your best efforts, you may find yourself in a situation where you prescription drug plan does not cover all of your medications. For example, you may have chosen a plan that had covered all of your existing medications but you were later prescribed a new medication that wasn't covered by your plan. Accordingly, we've assembled some tips below to assist you reduce the cost of your uncovered drugs.

1. Talk to your doctor about alternative prescriptions. There may be generic substitutes for the drug that you’re taking or there might be another branded product that is therapeutically equivalent to the one you’re taking that is covered by your plan. Your doctor can work with your pharmacist to help find the lowest cost medication regimen.
   
    
2. Shop around. Following Wal-Mart’s lead, many pharmacy chains now offer attractive prices not only for generic medications but also for brand name products. Since different pharmacy chains charge very different prices for the same medication, it pays to be a rigorous comparison shopper. 
   
    
3. Try mail order or investigate a discount drug card. Mail order prescriptions typically come in a 90-day supply that has a lower cost per dose than your normal 30-day supply. With respect to discount drug cards, be certain to read the fine print with these programs and verify that the drugs come from a reputable source. In general, avoid buying drugs from outside the U.S.. The FDA in the U.S. monitors the quality of the drugs sold here as well as their labeling. That’s not the case with drugs bought directly from Canada and other international sources.

Remember, follow the above steps only if your drug isn’t covered by your plan. If your drug is covered by your prescription drug plan and you’ve hit the gap (or the 'doughnut hole' as some call it) where your co-payment no longer applies, your plan may extend special pricing while you’re in the gap. Also if you’re in the gap, buying from other sources will prevent your purchases from counting toward the catastrophic coverage threshold. Still have questions? Call us at 1-800-838-0346 and our friendly and knowledgeable representatives will help point you in the right direction.

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