‘Tis the season, 11/15/07 - 12/31/07, to review drugs. Today, I’m changing my Medicare-Part D Plan, the one that covers drugs. Last year, I just kept the same plan and let it roll over to the new year. Now, it is time for a change.
During this time, it is worth repeating a word of caution on ID Theft, i.e. DO NOT RESPOND TO A TELEPHONE SOLICITATION OR INQUIRY REGARDING ANY MEDICARE ISSUE. You have to initiate the call to a number listed for Medicare. Never give information over the phone if you do not initiate the call.
This is the way I understand the 2008 Medicare-Part D rules.
- It is a one-year policy with a Medicare-approved insurance company that complies with or exceeds Medicare rules.
- You have to sign up for a policy during your initial “Medicare Eligibility Period” or pay a penalty if you decide to join later.
- The policies may limit the specific drugs covered, as listed in their “formulary”, as well as the participating pharmacies, as listing in their “network”.
- You can either pay the monthly fee or have Medicare deduct it from Social Security.
- You pay the first $275 of any drug costs.
- The plan pays 75% of the next $2,510 of drug costs, and you pay 25%.
- You pay all of the costs ($3,216.25) between $2,510 and $5,726.25, i.e. for the famed “Donut Hole”.
- Once the total drug costs exceed $5,726.25, you make co-payments of $2.25 for generic prescriptions and $5.60 for all other drugs.
There are slightly different rules for folks that already have some drug coverage, are institutionalized, or are on Medicaid.
To evaluate the various plans for my state, I went to Medicare.gov and clicked on “Prescription Drug Plans”, then selected “Plans in Your Area”. This gave a concise list of available plans. After reviewing the formulary, network, and premium of a few plans, I picked a new plan that seemed to suit me better. I was able to complete the enrollment right online, and the deed was done well before the year-end deadline.
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