QUESTION:  I am losing my group health coverage with General Motors, 1-1-2009, that I have had since I retired. Now I must find a Medicare Supplement and make sure my benefits are as good as what I had.  How do I compare these plans, it is so confusing?

ANSWER:  We have been contacted by hundreds of General Motors retirees about this very subject.  Keep in mind you will only have 63 days to get your Medicare Supplement with no underwriting on a guarenteed issue basis.  Let me run down the best Medicare Supplement plans and what they do and do not cover for you.

Plan J - This is the Cadillac of Medicare Supplement Plans.  Some people like to pay for all the bells and whisles even though they may possibly not need them, just to have that extra luxury.  Plan J has everything all the other plan have plus the following: 

Prevenative Care - This is an extra $120.00 per year for prevenative care such as a physical.  However, if you have any health issues your doctor will do all the bloodwork anyway and you will end up getting the equivalent service.

Home Heath Care - This is $40 per day up to $1,600.00 of unskilled care per year, such as bathing, household chores.  If you need this type of care you are probably getting skilled care as well and this is covered under other less expensive plans.  You can’t get much for $40 a day these days.

Excess Charges - Plan J will cover 100% of any charges over the limit that Medicare allows for your illness that your doctor bills you.  However, 99% of the time, your doctor will only charge you what he is allowed to charge you under Medicare rules.

Part B Deductile - There is a $135.00 yearly deductible on a Medicare Supplement.  Plan J covers this for you, however, you may be paying more in premium for this $135 than it is worth.

Plan F - Plan F is the Oldsmobile of Medicare Supplements.  It covers everything plan J covers except the following:

Home Heath Care  - $1,600.00 per year

Preventative Care - $120 per year

Plan G - Plan G is the Chevrolet of Medicare Supplements.  It is the most cost effective plan if paying the premium is an issue for you, yet it still has good coverage.  Plan G has everything including Home Heath Care except:

Prevenative Care - $120 per year

Excess Charge Coverage - This plan does pay for 80% of excess charges.  Which will be more than sufficient in most cases.

Part B Deductible Coverage - Keep in mind that if you want your plan to pay for the $135 a year deductible you may be paying more in premium than it is worth.

 As you can see, there are many things to consider.  It all comes down to how much premium you want to pay for coverage you may not need.  Some people want it all and don’t mind paying a higher premium per month to get it.  All Medicare Supplements pay the 20% of all your doctor and hospital bills that Medicare does not cover with their 80%.  You can decide if you want all the extras, or maybe you don’t mind rolling up your own windows or not having heated leather seats.  It is up to you!!

At My Part D USA we can consult with you and help you choose the plan that would be best for you based on YOUR NEEDS and DESIRES.  We can also help you get your Supplement, no matter what Plan you choose at the lowest prices.

 MEDICARE ADVANTAGE PLANS should be avoided, unless you cannot pay the monthly premium on Original Medicare combined with a Medicare Supplement.  That is what we recommend and we are standing by this.  Keep in mind that you will be approached by many Medicare Advantage Plan salespersons, telling you that their plan is better than Original Medicare, BUT they do not compare against Original Medicare with a Traditional Medicare Supplement.  There are many co-pays and hoops to jump through. 

You have worked hard and deserve the BEST COVERAGE!

When you come off your retirement plan you only have 63 days from the end of your group plan to get a Medicare Supplement with NO UNDERWRITING.  This is the only time you will have NO HEALTH QUESTIONS ASKED AND A GUARANTEED ENROLLMENT ON THE PLAN OF YOUR CHOICE!

 If you join a Medicare Advantage Plan instead, you may never have another change to get a Traditional Medicare Supplement without going through underwriting and possibly turned down for health reasons.

I hope this answer helped you understand your options.  You can write to me, Karyn Blake, with any other questions and I will be glad to find an answer for you!

 Call us today toll free at:  866-752-1795

The United States House of Representatives Committe on Oversight and Government Reform has just issued a report about Part D Plans and how much the drug plan companies are making from taxpayers. 

There is a huge windfall of revenue going to the drug plan companies because Medicare cannot negotiate prices with the Drug Manufacturers in the same way that Medicaid does.

Eliminating the drug manufacturer windfall would realize substantial savings to federal taxpayers.  Over the next ten years, taxpayers would save $86 billion if the Medicare Part D insurers paid Medicaid prices for drugs used by the dual eligible beneficiaries (people on extra help programs).  If Medicare negotiated directly with the drug manufacturers and obtained prices equivalent to the Medicaid prices for ALL MEDICARE BENEFICIARIES, the potential savings to taxpayers increases to $156 billion.

PLEASE, FOLKS, CALL OR WRITE YOUR SENATORS, CONGRESSMAN, LOCAL OFFICALS AND EVEN THE PRESIDENT TO INSIST MEDICARE BE ABLE TO NEGOCIATE PRICES WITH DRUG MANUFACTURERS!!! 

This would really make such a huge difference in the price you pay for your medications!!!

TAKE THE TIME TO MAKE SOME NOISE ABOUT

THIS!!!  IT IS YOUR MONEY, SO SAVE IT!!!

Do you have several different doctors that you see for your healthcare? 

If so, please be aware that you need to tell every doctor you see about ALL the prescriptions you take.  Many times we find that people have too many prescriptions for the same health problem.  If one doctor prescribes a medication for you and you do not share this with the other doctors that care for you, duplicate prescriptions can occur. 

The average senior citizen takes 4 to 6 different kinds of prescriptions a day and refills their meds 12 to 17 times a year.  Can you imagine how much you could save if you made sure every prescription was actually NEEDED!  As you know EVERY PRESCRIPTION YOU GET FILLED GOES TOWARD YOUR FALLING INTO THE “DONUT HOLE”. 

We see many people taking several kinds of medications that treat the same ailment.  Sometimes this is necessary, but many times it is not.  Be sure you discuss all your meds with every doctor you see!!  If you are not taking the generic form, ask the doctor if you can switch.  Ask your doctor if there is a less expensive medication for your problem.  Many times doctors will prescribe the newest most expensive medications instead of the old tried and true less expensive meds.  Don’t be shy to explain to your doctor you MUST SAVE AS MUCH AS POSSIBLE ON YOUR MEDS!!

Anytime your doctor gives you a NEW medication, ask him to give you samples to take at first.  Many times the NEW medication will not work for you.  If you have filled a complete prescription for this medication IT WILL COUNT TOWARDS YOUR FALLING INTO THE “DONUT HOLE”.  I can’t tell you how often this happens, so please do yourself a favor and don’t be afraid to ASK FOR SAMPLES TILL YOU ARE SURE THIS NEW MEDICATION WORKS FOR YOU!!

We have been searching for a reputable discount drug card to recommend to you for quite some time now. 

I have found www.EASYDRUGCARD.COM  website and have spoken to the CEO and Founder, Christopher Peterson.  This website was created to assist individuals and families currently paying full price for their medications by offering a FREE prescription drug discount card.  There are NO FEES or other costs to obtain and keep this card, and it never expires. 

The reason they got started with this website is they were helping their elderly parents with the high cost of medications.  They realized that many other people needed help as well. 

You can go to this website and easily print off a card to take to the store with you and they are accepted at many retail pharmacies.  Please go to www.EASYDRUGCARD.COM and read all the details about this great offer of assistance.

I would be interested to hear about your savings experience.  Let me know how it goes. 

If you are in the “donut hole” or cannot pay for your expensive medications you may want to try to contact the actual drug manufactuer to see if you qualify to get help from them. 

Pharmaceutical companies offer assistance programs for the drugs they make.  To see if any programs are available for the drugs you are taking, please go to the CMS medicare Part D webpage http://www.medicare.gov/pap/index.asp  select the letter in the list provided to see if your drug is on the list.  If your drug is on the list, click on the link labeled “details” for detailed information about the program.

Also, there are some states that offer help with paying drug plan premiums and/or other drug costs.  You can find out if your State has a program by visiting the CMS State Pharmaceutical Assistance Program site at http://www.medicare.gov/spap.asp

If you have had an experience with getting help this way, we would like to hear from you.  It helps other people to know what you have gone through.  You can write me by using the link at the top right corner of this site.

I have been getting many questions about DISCOUNT DRUG CARDS.  I have written other blogs warning you about some of them and to never pay a fee to recieve a discount.

There are some NEW cards circulating all across the country from reputable organizations that anyone that is paying retail for their medications or in the “donut hole” should definately check out!!

Please call your local United Way office, your local County or City Health Clinics, and also check with many of your local pharmacies.  Some cards will give you a better discount than others.

Just be sure that you never pay a FEE!  If someone asks you to pay for a discount card, you can be sure it is not one that is regulated by a reputable organization.

The discount cards I have had news reports about are located in Austin, Texas; Gastonia, North Carolina and Brevard County, Florida.  These cards are issued by non-profit organizations such as United Way and others.  Check in your local area to see if a discount card is available for you!

QUESTION:

My mother has only a few hundred dollars left before she will go into the donut hole.  Do you know of any other kind of insurance we can get to cover her drugs during this time?  I don’t think she will be able to afford to pay for them when she has to pay full price.  What can I do to help her?

ANSWER:

I have not heard of any kind of insurance product that will cover drugs during the “donut hole”.  It is a shame that your mother may not be able to pay for her medications.  There are several things you can do.

1.  Contact the manufacturer of that particular drug and ask them if they have any “free help” programs.  Many times they do help people with low incomes.

2.  Find out if you qualify for the “extra help” programs through Social Security.  If you qualify, you will not have a donut hole on your Part D Plan.

3.  IF YOU KNOW THAT YOU WILL NOT REACH THE OTHER SIDE OF THE DONUT HOLE TO THE 95% COVERAGE, YOU MUST BEGIN TO COMPARE PRICES.  YOU NEED TO SHOP ANYWHERE YOU CAN TO GET YOUR MEDICATIONS AT A LOWER PRICE.  DO NOT USE YOUR DRUG PLAN CARD!  YOU WILL STILL HAVE TO PAY YOUR PREMIUMS TO YOUR DRUG PLAN, BUT CERTAINLY YOU CAN FIND BETTER PRICES FOR YOUR DRUGS!

4.  Next year, at the beginning of your plan for 2009, try to buy all your generics and lower priced medication at large retailers that have $4 generics.  This will leave more in the pot to pay for your very expensive medications, thereby extending the time it takes you to reach the dreaded “donut hole”.

If any of my readers knows of an insurance plan to cover the “donut hole”, please CONTACT ME ASAP, so we can check it out.

Until then, we must make the most of our drug plans and save as much as possible!

We get letters everyday from people who are having trouble with getting a drug covered under their drug plan.  We also get letters from people who have been billed incorrectly, but the drug plan will not change it or help them.  There are many issues that come up and many people do not know where to go for help.

Remember to contact the MEDICARE RIGHTS CENTER! 

NEW YORK OFFICE - 212-869-3850

WASHINGTON D.C. OFFICE - 202-544-5561

They have lawyers there that can help you resolve your problems.  You can also contact Medicare directly, but many times they are very busy and you may need an alternate resource.