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MEDICAREDRUGPLANS.COM OFFERS TIPS FOR SENIORS ON PICKING A MEDICARE DRUG PLAN

WESTCHESTER COUNTY, NEW YORK – NOVEMBER 14, 2005 – To help seniors make smarter decisions about the new Medicare Part D prescription drug plans, Dr. Tod Cooperman, MD, President of MedicareDrugPlans.com, offers the following advice, posted today in the Forums on www.medicaredrugplans.com. MedicareDrugPlans.com is a free website for consumers that provides information about Medicare-approved drug plans as well as consumer ratings, reviews, and forums for discussion.

First – Check the basics:

  • Does it cover your drugs? Some plans cover all and some cover only about 70%. If you can’t cover all or most of your drugs, it may not be worthwhile. Use Medicare’s online Formulary Finder to see if your drugs are covered – although you’ll need to contact the plan directly to get your cost for the drug. Also, make sure convenient pharmacies participate.
  • What is the monthly premium? This can range from $0 to over $100 – average is about $37.
  • What is the deductible? Standard is $250, but some drop it to $0. If you only use one drug, a zero deductible could make it a lot more worthwhile.
  • Gap coverage? This is coverage during the “doughnut hole,” during which you have no coverage in a standard plan. However, some plans will help pay for generics and/or give you discounted pricing on certain drugs during the gap.

Second – Picking a plan depends on how many drugs you use:

Depending on how many drugs you use, some drug plans are a better option for you than others – assuming that your drugs are covered

  • No medication: You won’t be able to save money. However, you can look at the plan as insurance. Consider a plan with the lowest premium (some are as low as $5/month). This way you also avoid a penalty had you not joined by May 15, 2006 but later decided to join a plan. You can switch to a different plan later on if necessary – at the end of every year.
  • 1 Drug: The plans may not be a great option, since most plans will cost you at least $300 per year just to be a member. You may save more buying from Canada, where you can save 40% to 60% on brand name medication. See the prices at www.PharmacyChecker.com. But if you want a plan for catastrophic insurance, look for a plan with no deductible and a reasonable monthly premium ($35 or less).
  • 2 – 3 Drugs: You’re a good candidate for joining a plan, and you can probably find a plan that can save you 40 to 50%. And by joining, your total out-of-pocket expenses won’t go much above $3600 even in the worst of situations. Look for a plan with reasonable monthly premiums and no deductible.
  • 4 or 5 Drugs: Your total savings may only be 30 or 40% (because you’ll end up in the coverage gap for part of the year) and you can probably save more buying from Canada. (See link above). But by not joining you won’t have the catastrophic coverage if you need more drugs, plus you’ll have to pay a penalty if you join after May 15, 2006. Consider joining a plan for the catastrophic coverage, but, if you reach the end of next year in the coverage gap, consider using a Canadian pharmacy until the beginning of the next year. Just be aware that drugs not bought through your plan don’t count toward your deductible or to get you across the coverage gap.
  • 6 or more Drugs: You’re a great candidate for joining a plan because your expenses are likely to be high enough for you to benefit from the 95% catastrophic coverage that kicks in when your total expenses exceed $3600. The plans can save you 40 to 50% or more. Look for a plan with reasonable monthly premiums and some type of coverage or discount during the gap.

Third – Use caution, don’t rush, learn more:

  • Don’t be rushed into a decision. If you definitely want to start in January, you have until the end of the year to enroll, and then you still have 6 months (until May 15) to join without a penalty. See what people start saying about their plans in the Ratings and Reviews on www.MedicareDrugPlans.com.
  • If you do decide to join, do it May 15, because the penalty after that means that your monthly premium will increase by at least 1% every month you wait to join. This penalty will persist throughout your Medicare drug coverage.
  • If you already have coverage, find out how it’s affected if you join a Medicare plan.
  • If you are low income or on Medicaid, the plans are even more attractive – far lower costs.
  • Avoid scams – they are beginning to crop out. Make sure the plan is truly Medicare-approved. See the “Scams” forum on www.MedicareDrugPlans.com.
  • Keep learning – Keep up on the issues that people face as they use these plans. Check the reviews as well as the forums on www.MedicareDrugPlans.com.

MedicareDrugPlans.com and its parent, PharmacyChecker.com, have no ownership in or from companies that sell or distribute pharmacy products, insurance or pharmacy benefits. PharmacyChecker.com is based in Westchester, New York. For further information contact Tod Cooperman, MD at tod.cooperman@medicaredrugplans.com or Gabriel Levitt, Vice President at gabriel.levitt@medicaredrugplans.com.

 

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