Medicare Alert: Only 3 Weeks Left!

The deadline for enrolling in Medicare’s prescription drug program is May 15.

That leaves you – or your family members – less than three weeks to make a decision.

But the program is so complicated that millions of eligible Americans have left this critical, potentially life-changing decision, until the last moment.

And even if you’ve already enrolled, there’s more you need to know and much more you need to do.

Right now, insurance companies are being swamped with calls, and government offices are overwhelmed. But since 30 million people have already enrolled, the authorities are insisting they’re not going to change the deadline.

So the crunch is on! Some insurance companies are even saying they have no appointments available until after the Medicare deadline, leaving some people in the lurch.

I’m the specialist for Medicare and health insurance at Weiss Ratings, Inc., and I’ve just written a special report designed to help consumers make the right decisions quickly and without pain. We’re sending out a press release on this subject to thousands of reporters later in the week. But we wanted to let you know about it first.

In light of the urgency, Martin has asked me to write this special guest column. In it, I give you the immediate instructions you need even before you get my report.

So let me skip over the details and tell you …

What I Think Your
Decision Should Be

Enroll! If you’re on Medicare or eligible for Medicare, just enroll.

That way you keep your options open: If you decide you want to drop or change your coverage later, no problem.

But if you don’t enroll now, and then you decide you want to get in later, you get slapped with onerous surcharges.

If you delay signing up for one month, the surcharge will be 1% (based on the average national premium) on top of your regular cost.

If you delay for two months, the surcharge will be 2% … three months, 3% … six months, 6%, etc.

And you will have to continue paying those surcharges for as long as you live!

The only exception to this rule is for people who are already enrolled in what’s called “creditable plans” – private or state plans which the government has identified as offering benefits which are as good as, or better than, the Medicare plan. How do you know if yours qualifies? Just call your plan provider’s customer service, ask them if your plan is “creditable,” and they should know.

How Will This Actually
Work out for You?

Let me walk you through a few scenarios:

Scenario A. You currently spend $380 per month, or $4,560 per year on prescriptions, and you choose the Standard Medicare Prescription Drug Benefit.

First, you pay a $250 deductible. Then, on the next $2,000 in expenses, you pay only 25%, or $500, in co-insurance. Finally, on the balance, you pay 75%, or another $2,310.

Your total cost for the drugs: $3,060. Your save: $1,500.

Scenario B. Now suppose you’re spending about $520 per month on prescriptions, or $6,240 per year. Here’s how it will work out:

You pay the $250 deductible and $500 co-insurance, same as in Scenario A. And you pay the full amount of the next level, which will be another $2,850.

Beyond that level is where you really start to save: You pay only 5% of the cost, a meager $57, while the government picks up the bill for the other 95%.

Your total cost for the drugs: $3,657. You save: $2,583.

Scenario C. Here’s where the program really shines: Suppose you spend $760 per month on prescriptions, or $9,120 per year …

You pay the $250 deductible and the $500 co-insurance. You pay the $2,850, same as Scenario B. But on the next level, since you’re responsible for only 5% of the remaining costs, you pay only $201.

Your total annual costs: $3,801.You save $5,319!

Bottom line: You can save at least some money in most scenarios … and you can save very substantial sums in a high-usage scenario!

Darn! I Wish It Were
Actually This Simple!

Unfortunately, bureaucrats and lawmakers don’t exactly have a penchant for making things easy and uncomplicated. For some reason, they always like to add a whole series of wrinkles and maybes that can drive even the brightest person batty.

For example, specific prescription drug coverage varies by plan. Sure, Medicare requires each plan to include at least two drugs in every drug category. But that doesn’t necessarily mean your medications will be covered. So you need to find a plan that covers all or most of the drugs you take, starting with the most expensive ones.
Each plan also divvies up the drugs it covers into different “drug tiers.” Essentially, the higher the tier, the higher your co-payment. Typically, generic drugs require the smallest co-payment, while the latest, high-end, name-brand drugs require the largest co-payment.
Another wrinkle: The drug plan providers negotiate discounts with pharmacies in their networks, which can save you extra money beyond the money that the government chips in. So many of your drugs will be cheaper than what you’d pay on your own. That’s good. What makes it complicated, though, is the fact that the discounts will differ depending on the plan and the pharmacy.
You could pay extra for “enhanced coverage,” which gets even more complicated.
Most important: How much will you have to pay in premiums can vary all over the lot. The average for standard benefits is $32 per month nationwide. But depending on where you live and the benefits you get, the price can change significantly. Plus, if you shop wrong, you can be sorely disappointed. If you shop right, you can save a lot of money.

In my report, I break all this down for you into easy-to-follow steps. But as I said a moment ago, with only three weeks to go, I want you to get started right away, even before you get my report. So …

Here’s What to
Do Right Now …

Just follow these steps:

Step 1. Go to the Medicare website at www.Medicare.gov.

Step 2. Under “Medicare Spotlights” find the item “Compare Medicare Prescription Drug Plans.” (On my screen right now, it’s the fourth item from the top. But that could change.) That should take you to the page entitled “Find a Medicare Prescription Drug Plan.”

Step 3. Scroll down to the headline “Where would you like to begin?” and click on the first item, also called “Find a Medicare Prescription Drug Plan.” When you do, here’s the screen you should get next:

Step 4. Enter your personal information, including your Medicare number, date of birth, when you signed up for Medicare Part A or B, etc.

Step 5. Click on “Search Plans.”

Step 6. If you already signed up for a plan, it will give you a chance to review that selection. If not, you will go straight to the screen to help you “Review Plan Results and Options.” This screen gives you three choices:

A. You can stick with the plan you’re currently on.

B. You can enroll in a “Medicare Advantage” Plan or other Medicare health plans. This is primarily HMOs or PPOs and may not be the best choice for you. You’d be limited to a particular network of doctors. The HMO may drop you at some point in the future. And besides, these plans are about more than just prescription drugs, something you may not want to deal with on such short notice. (However, if you want to take the time, my report gives you all the pros and cons.”)

C. You can check out the Medicare Prescription Drug Plans. These are the stand-alone prescription drug plans which you should be focusing on. So this is the box to click.

Step 7. At the bottom of the screen, click on “Search for Medicare Prescription Drug Plans.” (To keep things simple, I would not click on the little box “Also include Medicare Advantage and Other Medicare Health Plans.”)

Step 8. You will come to a new screen that tells you how many plans are available in your area. But before viewing the list, I’d narrow it down to the ones that actually cover the drugs you’re currently taking. So under “B,” click on “Enter my medications.”

Step 9. Once you’ve got a short list of plans available in your area covering your medications, it’s time to shop.

The Medicare website will give you the numbers to call. And if you can’t reach one of them easily, go to the next. Which one should you choose? They don’t offer comparable benefits. But overall, I think it makes sense to go with the least expensive company with a Weiss safety rating of B- or better.

Step 10. Order my report – the “Weiss Ratings’ Consumer Guide to Medicare Prescription Drug Coverage.”

It includes 26 pages of listings with all the plans in the country, along with their Weiss Safety Ratings and phone numbers.

It gives you the toll-free numbers of all health insurance assistance programs in every state.

It also gives you the toll-free numbers for all the pharmacy assistance programs.

It explains the prescription drug program in detail so you can understand the deductibles and coverage limits and how you can best take advantage of your options.

Equally important, it tells you what to do after you enroll:

How to get your prescriptions filled.
What you need to know regarding the costs of the drugs.
How to monitor your drug expenditures and track what benefit level you’ve reached. Deductible level? Co-payment level? 5% level?
What your options are if you are prescribed a drug not covered by your drug plan.
Whether you should switch drug plans – how and when?

All told, my report has 79 pages with all the details mapped out for you in a simple, easy-to-use workbook format. But its just $49 – peanuts in comparison to the money you can save by choosing the plan and options that are right for you.

Order it by calling Weiss Ratings at 800-289-9222.

Best wishes and good luck!

Donna O’Rourke
Senior Health Insurance Analyst
Weiss Ratings, Inc.

For more information and archived issues, visit http://legacy.weissinc.com.

About MONEY AND MARKETS

MONEY AND MARKETS (MAM) is published by Weiss Research, Inc. and written by Martin D. Weiss along with Larry Edelson, Tony Sagami and other contributors. To avoid conflicts of interest, Weiss Research and its staff do not hold positions in companies recommended in MAM. Nor do we accept any compensation for such recommendations. The comments, graphs, forecasts, and indices published in MAM are based upon data whose accuracy is deemed reliable but not guaranteed. Performance returns cited are derived from our best estimates but must be considered hypothetical inasmuch as we do not track the actual prices investors pay or receive. Contributors include Jennifer Moran, John Burke, Beth Cain, Red Morgan, Ekaterina Evseeva, Amber Dakar, Michael Larson, Monica Lewman-Garcia, Julie Trudeau and others.

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