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Boomers Can Help Seniors Finding Best Medicare Prescription Drug Plan

Armen Hareyan's picture

The Annual Election Period for the Medicare Prescription Drug Program runs November 15th - December 31st. Unfortunately, many seniors are still confused about choosing a Medicare drug plan. Eldercare expert provides the solution.

The second Annual Election Period for the Medicare Prescription Drug Program is here. The complexity of the program, however, has many seniors still confused and likely to be paying more for their drugs than they have to. Eldercare advisor Esther Koch, who is also a Medicare Aging Network Partner with the Administration on Aging and the Centers for Medicare and Medicaid, has the solution.

"The answer to how to select a stand-alone Medicare Prescription Drug Plan is easier than most people think," says Koch. "The solution is for web-savvy Boomers to help their parents compare plan choices by using the Medicare Prescription Drug Plan Finder at www.medicare.gov" Koch adds, "This is an opportunity for Boomers to be there for their parents. They need you!"

Seniors who are in a stand-alone Medicare Prescription Drug Plan, or have no prescription drug coverage, are the ones who need to take action now and will need to review plan offerings annually. Even if a senior's drugs don't change, it's likely that the plan's formulary of drugs covered and pricing will. "I haven't yet had a client whose optimum plan choice remained the same each year," states Koch.

For seniors with retiree drug coverage there is probably nothing to do as long as the senior received notification that the drug coverage is classified as creditable. Seniors with Medicare Advantage health plans that include prescription drugs are also already covered. The best help for seniors on government assistance programs is available through their State Health Insurance Assistance Program.

"Choosing a Medicare Prescription Drug Plan is based on different selection criteria than for most insurance," highlights Koch. What's most important is the total estimated annual cost which is driven by a combination of factors including: whether the plan's formulary covers all of a senior's drugs; individual drug classification and pricing; monthly premium; deductible amount; and whether doughnut hole coverage is included. A high premium plan does not necessarily equate to a better option for a senior.

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The Government has developed an incredibly powerful search tool to compare drug plan options. "To make an informed decision on a stand-alone plan use the Medicare Prescription Drug Plan Finder at www.medicare.gov It is impossible to manually review the 50-plus plan options that most people have," says Koch.

By entering their parent's zip code and drug name, dosage and 30-day supply, Boomers can obtain a prioritized list of drug plan options sorted from least expensive to most expensive plan based on total estimated annual costs including premiums, deductibles, copays and coinsurance. The five least expensive plans will show up initially. You can display all plans, do side-by-side comparisons of 3 plans and drill down to specific information on how to lower drug costs. The drug list can even be saved for later reference.

Total costs vary widely by plan. Koch emphasizes, "If you view all plans and compare the estimated annual cost of the first and last plan listed you will see just how widely drug costs can vary for your parent. And remember, this is for the same set of drugs." Koch continues, "Think of this as getting a list of the total cost of all of your holiday gifts if the same gifts were purchased from some 50 different retailers. You should be most interested in the least expensive plans."

Once you have reviewed the options and decided on a plan, it is best to enroll on the plan provider's website. It is also recommended to enroll during the beginning of the election period to ensure that coverage data is available to your pharmacy by January 1st.

For more information on Medicare Rx and how to use the Medicare Prescription Drug Plan Finder visit the Encore Management website at Medicare Rx tab.

Esther Koch is a gerontologist and eldercare advisor. Her firm, Encore Management, provides personal and corporate advisory services and seminars to assist Boomers with the range of issues associated with caring for an aging parent and their own aging. Her media interviews and articles have appeared on television, radio and in print.