In a time when more miracle drugs are available to people, the price of medication has soared beyond the financial reach of those who need them most. When the public outcry reached new levels in 2005, the federal government stepped up with Medicare Part D to help. While it is not a perfect program, it far surpasses anything else available for the price.
The mounting complaints about the system have given way to minor complaints about an occasional formulary problem. Now that Medicare Part D has passed its first anniversary, most of the early problems have been ironed out. The program is following the path of the Medicare supplement program before it.
When Medicare supplements first were introduced, each company had a large group of options that you could choose from and build the plan that best fit your needs. As time went by, insurance agents and companies begin to find patterns in what seemed to work best for seniors.
This created a narrowing of options that were offered to customers. Eventually, the Medigap plans were developed, and all companies offer the same set of plans for about the same price. This made the option soup much less complicated.
In order to find the true needs of seniors regarding prescription drugs, the government again allowed a huge number of options to be offered in all ranges of price and coverage. A time goes by, these plans will be narrowed into a much more understandable and manageable menu. For now, most seniors rely on their pharmacist and doctor to find the few plans that best suit their needs.
Actually, most of the time the best plans can be located at the www.medicare.gov website within thirty minutes. You need a list of your prescription drugs and the state that you live in. Armed with this information, the website will generate a list of the top five to twenty plans for you. A year ago, this was a list of the top 200 or so plans. The narrowing has already begun.
Medicare Part D has two ugly areas. In January or the first month of coverage, a deductible has to be met. In 2008, this is $265. Until you meet this amount, your prescriptions will be pricey. Once the deductible is met, your wallet will feel much heavier with the money you will save.
If you have over $250 per month in drug costs, before the end of the year, you will run out of benefit. Again, the current maximum is $2,650. At this point, you will pay a high price for your drugs until the year ends, and you meet the next year’s deductible. So, the net effect for the vast majority of seniors is that they get 10 months or less of excellent coverage.
For those who spend really big money on prescriptions, they will pass through the gap and Medicare Part D will begin to pick up the cost of their medications again at an even better deal. This continues through the end of the calendar year when the deductible again must be met.
Some Part D plans will cover the deductible and the gap. However, you will be considerably more for that option. You need to examine your prescription costs and determine what will be the best value for you. Medicare Part D plans cost from about $20 per month up to $200 per month. While you get what you pay for, most seniors fit best in the cheaper plan.
If you have Medicaid, you are considered dual eligible, and Medicaid will assign you a plan that will not cost you any premium. Medicaid picks up the deductible and the covers the gap. Family services in your state or area can help guide you through the procedure for this combined coverage.
If you participate in an HMO Medicare Supplement, you may not have additional premiums to pay because the HMO combines Part D with your supplement. You could have the same limitations on medications as you do on doctors and hospitals. Once again, you get what you pay for.