Choosing 2011 Medicare Supplement + Part D Plans

15 years ago

May I whine a little here? I hate this chore, and it comes at such a busy time of year! The Medicare Supplement plans offered by my DH's former employer have jusst arrived, and we must choose by Dec. 21.

I'm grateful to HAVE a choice, but am going nuts weighing which plan/plans to take. DH will be taking a Part D plan for the first time, too. He took no expensive meds until this year; would have paid hundreds to have a plan while his actual drug expenses were only a few dollars.

I can't get a straight answer on this 'penalty' -- whether it applies and how long it applies. It appears he could have to pay for 60 months of not having bought a plan, dating from the time he was first eligible for one. If that's the case his cost for one drug plan would nearly double. Would he pay the penalty *forever* or just 2011?

When he was first prescribed some expensive drugs at the beginning of 2010 he did get a slight reduction via a card from our county -- took a few dollars off. We are going to have a whopping medical deduction on our Federal taxes for this year!

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Comments (10)

sushipup1
15 years ago
You have to have medical bills exceeding 7% of your income... that's a lot!

Contact the local area agency on aging for HICAP (Health Insurance Counseling and Advocacy Program) classes. We have them here every week while the open enrollment is going on. Better to attend a class than to try to swim thru it all alone.
chisue
Original Author
15 years ago
sushipup -- Thanks. I think we've sorted all this now. If anyone else thinks they will have to pay a penalty...they *will*, and they will *forever*. It's based in 2006 when Part D first became available. Looks like DH will pay $17.60 added to every monthly premium for any Part D plan as long as he has a plan. Maybe he won't always need expensive drugs and can drop the insurance someday.

Once again it looks like we are ahead to take one of the Medicare Supplement plans offered by DH's former employer. We're ahead to take outside plans for Part D.

The supplement is the same one we had this year, with Aetna. We've been completely satisfied with the company's service.

I had Part D with Coventry this year and had no complaints, but I can save two hundred dollars in premiums by switching to United HealthCare. I didn't like the company when we had medical insurance from them, but we'll see.
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It is confusing, Mare...and that's what got me into trouble in the first place. Let me see if I can explain my particular issue to further clarify why I'm being charged a penalty. When my husband died a few years ago, all my benefits died with him due to an agreement he had made with the PBA long before he even knew me. His decision, unfortunately, was irreversible. Throughout our married life...all contact involving his benefits package had to be made by him even though I was covered under all his plans, therefor I was often left in the dark about what the plan included and who the carriers were. I was already enrolled in Medicare when he passed and knew that I would have to replace the supplemental policy he'd had for me with BC/BS. I did so immediately. What I didn't know was that I had to replace the Medicare D policy. I had never needed it and had no idea what it was let alone the fact that it existed as part of his benefits package. To make matters worse, the PBA didn't notify me that I had to replace this coverage with a policy of my own choosing. I went for almost 4 years without realizing that I was in default with Medicare. Fortunately, it was brought to my attention and I applied for a policy but in so doing, I learned that I was going to be penalized for the time that had lapsed between the loss of my husband's coverage for me and my "awakening". The penalty is based on a formula...1% of the policy monthly premium...times the number of months that one goes without coverage. It was a substantial amount to me and I had limited recourse. I contacted Medicare and filed a challenge. They agreed that I had a basis for my challenge. They reduced the penalty by 12 months...but said ignorance of the law was no excuse and I was left responsible for the remaining month's penalty. The penalty is NEVER removed. From now until the day I die...I will have that penalty added to whatever Medicare Part D plan I carry. My only hope to be relieved of this burden is that two US high courts agree with me...that the penalty, along with the Federal edict to force people to carry health insurance above and beyond Medicare...is illegal. If the Supreme Court agrees with the two lower courts, the entire forced insurance system will be reversed and my penalty will be dropped. Needless to say, I'm anxiously awaiting their decision. I hope this gives you a little more info. If you are already enrolled in Medicare, the booklet that they send out every year will give you more information. Or, you can call their office. I've found them to be very helpful...even thought I don't always agree with them. As long as you get Medicare Part D coverage as soon as you're eligible, you shouldn't have to worry about a penalty...unless somewhere along the line you decide to drop the coverage...and then pick it up again at some later date. You'd be penalized for the lapsed coverage time. HTH Anne
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duluthinbloomz4
15 years ago
Yes, the penalty is forever. I feel quite fortunate in that my retirement benefit health insurance drug plan is "creditable" so I don't have to think about Part D. I must say, the literature that fills up mail boxes is dizzying for those who must make a choice.
chisue
Original Author
15 years ago
Hello, Duluth! DH and I are LOL at all the United HealthCare commercials on TV. I first requested literature from them on a Part D plan October 26. Nothing arrived. I called again Nov. 11. They said the intake person had misdirected my request but they'd send out info that week. NOTHING! I called a third time and was told to look online -- that they wouldn't be sending a formulary in the packet anyway. Okay...and then we received two sets of identical info -- for people living in longterm care facilities. Two days later...more longterm care info.

I HOPE we won't be sorry we chose United Part D!

Oh, I should add that we are still receiving denial of payment notices from United for current charges from when we did have them as Medicare secondary three years ago. We've called and written to them and to Medicare. There's no stopping it! Well, it's their time and postage, and the charges are being covered by Aetna.
duluthinbloomz4
15 years ago
Oh what a tangled web... I get blitzed with AARP (United), Humana, along with insurers I've never heard of. I must admit the mailings are dropping off sharply now - probably only to start up again during the 2011 open enrollment season.

I guess the test is when one needs the first prescription filled. I'm on a few maintenance drugs, and all of them but one are generics; and futzed around with the mail order option for quite a long time with very few problems. I'd send in the scrips and get them filled for 90 days + three 90 day refills which I'd reorder online.

I'm a face to face person - I got to not wanting a pharmacy in a faraway state possibly screwing up. So Thursday when I had my dr's appt and mammogram, I brought the new round of Rx to the pharmacy in the building's lobby. My plan was on their books, same copays, etc. One less little stressor in life - just a quick trip downtown every 90 days.

PS, chisue - my health insurance carrier is UMR (basically United). They do seem to do better on drugs than on anything else - which is why I'm paying the extra for Medicare Part B. But until and if ever things change with my "creditable" drug coverage, I can recycle the blizzard of paper.

None of this is particularly enlightening. I'm an educated reasonably intelligent woman, but this whole insurance thing (even my own coverage) is almost beyond grasp.
chisue
Original Author
15 years ago
Duluth -- Do you know if there's any discount if you are an AARP member? When AARP first formed I thought it was going to be a great lobbying group. Then the co-opting started. Now I think it's just a tool of the insurers.
duluthinbloomz4
15 years ago
I don't know about the AARP angle and any discounts. I joined AARP when I turned 50 and so far the only benefit is them filling up my mailbox with junk mail. Well that's not entirely true - I got an AARP discount from my lawyer when I had some legal papers drawn up.

But AARP has no bearing whatsoever on my retirement benefit UMR health insurance.

I know United is the ultimate carrier of the AARP insurance... captive audience for their insurance plans. I wouldn't even know where to start trying to figure out of there were discounts involved other than by sitting on the phone punching buttons on a menue for a morning.

Maybe there's an AARP member out there who has some understanding of membership benefits with regards to insurance or the Medicare Part D.
chisue
Original Author
15 years ago
Thanks, Duluth.

I'm still trying to see if there's a way around this lifelong *penalty*.

A 'Medicare-supplement-plus-drugs' plan offered by DH's former employer styles its' drug portion not as a Part D, but as a 'pharmacy plan'. It covers everything a Part D would. If DH took that plan for 2011, I believe that in 2012 any Part D insurer would consider that he'd HAD 'credible' drug insurance -- and would not impose the penalty.

Guess I have to talk to Medicare again. Sigh.
duluthinbloomz4
15 years ago
You really might want to consider the former employer's pharmacy plan - but where I'm a bit confused... if your husband goes for the pharmacy plan for drug coverage and that proves satisfactory - why would there be a need for a switch to the Medicare Part D in 2012? He would, in effect, be dropping his creditable coverage and that creditable status doesn't carry over to a new plan (ie Medicare Part D because they don't care what you might have had), and would be subject to the forever penalty.

Creditable is just comparing what you have against whatever else is out there. An actuarial firm determines that your plan offers Rx coverage that is equal to or better than Medicare Part D.

Should be easy enough for him to get the boiler plate notice of "creditable" insurance for drugs from his former employer to keep in his files if he goes with what they're offering. In fact, it's a requirement that the notice be sent each year. It's an unimpressive few sheets of paper stating simply: The Society (I'm retired from the Nat'l Geographic Society) is required to issue this annual notice to participants. Then it goes on to explain Medicare Part D, why I don't need it, why I can't be covered for drugs under more than one plan, and what happens if I drop what I have for something else.

I still think that the Medicare Part D penalty is imposed whenever it is not signed up for when you initially become Medicare eligible at 65.

Guess I would check with the former employer - HR there should be on top of what they offer. And I'd call Medicare too - or your closest SS office. I found the people at our Social Security office really helpful - on the phone and in person.
chisue
Original Author
15 years ago
Today my brain kicked in with a memory that DH had drug coverage folded into a medical plan from his former employer. I called them. He had creditable drug coverage through 12/31/08. They're mailing me verification.

So, that cuts the penalty to 24 months and is $7.76/mo. but it's still *forever*.

The current 'medical plus drug plan' he is offered for 2010 isn't as good a buy for us as another 'medical only plan' they offer. The company's stand-alone drug plan is extremely expensive. We come out ahead with the company's medical plan plus a Part D from United HealthCare.

I don't know how Soc. Sec. or a company offering Part D for 2011 would KNOW if you had Part D or equivalent. I had my Part D premium deducted from my Soc. Sec. for 2010, so that's obvious, but in 2009 I paid my premium by check.

If he has to pay the penalty -- and everyone else does too -- that's OK. I just don't want to be the dumb bunny who pays if others don't.

Choosing 2011 Medicare Supplement + Part D Plans

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Choosing 2011 Medicare Supplement + Part D Plans

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