Explain Medicare Part D Deductibles
8 years ago
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Choosing 2011 Medicare Supplement + Part D Plans
Comments (10)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....See MoreMedicare Part D Question
Comments (6)This is why I am so appreciative of my Medigap policy. It pays any and all deductibles. Medicare Advantage plans are the ones that include medical (so you don't have Original Medicare) and prescription drugs. My Medigap policy is through the California Public Employee Retirement System (CalPERS) for State Retirees, so I have Original Medicare for hospitalization and medical, and the Medigap policy picks up the deductibles and is a second, supplemental, insurance for both. With this coverage I pay zero (the State even reimburses me for the monthly Medicare premium and also pays the monthly Medigap policy premium). The Medigap policy also includes prescription drug coverage (PSP). The PSP has no deductible, just co-pays (e.g., no more than $5 for a 34-day supply for a generic; no more than $10 for a 90-day supply of a generic). The great thing is that the PSP still pays for medications through what would otherwise be the Coverage Gap Stage (a/k/a the "donut hole"). All I would have to pay is the same co-pay as during the Initial Coverage Stage. When I last filled my high blood pressure medications, my co-pay on one of them was LOWER through my Part D coverage (it was $8) than it was when I was on the "basic" insurance as an active state employee (when I paid $10). ChiSue, didn't you say before that you have a Medicare Advantage Plan? Are you thinking of changing to Original Medicare with a separate Plan D?...See MoreMisunderstanding Medicare Part D "Annual Costs"
Comments (2)I figured it out. The answer may help someone else. The annual cost is less than the premium plus the deductible because DH won't use up the whole $400 deductible paying for his two daily meds under this plan. (Of course he will have some additional prescriptions, but it's not possible to know what those meds will be.) With this plan his meds total $316/year. Meds @ $316 + Premiums @ $270 = $586/year. It still seems 'too good to be true' because other plans figure his meds costing much more than this plan, even using those plans' preferred pharmacies. (This plan uses Walgreens.) *I* am still stuck with the Never-To-Be-Generic Advair. I will pay an insurance company $350/year for the privilege of paying $850/year for the Advair. (Retail $4000/year.) Minimum medication costs for us will total $1786. We have another $2500 for Medicare Part B. Then there are our ($2100 deductible) Medicare supplement policies...another $2000. We're over $6000 before other Out Of Pocket medical and medication expenses. The total will be more than I budget for food....See MoreForgive My Asking Again About Medicare's Part D
Comments (8)It will depend on the policy where the deductible is paid. Rather than worrying about that I would check each companies formulary to see what they cover for each of your medicines along with any co-pays for that medicine. Reason why I posted the "where" is some consider the co-pay as going to the deductible others want the deductible paid before the co-pay starts. Knowing how much your regular medicines will cost is a good starting point then follow Elmer's suggestion on the ones that you think you may want....See More- 8 years ago
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