(iDAD) -- December 20, 2006 -- The first annual December 31st deadline for the new Medicare Prescription Drug Program is fast approaching. Unfortunately, the complexity of the program has many seniors still confused.
"The best solution is for web-savvy Boomers to help their parents by using the Medicare Prescription Drug Plan Finder to systematically compare the 50 or so plan choices," says eldercare advisor Esther Koch who is also a Medicare Aging Network Partner with the Administration on Aging and the Centers for Medicare and Medicaid.
Medicare Part D: Getting Started
You first need to know exactly what type of healthcare coverage their parent has and whether it also includes prescription drug coverage.
For seniors with an employer or union retiree health plan or a Medicare Advantage health plan, prescription drug coverage is likely to already be included. In these instances, there is probably nothing to do as long as the senior received notification that the drug coverage is 'creditable' coverage.
It is important to understand that there are two types of Medicare drug plans:
1. Medicare Prescription Drug Plans (commonly referred to as 'stand alone' plans)
2. Medicare Advantage Plans.
"The seniors that really need to review plans annually are those who have 'stand alone' Prescription Drug Plans," says Koch.
"The goal is to select a Prescription Drug Plan whose formulary covers all of a senior's drug needs," Koch points out. Since it is likely that a senior's drugs plus the plan's formulary, tier structure and pricing will change annually, that may not be the same plan each year.
Drug Plan Finder
"The primary web-based tool is the Medicare Prescription Drug Plan Finder at www.medicare.gov."
By entering you parent's zip code and drug names, dosage and 30-day supply, you will obtain a prioritized list of their parent's plan options. You can even save their work and return to it.
Plan options will be sorted from least expensive to most expensive plan based on total estimated annual costs including premiums, deductibles, copays and coinsurance. Total costs vary widely by plan.
"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," says Koch.
"It is the total estimated annual cost that is most important, not just the amount of the monthly premium or whether donut hole coverage is included."
The five least expensive plans will show up initially. "You can show all plans, do side-by-side comparisons of up to 3 plans at a time, and drill down to more detailed information. Once you have analyzed options and decided on a plan, it is best to go to the plan's website to enroll," Koch points out.
Seniors With Limited Resources, Income
Special rules apply to seniors with limited income and resources. These rules are very detailed so the best sources of assistance are:
- Your parent's State Health Insurance Assistance Program at http://www.medicare.gov/contacts/static/allStateContacts.asp
- Social Security at www.socialsecurity.gov and 1-800-772-1213; and
- Medicare at www.medicare.gov and 1-800-MEDICARE.
