Medicare Rx: Seniors Need The Help Of Their Boomer Children
San Mateo, CA November 14, 2006
The first Annual Election Period for Medicare Rx, November 15th - December 31st, is here and seniors are still confused. The solution lies with their Boomer children getting involved. Here's what they need to know.
November 15th to December 31st, the first annual election period for the new Medicare Prescription Drug Program, is here. Unfortunately, many seniors are just as confused now as they were earlier this year.“Rather than attempt to figure this out on their own, the best solution is for Boomers to help their parents”, says aging and eldercare advisor Esther Koch, who is also a Medicare Aging Network Partner with the Administration on Aging and the Centers for Medicare and Medicaid.
First, Koch explains, “you need to know exactly what type of healthcare coverage your parents have.”“Then,” she continues, “whether it includes prescription drug coverage.For seniors with Medicare Advantage, union or retiree health plans, prescription drug coverage is likely to already be included.In these instances there is probably nothing to do, as long as your parent received notification of “creditable” coverage.”
There are two types of Medicare drug plans: “stand alone” Medicare Prescription Drug Plans and 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 “stand alone” plan whose formulary covers all of a senior’s drug needs.Since it is likely that those drug needs will vary year to year, that may or may not be the same plan each year.”“In addition”, continues Koch, “the plan’s formulary, plus tier structure and pricing, are likely to change annually, too.”
“To make an informed decision on a “stand alone” Prescription Drug Plan, you must use a web-based tool to systematically compare the 50 or so plans in your parent’s area.This is why web savvy Boomers can be so helpful to their parents”, says Koch.
Koch continues, “The primary web-based tool is the Medicare Prescription Drug Plan Finder at www.medicare.gov.By entering your parent’s zip code and drug information, you will obtain a prioritized list of your parent’s plan options.You can even save your work and return to it.Detailed steps are outlined at www.encoremgmt.com under the Medicare Rx tab. “Your parent’s plan options”, Koch emphasizes, “will be sorted from least expensive to most expensive plan based on total estimated annual drug costs including premiums, deductibles, copays and coinsurance.Think of this as getting a list of the total cost of all of your holiday gifts if the same basket of gifts were purchased from some 50 different retailers.You should be most interested in the least expensive plans”, says Koch. Koch continues, “The five least expensive 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,” Koch states, “it is best to go to the plan’s website to enroll.”
“Special rules apply to seniors with limited income and resources”, says Koch. “These rules are very detailed so the best sources of assistance are: