My Part D USA

Many of you have been writing in to get your comparison for 2009.  Unfortunately the Centers for Medicare do NOT send us the data to build our comparison until around November 1.  They also tell us that we cannot have comparisons or enrollments available to you until November 15th.  That is the beginning of the AEP or Annual Election Period.

I wish we could do this for you sooner, but our hands are tied.

I do know that you will be very pleased to see your comparisons on Nov. 15th and since you cannot enroll any earlier than that, you can wait to make your final selections. 

The comparisons have your top 5 plans for savings on your co-pays and premiums listed along side each of your medications.  It is a very easy process and the information can help you greatly on choosing the drug plan that will cover every drug you take at the lowest prices.

WE LOOK FORWARD TO SERVING YOU ON NOVEMBER 15TH, 2009!!!

I have found more large retailers that have a list of Generics for $4.

Giant Eagle,  Kmart,  Kroger,  Schnucks,  Target,  Walmart/Sams Club,  Wegmans

I can send you the link for these lists if you cannot find it online yourself.  You can google the store name and find it on their websites.

This is going to help you out so much in 2009.   If you begin January 1, 2009 buying your generics OFF YOUR DRUG PLAN , you will not go into the “dreaded donut hole” as quickly in 2009.  Now wouldn’t that just be fantastic???  Do not show the pharmacy your drug plan card and tell them this is NOT to be applied to your drug plan.  Some people go to one store to buy their generics, and go to another one to use their drug card, just to avoid confusion.

For those of you who get to the other side of the donut hole and get 95% coverage, you DO NOT WANT TO FOLLOW THIS PIECE OF ADVICE.  YOU NEED TO GET TO THE 95% COVERAGE ASAP!!

Even though you are paying the generic co-pays on your Part D Drug Plan, the Drug Plan dings you a much higher retail price that goes toward your falling into the donut hole!  So, you can see how that could keep you out of the donut hole so very much longer and then you will have more money in the pot to pay for your really expensive medications. 

Dear Readers,

A few weeks ago we sent out over 10,000 worksheets to people who have enrolled with us last year.  Every year we do this so you have some warning about the changes to your drug plans coming up January 1, 2009.

It never fails that when some people go to the pharmacy for the 1st time after the New Year, they call us crying about their co-pays going up and why we didn’t tell them.  I talk about this all year on the BLOG that ALL THE DRUG PLANS CHANGE EVERY YEAR.  THE DRUG PLAN YOU HAD IN 2008 MAY NOT COVER YOUR DRUGS IN 2009 OR THEY COULD HAVE GONE UP SIGNIFICANTLY IN CO-PAYS.

We cannot give 10,000 people a personal phone call.

Please remember that you can see your comparison LIVE ONLINE BEGINNING NOV. 15TH, 2008

QUESTION: I have always had a Group Health and Drug Policy through my retirement plan with my employer.  I have been told that when I join a Medicare Plan I will need to re-enroll and re-evaluate my Medicare Plan each year as I did with my group health.  Is this true?

ANSWER: No sir, this is not true in most cases.  If you join a Medicare Supplement plan, as I have advised the people who are losing retirement group health benefits, you will not need to ever re-enroll or re-evaluate your Medicare Supplement.  Medicare Supplement benefits never change.  They are regulated by the Centers for Medicare.  They all contain the exact same benefits, no matter if you get a AARP, Bankers Life, Mutual of Omaha, BC/BS etc…They all are the same benefits.  A plan F is a plan F or a plan J is a plan J no matter where you get it or what carrier you choose to enroll with.  The only difference is the price you will pay in your monthly premiums.  So you should MAKE SURE YOU GET A COMPARISON OF SUPPLEMENT PRICES FROM DIFFERENT CARRIERS AND ENROLL WITH AN A-RATED COMPANY. There are some Medicare Supplement carriers out there that are B-Rated.  Please do not consider these companies.  The only exception of re-evaluating your Medicare Supplement Policy would be to get a lower premium.  That is why you should GET a good rate up front!!!

YOU CAN NEVER BE CANCELLED FOR HEALTH REASONS ON YOUR MEDICARE SUPPLEMENT POLICY.  YOU ARE GUARANTEED COVERAGE FOR LIFE WITH NO RE-ENROLLMENT TO WORRY ABOUT EACH YEAR!  THE ONLY WAY TO LOSE YOUR POLICY IS FOR NON-PAYMENT OR YOU WISH TO CANCEL YOUR POLICY!

I can understand why you would be confused since you had to re-evaluate your group policy each year.  The group health companies change their benefits and prices each year, so you should have had the opportunity to re-evaluate them each year and make changes.

If you choose to join a MEDICARE ADVANTAGE PLAN, going against all my best advice, these can and do change.  You can jump from one MAPD to the next.  They may be hoping that you do, because each year they would get a brand spanking new commission every time you changed.  If a Medicare Advantage Plan is not making money in a certain area, they can decide to cancel coverage there.  I have seen that many times.  They do have lower premium rates than Medicare Supplements, but folks, remember that you get what you pay for, especially in this case.

The only part of your Medicare coverage you will need to look into each year is your Part D drug plan.  These plans DO CHANGE EVERY YEAR. You will need to get a comparison each year to make sure the plan you are on still covers every one of your prescriptions and at the lowest co-pays and premiums.  Don’t let this upset you, because we have them online every year and you can get this in 5 minutes or you can go to Medicare.gov and get one there as well.

QUESTION: I have been told that a Medicare Advantage Plan does not ask any health questions, but a Medicare Supplement does ask health questions.  Why is this and wouldn’t it be easier to get a Medicare Advantage plan since they do not ask questions?

ANSWER: The only questions Medicare Advantage Plans ask about is end stage renal disease, they do not take people with kidney failure.  That is why these plans are good for people on disability or for people who can absolutely NOT afford the premium on a Medicare Supplement Policy.  It is a risky plan.  There are just too many variables involved, such as your doctor can accept a Medicare Advantage Plan at one appointment and refuse it at your next appointment.  They have no set network of doctors or hospitals that quarantee you THEY WILL accept their terms of payment.  You see, Medicare does not pay your doctors and hospitals on a Medicare Advantage Plan.  The actual Insurance Company does it.  That is why many doctors and hospitals will not take the risk of NOT GETTING PAID BY THE MEDICARE ADVANTAGE PLAN.  SO, LADIES AND GENTELMAN, I ASK YOU…….WHY WOULD YOU TAKE THAT RISK?????

With a Medicare Supplement Plan you have a 63 day guaranteed enrollment with NO HEALTH QUESTIONS ASKED AND NO PRE-EXISTING EXCLUSIONS. That is why we tell you to get one NOW. After your 63 days you will go through underwriting and may get turned down for health reasons.

So to answer your question, if you take my advice and go ahead and get a Medicare Supplement now, it is JUST AS EASY to get the best coverage.

I’d like to say “Thank YOU”, to everyone who has written in to me the last week or so with all the kind and thoughtful words of appreciation for the BLOG.  It means so much to me that you have found the information helpful. 

My Part D USA’s main objective is to be a useful resource for helping you make good decisions regarding your Part D drug plans and health coverage during this confusing time of decision making. 

Medicare has become more confusing the last few years and I get letters everyday from people telling me how hard it is to know the best thing for them.  We are not in competition with anyone else that you may talk to about Medicare.  Our #1 goal is to equip you with he most comprehensive information we have available from our many years of service to Medicare benficiaries, and tell you things that you may not hear from other salespeople. 

I have found that you can be honest and work for the people and still make a living in this dog eat dog economy.  So many companies try to be successful doing what is best for them, instead of what is best for others.  I don’t understand that mind set.  To me it seems so much easier to just do the “right thing”. 

No matter who you choose to work with to get your drug plan and health coverage, please take the advice on the BLOG to heart.   We wish everyone involved with Medicare enrollments the very best, it is not to our advantage to downgrade anyone.  I just wanted to pose questions that you should ask and then it is up to you to evaluate what you consider best for you!!  Now you know what questions to ask and what to look for, no matter where you go or who you talk with for your enrollment needs. 

Questions to ask your healthcare rep:

1.  Can you give me a Part D Plan comparison of plans based on my individual prescriptions and show me the actual  co-pays and premiums of each plan to save the most money?  There are at least 50 plans in each state, all with different co-pays for each drug. 

2.  Do you have a comparison of Medicare Supplement prices for several companies in my State?  Remember all the benefits will be the same, don’t get sold on a company name.

3.  What is the comparison between a Medicare Advantage Plan against staying on Original Medicare combined with a Medicare Supplement and a Stand Alone Part D Plan?  Remember, if they tell you that a Medicare Advantage Plan is better than Original Medicare, that is not the comparison you need!!  If you are considering joining a Medicare Advantage Plan, remember that you may not be able to get anything else after your 63 days of open enrollment without going through underwriting and possibly getting turned down for health reasons.

4.   If you are talking to me about joining a Medicare Advantage Plan with a built in Part D drug plan, can you give me a comparison of the stand alone plans to make sure the MAPD’s plan will save me the most money and cover my drugs?, or can I get a Medicare Advantage plan and still have my choice of Part D drug plans?  Remember, if you really want a Medicare Advantage plan, even after all my warnings, you need to get one that does NOT have a built in Part D plan, so at least you can save the most on your drugs.

You need Two Different Policies:

1.   Lowest Price Med Sup Policy

2.  Part D drug plan that covers meds at lowest prices

Again, I thank you for reading the blog.  Just let me know if you need a copy of the Walmart list for $4 generics. 

I wanted to go over several things we discussed at the meeting in Ohio last Wednesday.  We also wanted to thank Tony Landers, Pat Moylan and Rosie Janus for inviting us to visit with you.  Also, a thank you must go to Paul Hansen, HR Director for 42 years at the Lordstown Plant, for putting us in touch with such a great group of Retirees.

The first speaker was a local pharmacist, Zen Forosty.  I was more than thrilled when I heard him talk about the very drug savings tips I have been writing about all year.  It means so much when a professional person gives such good advice and I’m sure people will have much more confidance in hearing it from him than from little ‘ole me. 

Here is the LIST OF TOP 10 TIPS TO MAKE THE BEST DECISIONS FOR HEALTHCARE AND DRUG SAVINGS.

1.  Not all Part D plans are the same.  There are over 50 plans in each state. 

2.  A ONE-SIZE-FITS-ALL approach is very dangerous. 

3. You must choose your drug plan based on your individual needs and the actual drug names that you use.  If you take a generic, look up the generic name.

4.  You must do a comparison of the drug plans based on the drugs you take.  You can do your own pencil work or we can help you do this during the AEP, beginning Nov. 15 – Dec. 31st.

5.   Beginning January 1, 2009, buy as many of your drugs OFF THE PART D PLAN as possible.  Over 400 drugs are listed on Wal-Marts generic drug list for $4 for a 30 day supply.  You can also go to other large retailers if you don’t like Wal-Mart.  I WILL EMAIL YOU THIS LIST IF YOU WRITE ME WITH A REQUEST.  This tip will keep you OUT of the “DREADED DONUT HOLE” longer in 2009.  Please read my other blogs with details of how to do this!

6.   When your doctor prescribes a new medication for you, as him for samples FIRST, or as a very helpful lady at the meeting told me, get a 5 or 10 day supply.  The reason for this is, you may not be able to take the new med because of the side effects or it may simply not work for you.  Every prescription you purchase goes TOWARD YOUR FALLING INTO THE “DREADED DONUT HOLE”.  So don’t get a full prescription until you know you will be taking this medication.  Please read my other blogs about drug savings tips.

7.  Make SURE YOU GET A MEDICARE SUPPLEMENT FIRST, before you choose a MEDICARE ADVANTAGE PLAN.

8.  You have what is called a 63 day Guarantee Issue Period in which to choose a Medicare Supplement with NO HEALTH QUESTIONS ASKED, and NO PRE-EXISTING CONDITIONS EXCLUDED.

9.  Remember a Plan F is a Plan F, a Plan J is a Plan J, no matter which insurance company you choose.  All these Medicare Supplement Plans are regulated by the Centers for Medicare and contain the exact SAME BENEFITS!  The only difference is the price you will pay for your premium, and folks there is no sense in paying more than you absolutely must pay to these insurance companies!

As I said before, you may ask yourself, why WILL THEY NOT TELL US?……IT MAY BE BECAUSE THEY GET PAID MORE.  The commissions on these MA Plan’s are at least double than if they helped you get a Med Sup first. 

I have been very concerned that GM Retirees will join plans that may be harmful for them because of the aggressive marketing of the Medicare Advantage Plans.  We have tried to get in touch with as many Retirees as possible, but of course we don’t have any way to do that and just rely on them coming to the website.

It truly is a sad day in our country when this kind of marketing is allowed, just like the crash of the housing markets, the Medicare system is going to fail if it does not get more regulations to make sure our Greatest Generation such as you GM Retirees do not have to be confused about the best coverage for you and your families!!!  I could go on and on, but will get off my soap box now.   

Yesterday I got a call from a GM Retiree in Ann Arbor, Michigan who had just read my blog.  It was not even 5 minutes after I posted it.   GOOD NEWS TRAVELS FAST!!!

  He was very excited about our meetings and told me how thankful he was that we are doing our outreach. 

If you or your group of retirees would like us to have a meeting in your area, please call my number toll free at 866-752-1795 or email me.  We will try to fit you into our schedule before the AEP beginning Nov. 15th through Dec. 31. 

Many of you are calling and sending us your list of meds NOW.  However, the Centers for Medicare have not yet released the disc for the complete list of prices for 2009.  Remember there are at least 50 different drug plans in each state to compare against. 

WE WANT YOU TO GET THE BEST PLAN TO SAVE YOU THE MOST MONEY!!

PLEASE USE OUR WORKSHEET TO FAX OR SNAIL MAIL YOUR LIST OF MEDS IN TO US BEFORE NOV. 15TH!  AFTER THAT YOU CAN ENTER THEM IN YOURSELF ON THE WEBSITE OR CALL OUR TOLL FREE NUMBER FOR HELP.  YOU MUST GIVE US THE GENERIC NAMES OF YOUR MEDS IF YOU TAKE THE GENERIC FORM OF YOUR MEDICATION TO GET AN ACCURATE COMPARISON!

 A HUGE Thank You goes out to all the great General Motors Retirees we met in Niles, Youngstown, and Lordstown, Ohio.  We had a really good meeting there.  The first person to speak was a local pharmacist who talked about how important it is to get a Part D drug comparison.  He also mentioned about buying your generics OFF your drug plan at Wal-Mart or another large retailer’s $4 list so you don’t go into the “dreaded donut hole” as quickly in 2009. 

The main thing we tried to get across was:

DO NOT JOIN A MEDICARE ADVANTAGE PLAN FIRST!!!!

If you think you may want to try a Medicare Advantage Plan, join a Medicare Supplement first.  That way you will be buying yourself a “12 month security of choice guarentee”.  Medicare states that if you get off a Medicare Supplement to join a Medicare Advantage Plan and decide you don’t like the Medicare Advantage Plan FOR ANY REASON, YOU HAVE 12 MONTHS TO GET BACK ON YOUR SUPPLEMENT WITH NO UNDERWRITING OR HEALTH QUESTIONS ASKED.  If you join a MAP first you may be STUCK WITH IT, because you will have to go through underwriting and you will have no guarantee of coverage.

The Medicare Advantage Plans DO NOT TELL YOU THIS!!!!

PLEASE MAKE SURE YOU TELL EVERYONE YOU KNOW ABOUT THIS VERY IMPORTANT INFORMATION.

You may ask yourself why some insurance agents are recommending Medicare Advantage Plans?  The commission earned on a Medicare Advantage Plan is more than double what they would get if they recommended a Medicare Supplement and a Stand Alone Part D Drug Plan, which is what the GM retirees really need!!!!  Many other agencies say that Medicare Advantage Plans are better than Original Medicare….BUT, they DO NOT compare Medicare Advantage Plans against Original Medicare combined with a Medicare Supplement and a Stand Alone Drug Plan!!!!  Read my other blogs on this topic.

We have been working with GM Retirees all over the country and we have had some great meetings.  They are so glad that someone out there is providing the best information available so they can make the best decision about their healthcare.  We thank you for all the kind words and appreciate the opportunity to assist you all with such a very important aspect of your retirement. 

If we didn’t answer all your questions in the meeting, please write to me and I will find an answer for you ASAP!!  IT WAS AN HONOR TO MEET EACH AND EVERY ONE OF YOU.