Archive for January, 2009

BEWARE: Do Not Switch Your Medigap Plan To Medicare Advantage Plans!

FROM JANUARY 1 TO MARCH 31ST

OF EVERY YEAR IS THE OPEN ENROLLMENT PERIOD FOR LIKE TO LIKE PLANS.  THIS MEANS THAT YOU CAN SWITCH FROM A MEDIGAP PLAN WITH A STAND ALONE PDP TO A (MAPD) MEDICARE ADVANTAGE PLAN WITH PRESCRIPTION DRUGS INCLUDED.  YOU CAN ALSO SWITCH BETWEEN MEDICARE ADVANTAGE PLANS OR CANCEL YOUR MAPD TO GO BACK TO A MEDIGAP PLAN WITH A STAND ALONE PDP.

THIS TIME OF YEAR YOU MAY BE BOMBARDED WITH ADVERTISEMENTS ON TV AND MAIL TELLING YOU THAT THE MEDICARE ADVANTAGE PLANS COVER MORE THAN ORIGINAL MEDICARE.  WELL, IT MAY HAVE A FEW LITTLE THINGS SUCH AS VERY, VERY LIMITED DENTAL COVERAGE, BUT THEY DO NOT COMPARE THE MEDICARE ADVANTAGE PLANS AGAINST MEDIGAP PLANS/MEDICARE SUPPLEMENTS.  THEY KNOW THEY COULD NOT HOLD A CANDLE TO THAT COMPARISON.  IT SOUNDS GOOD ON TV, BUT BEWARE…..MAPD’S DO NOT HAVE NEAR THE COMPREHENSIVE COVERAGE PROVIDED BY YOUR MEDIGAP PLAN.

SOME DOCTORS AND HOSPITALS WILL NOT ACCEPT THE TERMS OF PAYMENT

FROM THE MAPD’S.  YOUR DOCTOR COULD ACCEPT YOUR COVERAGE AT ONE VISIT AND DECIDE NOT TO ACCEPT IT AT THE NEXT APPOINTMENT.  THERE IS NO GUARANTEED NETWORK

OF DOCTORS AND HOSPITALS PROVIDED FOR YOU IN THE MAPD’S.  WITH A MEDIGAP PLAN YOU CAN GO TO ANY DOCTOR OR HOSPITAL OF YOUR CHOICE WITH NO WORRIES.

ALSO, THE PRESCRIPTION DRUG COVERAGE WITH AN MAPD IS ALMOST ALWAYS INFERIOR

TO CHOOSING A STAND ALONE DRUG PLAN.  THE FORMULARIES DO NOT COVER AS MANY DRUGS AND THEIR CO-PAYS ARE HIGHER.  WHEN YOU CAN CHOOSE A DRUG PLAN BASED ON YOUR INDIVIDUAL MEDICATIONS AND FIND THE LOWEST CO-PAYS WHY WOULD YOU TAKE A PLAN YOU HAVE NO CONTROL OVER?

THE ONLY PEOPLE WE RECOMMEND MEDICARE ADVANTAGE PLANS TO ARE THOSE THAT ARE ON DISABILITY OR THOSE THAT CANNOT GET ANY OTHER TYPE OF COVERAGE DUE TO HEALTH REASONS .  ALSO THERE ARE SOME PEOPLE THAT CAN ABSOLUTELY NOT AFFORD THE PREMIUMS ON A MEDIGAP PLAN AND THE MEDICARE ADVANTAGE PLAN WOULD BE BETTER THAN NOTHING AT ALL IN SOME CASES.  HOWEVER, MANY OF THE MAPD’S HAVE GONE UP ON THEIR RATES AND SOME OF THEM ARE AS HIGH IN PREMIUM AS A MEDIGAP PLAN NOW.  PLEASE MAKE SURE THAT IF YOU THINK YOU WANT TO JOIN AN MAPD THAT YOU ALSO COMPARE PREMIUM PRICES ON A MEDIGAP PLAN.  IT WOULD BE VERY UNFORTUNATE TO BE PAYING THE SAME AMOUNT FOR AN INFERIOR COVERAGE PLAN.

I AM ALWAYS VERY ENTERTAINED BY THE TV COMMERCIALS FOR MEDICARE COVERAGE.  I GUESS THAT IS BECAUSE I CAN READ BETWEEN THE LINES AND SEE WHAT INFORMATION THEY ARE DELIBERATELY LEAVING OUT OR HOW THEY ARE SPINNING THE BENEFITS THEY OFFER

TO SOUND SO MUCH BETTER THAN ANYTHING ELSE.  IF I DIDN’T KNOW BETTER, I MIGHT CONSIDER THEM AS WELL.  THAT IS WHY I WANTED TO WARN YOU ALL ABOUT THE HURRICANE A’COMMIN’ DOWN THE PIKE.  I CAN HEAR THE WINDS AND SEE THE RAIN.

IF YOU HAVE ANY QUESTIONS ABOUT SOMETHING YOU WERE TOLD OR HEARD ON TV, PLEASE WRITE ME AND I CAN HELP YOU UNDERSTAND THE TRUE MEANING.  TAKE CARE!  KARYN

Please write to me, Karyn Blake, here at My Part D USA’s blog at kblake@MyPartDusa.org. Or you can email this article to a friend.

Published by mypartdusa on January 16, 2009 in Uncategorized.

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Medicare Says: You Can Buy Your Generics OFF Your Part D Drug Plan, There Is NO Penalty For Pharmacies, YOU or Anyone!!

WELCOME TO 2009!!

I hope you all have had a great beginning to 2009 and enjoyed your Holiday Seasons with family and friends…..NOW it is time to get back to business as usual.  Over the Holidays I got lots of emails questioning me about if it was legal to buy your GENERIC DRUGS OFF YOUR PART D DRUG PLAN. 

YES, YES, YES!!

I also got emails and phone calls telling me that some PHARMACIES were telling them that if they do not file all prescriptions on their Part D Plan they get a penalty from the Centers For Medicare.

NO, NO, NO!!!

FOLKS, TODAY I TALKED WITH MR. TARTELLA, Senior Compliance Officer, WITH THE CENTERS FOR MEDICARE.  HE TOLD ME THAT EVERY SENIOR OR PERSON ON MEDICARE PART D PLANS CAN MAKE THE CHOICE TO FILE IT WITH THEIR PART D PLAN OR TO PAY CASH AND REQUEST IT NOT BE FILED WITH THEIR INSURANCE.  THERE IS NO PENALTY TO THE PHARMACY INVOLVED.  HIS WORDS TO ME WERE…..HOW WOULD WE FIND OUT ABOUT IT ANYWAY? 

The reason the pharmacy tells you this is that they get paid more if they file it with your Part D Plan.  IF A PHAMACIST TELLS YOU THIS, TELL HIM THAT YOU KNOW BETTER AND THAT YOU WILL TAKE YOUR BUSINESS SOMEPLACE ELSE.  NO ONE CAN FORCE YOU TO FILE INSURANCE CLAIMS.

If you begin the year by purchasing all your GENERICS OFF YOUR PART D DRUG PLAN

, you will NOT FALL INTO THE “DREADED DONUT HOLE” AS QUICKLY IN 2009.  PLEASE   READ MY OTHER BLOGS ABOUT HOW TO MAKE SURE YOUR PHARMACIST IS NOT FILING YOUR GENERICS ON YOUR DRUG PLAN.  Click on “DONUT HOLE HELP” catagory on the left side of this blog.  Also, I have a link that will let you know what retailer will sell you your GENERICS at the lowest price, some even sell them for $4 for a 30 day supply.

Please keep me posted as to how this goes for you!!!  You can even tell your pharmacist to read this BLOG .  My goal is to help you save the most money as possible this year on your meds.  Keep this website in your “favorites”, so you can check back to read the latest info.

Please write to me, Karyn Blake, here at My Part D USA’s blog at kblake@MyPartDusa.org. Or you can email this article to a friend.

Published by mypartdusa on January 15, 2009 in Drug Savings Tips.

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