This just in from a caring reader:

Hi, Karyn.  It is J. Adams in Kentucky again….just read your article on “YOU HAD BETTER SHOP AROUND”.  You are absolutely correct in that generics do not have to be charged against your $2,830 you get in drug benefits before you hit the “dreaded donut hole” in 2010.  In fact, even though most pharmacies will ask for your medicare number, you must DECLINE this and end any possibility the pharmacy can charge your Part D plan.  I use Krogers and get a 30 day supply of generics for $4 each.  In the beginning they asked for my Medicare number and Social Security Number.  I SIMPLY DECLINED AND TOLD THEM I’D BE PAYING FOR MY GENERICS MYSELF. No problem from them after that!  I also told them they had no need for that information.

Please feel free to pass this tip onto your other people with these questions  Please tell your people there are other ways they can verify who you are.  Kroger uses my date of birth and the last 4 digits of my telephone number. It works just fine!

THANK YOU SO MUCH FOR SHARING THAT GREAT TIP, J. in Kentucky

QUESTION:  I am losing my Retirement Plan from my company I worked at for many years.  They are telling me that I can only choose between plans they are giving me at this insurance enrollment number.  If I use another enrollment method or get different plans from what they are offering they won’t pay for it anymore.  Can they do this?  What do I really need to be concerned about getting on Medicare?

ANSWER:  Yes, Virginia, there really is a Santa Claus!  I’m sorry for being sarcastic, but it is amazing to me that companies out there are trying to confuse people getting on Medicare.  YOU STILL HAVE CHOICES JUST LIKE EVERY OTHER AMERICAN CITIZEN WHEN THEY ARE FIRST GETTING ON MEDICARE!! What your company is really saying is…..we have made a deal with these “certain” insurance companies that if you “enroll” with them AND take out the plans “we want you to take out”  WE WILL HELP YOU PAY FOR IT.

Most people when they retire go on Medicare with no financial help.  Usually if you have retired from a company, you can afford the $100 a month, give or take a little, for premium on a MedicareSupplement/Medigap plan, which is most certainly the best coverage and what you should be offered. If you are desperate and cannot afford this premium, THEN and only THEN should you take up the offer from your employer and join a Medicare Advantage Plan.  This is INFERIOR COVERAGE AND HAS NO NETWORK OF DOCTORS OR HOSPITALS THAT WILL ACCEPT THESE PLANS. Also, they are not going to be available after 2011 anyway.  So, my “educated guess” (yes, I’m being sarcastic again)  is that since the insurance company gets paid at least twice the commission for selling you Medicare Advantage Plans, they want to get these sold as long as they can, and they make some kind of “deal” with your employer.

After 2011, you will be right back in the same spot of choosing another kind of health plan.  Please read more about Medicare Advantage Plans under the “category section” on the left side of the homepage of the blog.

What you need to do is to call a local agent that you trust, or contact us and get a comparison of Premiums on a Medicare Supplement/Medigap plan and also a comparison based on your drugs, of a Stand Alone Part D for drugs plan.  That is ALL you NEED.

Now some of you are also used to having dental and vision coverage under your retirement program.  There are no insurance plans for people on Medicare for dental and vision.  The Medicare Advantage Plans have these little teaser benefits, but nothing like you used to have and should not be a deciding factor in chosing to use a Medicare Advantage Plan.  Believe me, if there were any kind of decent vision and dental plan out there for Medicare beneficiaries, I would have found it.  There are plans you can join, BUT THE PREMIUM IS NOT WORTH THE BENEFITS, OR YOU ARE WASTING YOUR MONEY. There are plenty of salespeople out there that will sell you dental and vision plans all day long.  So just think about that…..

When picking out a Part D plan, the only thing you need to worry about is saving the most on your co-pay and premium for the first $2,830 worth of drugs you buy.  After that, you don’t need to use your drug plan at all….you NEED TO SHOP AROUND AND BUY YOUR DRUGS AT THE PLACE YOU CAN FIND THE BEST PRICE NOT USING YOUR DRUG CARD.   ALSO, BEGIN THE YEAR BY NOT BUYING YOUR GENERICS ON YOUR DRUG CARD. If you read my other blogs about “drug savings tips” you will understand how this will keep you OUT of the DREADED DONUT HOLE LONGER EACH YEAR!   The only people who should buy all their drugs on their drug plan are those that will hit the donut hole and reach the other side to the 95% coverage!!  Get past that donut hole ASAP and begin getting your 95% coverage.

So, please find yourself a comparison of Medicare Supplement/Medigap plans and a Part D Plan, based on your prescriptions and enroll on those 2 things.  You will be glad you did!!!!

Go to www.MyPartDusa.com and enter in your drugs and tell us what situation you are dealing with in the comments.  We will honestly help you understand and get the best coverage!!!

THOUGHT FOR THE DAY:  Life isn’t about waiting for the storm to pass, but learning to dance in the rain.

Many of you have lost your employer coverage recently.  We know how suddenly being thrown into the Medicare system with every insurance company sending you information on their products can be so confusing and downright overwhelming!

We have also heard that some companies and even government employees and teachers have been offered ONLY a choice of Medicare Advantage Plans.  Some companies even tell their employees that if they use a PARTICULAR INSURANCE AGENCY to take out their coverage they will get more money to help pay for it.  In other words they are steering you to use a particular insurance agency or insurance company if you want any financial help to pay for your Medicare coverage.

This is amazing!  ARE THEY REALLY TAKING AWAY YOUR CHOICES?  NO, THEY ARE NOT!

They are making you feel as though your only options are to take what they want you to take, when the truth is, when you lose coverage from your employer, you are FREE to join whatever plans you KNOW are best for you, and that is CERTAINLY NOT a Medicare Advantage Plan.  Please read my other blogs under the category section on the left hand side under MEDICARE ADVANTAGE PLANS.

Please know that it is NOT to your advantage to choose anything other than using your Original Medicare Benefits, Part A & Part B and joining a Medicare Supplement/Medigap Plan and a stand alone Part D plan.  You may not get the extra $50 a month to help pay for it, but if you can possibly pay for a premium for a Medigap plan, you must decide to do what is in your best interests.

The main reason these companies want you to join Medicare Advantage Plans is the commission is so much higher for them.  They make more money when you join Medicare Advantage Plans.   I’ll let you wonder why your employer would only give you Medicare Advantage Plans as an option???  You can think about that.

In the year 2011, there will no longer be Medicare Advantage Plans as we know them today.  Even this year, many, many Medicare Advantage Plans have taken themselves OFF the market and many peope are losing coverage from their Medicare Advantage Plan.  The main reason for this is they have NO NETWORK OF DOCTORS  OR HOSPITALS THAT WILL TAKE THIS COVERAGE. You have no way of knowing if the doctor you have seen the past 10 years is going to accept the Medicare Advantage Plan or your preferred hospital will take the coverage.  If they do take it NOW, they can STOP taking it anytime they choose and you will be without coverage.

Tell me, WHY would you take that risk? Medicare Advantage Plans do not pay for durable medical equipment and many times your health is left up to the bean counters, not your doctor!  If you can afford the premium on a Medigap plan, why would you risk your healthcare?

So, the main point I am trying to make is do NOT feel trapped into taking whatever they throw at you.  You have the same choices as anyone else getting on Medicare coverage and you can choose to go to any agency, any website, any company that YOU CHOOSE, to find the best, most affordable coverage.

We can help you here if you are losing employer coverage to give you Medigap cost comparisons along with Part D drug plan comparisons.   We have helped thousands of GM, Whirlpool and other companies retirees…..JUST READ ALL OUR TESTIMONIALS!

GO TO www.MyPartDusa.com and enter in your meds and tell us what your concerns are about your choices today.

I am not yet on Medicare, but every time I go into a pharmacy I check to see what kind of programs they have for Medicare beneficiaries.  Yesterday at CVS I saw a plan where they have over 400 generic drugs for $9.99 for a 90 day supply.  I know that Walgreens, Wal-Mart, Costco, Sam’s Club and many other places have these plans as well. You may ask, “but why should I do this when my co-pay is cheaper than that?”  Even though your co-pay is $4, your drug plan dings you $20, $30 or $40 dollars or more because it is the RETAIL PRICES that count toward your donut hole amount of $2,700.  This pushes you closer and closer into the donut hole.  DON’T BUY YOUR GENERICS ON YOUR DRUG PLAN!  SAVE YOUR $2,700 FOR BRANDS YOU MUST HAVE THAT ARE MORE EXPENSIVE.

I also asked the pharmacist if they made claims on your Part D drug plans when you had this program and he told me absolutely NOT!  The reason I asked them that is I have recieved many emails from readers telling me their pharmacist said it was against the law if they didn’t file a claim.  This is a downright LIE! They just get a higher re-embursement if they file a claim.  If your pharmacist tells you this, give him/her my number and I’ll report them to Medicare or you can do so yourself at 800-633-4227.

Many of you are now in the “DREADED DONUT HOLE”.  Please know that if you begin 2010 by using these generic programs instead of using your Part D plan on your generics you will stay OUT of the donut hole months longer next year!

ONE MORE THING: Read your monthly drug plan statements like it was your bank statement.  See what claims have been charged to you to push you further and further towards the donut hole.  Many people report duplicate claims.

YOU MUST SHOP AROUND! Even on my own meds, I found huge differences in prices from one pharmacy to the next on the same exact medication.  One medications was $127.00 at one pharmacy and $67.00 at another pharmacy.  Don’t just pay them, tell them you can get it cheaper down the street.  Shop around and find the best price either locally or online.  When you are in the DREADED DONUT HOLE, YOU CAN’T BE FAITHFUL AND USE YOUR PART D PLAN, YOU MUST GET YOUR MEDICATIONS ANYWHERE YOU CAN FIND THEM CHEAPER NOT USING YOUR DRUG PLAN!  YOUR PART D DRUG PLAN IS NOT FAITHFUL TO YOU!

If you know you will get to the 95% coverage, then you must use your drug plan through the donut hole….but if you fall in, never to get out for the year….just act like you don’t even have a Drug Plan, except you must continue to pay the premiums or be penalized.

I know I sound like a broken record, but I’m still getting so much email on this subject!  Hope this helps.

THOUGHT FOR THE DAY:  Your Integrity Will Affect Your Destiny; Don’t Leave Home Without It!

Since I get so many questions by email everyday I thought I would share some of them with you, just in case!

QUESTION: Does Medicare pay for any kind of herbal or natural treatments instead of just prescription medication?

ANSWER: No, Medicare does not consider herbs true medications and will not cover these expenses.  I understand why you would want to know this because I have been in my local health food store and know how much the supplements many doctors recommend cost, such as Omega 3 fish oil, and antioxidant herbal additions to your treatment.

My advise to you if you want to use herbal supplements in addition to or instead of standard prescription medications is to find a Doctor in your area who deals with both ways of treatment.  Many herbs can interfere with your prescriptions, so you need to disclose everything you take to EVERY doctor you see.

There are recent studies that the herb Astragalus has been used in combination with other drugs to treat cancer and can boost the power of some types of chemotherapy.  Ginseng is another herb that can boost energy in cancer patients, and Glutamine can help with your digestive tract and the damage chemo does to your body.  Chronic inflammation is known to fuel the growth of tumors and Omega 3 fatty acids in fish oil and flaxseed are potent anit-inflammatories that slow tumor growth.

Omega 3’s also help your heart and joints, so even though taking fish oil does not sounds very appetizing, they have caplets or flavored oil that goes down easily.

No matter what kind of treatment you choose, make sure that everything you take works well together and check with your doctor, or find one that has an open mind about both natural remedies and prescription drugs!

QUESTION: Ms. Blake, last year my husband, who was on SS disability turned 65.  During the enrollment period for a supplelment where he could NOT be turned down because of medical reasons, a Medicare Advantage rep talked us into going with (a certain MAPD).  It was all so confusing to us and what he said SOUNDED GOOD, but now that my husband is past that enrollment period, we know the truth and he would not be able to pass a medical exam for a Medigap/Medicare Supplement.  Is there any hope for us? Also, he is in the “dreaded donut hole”.

ANSWER: I am happy to tell you that because you were misled and you are within the 12 months of joining an MAPD, you can change back to a Medicare Supplement with no health questions and a stand alone Part D plan. You need to call Medicare directly and tell them about your situation and that you were confused about the benefits provided by the MAPD and the way the salesperson explained it to you was not clear.  They can enroll you back into the ORIGINAL MEDICARE SYSTEM. When that is done you can call us here at My Part D USA or someone else you can trust locally that will help you and KNOW HOW to deal with this process.  Also, if your income is low enough you can go to your local SS office and tell them you want to apply for MEDICARE PART D LIMITED INCOME SUBSIDY.  SS will send you a letter telling you if you qualified or not.  If you did, you MUST send a copy of that letter to your Part D plan provider, so they will know not to bill you for a premium, that you will have NO DONUT HOLE and all your drugs will be between 4 to 8 dollars for a 30 day supply.  If you cannot qualify for this, please contact the actual manufacturer of your husbands most expensive drugs, many times their income levels are higher to qualify for help and you can get discounts that way.  You can also shop around, not using your drug plan during the donut hole! There are also FREE DISCOUNT CARDS, you can download, as I have talked about on the blog before, just look in the category section.  Remember to read my other blogs about ways to MAXIMZE your drug plan beginning next January to NEVER buy your generics using your drug plan so you can save your c0-pays for the more expensive brand name drugs.  This will also keep you OUT of the donut hole longer each year.

THOUGHT FOR THE DAY:  If you laugh a lot, when you get older your wrinkles will be in the right places!

I get asked many times everyday how we can give you a free drug plan comparison.  The Centers for Medicare sends us all the new drug plans and prices for every state each year.  Using a list of your medications that you supply for us, we do a comparison for you to find the drug plan that will cover EVERY drug you take at the lowest co-pays and premiums.  WE DO NOT GET PAID FOR DOING THIS AND YOUR ENROLLMENT GOES DIRECTLY TO MEDICARE.  We are not selling drug plans or giving you biased advice.  We simply tell you the best plan for each individual based on your medications!

1. One Way to Maximize your drug savings is to ask your Doctor to give you higher dosages on your pills. Let’s say you take 50 mgs. of Tramadol twice a day, ask your Doctor to give you 100 mg. pills that you can break in half.  You will get twice the medicine and the price remains basically the same.  CAUTION: Please be careful when cutting your pills in half to make sure you continue to get the correct dosage.  Ask your doctor for instructions.

2. Always try to take generics over brands.  HOT TIP: At least once a year go over all your prescriptions with your Doctor to make sure a generic has not been released on the medication you are taking.  This could save you hundreds of dollars.

3. IT IS NOT ILLEGAL TO BUY YOUR GENERICS OFF YOUR DRUG PLAN.  YOU WILL NOT FALL INTO THE “DONUT HOLE” AS QUICKLY IF YOU FOLLOW THIS ADVICE. Wal-Mart and some other large retailers and chain pharmacies are selling generics now for only $4.  You can buy your generics from them WITHOUT USING YOUR DRUG PLAN. This will keep you OUT of the “dreaded donut hole” longer each year.  Every prescription you purchase using your drug card add up to reaching the “dreaded donut hole” and this savings tip will leave  more in the pot to pay for your expensive meds.  Click on “drug savings tips” & “donut hole help” on the left hand side of this blog under categories.  Your pharmacy may a tell you it is illegal to NOT file a claim.  The reason they say this is because they get a higher reimbursement when you use your drug plan. Tell them YOU KNOW YOUR RIGHTS! You can learn the process to make sure the pharmacy does NOT file an unwanted claim on your drug plan insurance.

4. MEDICARE REFORM: DO YOU AGREE WITH OUR TOP 10 LIST OF THINGS WRONG WITH MEDICARE? COULD YOU COME UP WITH YOUR OWN LIST?  I’LL BET YOU COULD!  PLEASE READ OUR NEW WEBSITE AND SEND IT TO YOUR GOVERNMENT OFFICIALS!  CHANGES NEED TO BE MADE TO OUR MEDICARE SYSTEM.  GO TO:  www.Top10ThingsWrongWithMedicare.com or scroll down to that blog now.

5. When your doctor prescribes a new medication tell him you need to use SAMPLES first, or have him write a prescription for just a few days use.  You would not believe how many people get meds that they can’t take because they don’t like the side effects or it just doesn’t work for them.  When you find out if you are going to actually use a medication, THEN purchase it using your drug card. This savings using this tip alone could keep you OUT of the “dreaded donut hole” months longer, decreasing your costs.

7. In addition to asking your Doctor for free samples; tell your doctor then and there that you need to take the older tried and true medications instead of the new designer drugs that are so expensive!  We all love Sally Field, but I doubt you want to help the drug companies pay for her high salary endorsement contract.  HA!  Who pays for all the expensive advertising we all see every night on TV?  YOU, the consumer!  Tell your doctor you want to try the least expensive drugs first and see if they work for you!

6. Consider the mail order option on your drug plan. This would be good to use on your Tier 2 & Tier 3 meds. NOT GENERICS! On some plans you can order a 90 day supply of your meds for a considerable discount.  Call the customer help line for the plan you joined and ask them how to use the mail order option.

7. If you fall into the “donut hole” and KNOW that you will never reach the other side to 95% catastrophic coverage, you can order or shop for your drugs anywhere without using your drug card.  You must still continue to pay your premiums so that you will not incur the 1% per month penalty for not having a drug plan, but there is NO NEED to pay more for your meds than you absolutely must! You will need to do a little research at this point at several pharmacies. Ask them the price of your drugs using your drug card and what they cost without using it.  Some drug plans inflate prices during the “dreaded donut hole” to make up for loses incurred while you were paying the much lower co-pays.  You can also search online to order your medications! Remember you cannot be loyal to your drug plan because your drug plan is not loyal to you!

8.  If you have problems of any kind with your drug plan during the year and need help to get results, contact the Medicare Rights Center.  They have free lawyers and counselors there to assist you. www.MedicareRights.org

9. Begin every year by READING THE BLOG! As I learn more savings tips during the year I post them on the blog.  I also answer questions that are sent in about Medicare coverage and benefits.  My Part D USA’s #1 goal is to keep you informed about all aspects of Medicare issues.  It may be hard to believe in today’s dog eat dog marketplace, but we are here to HELP THE PEOPLE, not insurance companies!

10.  We always recommend that those of you who can afford the premiums on a Traditional Medicare Supplement stay on them instead of switching or choosing a Medicare Advantage Plan.  You may be approached by a salesperson telling you that MAPD plans are better than original Medicare, but they do not compare against original Medicare combined with a Medicare Supplement and a stand alone Part D drug plan.  The reason for this is the commissions paid on MAPD’s are at least double than if they recommended a Medicare Supplement.  There are some folks that need a MAPD because of being on disability or have health issues and cannot get enrolled on anything else.  Please read my blogs on the differences between MAPD’s and Medicare Supplements!  Educate yourself before you enroll on health care plans.

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

• download battlefield earth a saga of the year 3000 movie

, 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.

QUESTION:

  I have been reading your blog and thought I would begin buying my generics off my Part D plan as you suggested, however, when I went to the pharmacy they said they could not do this because it was illegal.  Is this true, and how do I find a pharmacy that will not bill my Part D plan?

ANSWER:  Thank you for that question!  I have had many people write in and ask me this, so I called the www.MedicareRights.org and asked them if this was wrong advice or if it was illegal.  They said that just like any other insurance plan you have, like your car, home, health etc… you can file your claim with the insurance plan or NOT, it is up to you, and it is NOT illegal.  PLEASE TAKE A FEW MINUTES AND GO TO THE CATAGORY SECTION ON THE LEFT SIDE OF THIS BLOG AND CLICK ON “DRUG SAVINGS TIPS” AND “DONUT HOLE HELP”.  YOU WILL SEE ALL THE BLOGS ON THESE SUBJECTS SO YOU DO NOT MISS ANYTHING!!!

I have found that the Part D Plans do not like me to give out this information, as they want everyone to FALL INTO THE “DREADED DONUT HOLE” as soon as possible.  There are some pharmacies that don’t want to let you NOT file your claim on the Part D plan, because they don’t make as much money on the prescription.  However, don’t let anyone discourage you from doing this , you will just have to find a pharmacy that will take your instructions either in your town or online.  I have also had people write in telling me that they told the pharmacy NOT to file it with their Part D, and they did it anyway. 

SO, HOW CAN YOU TELL IF THE PHARMACY HAS FILED YOUR GENERIC PURCHASE WITH YOUR PART D PLAN???  I called my local Wal-Mart pharmacy and the pharmacist told me that there is a code in the upper right corner or your ticket that comes with your bag that holds the pill bottles.  If it has an abrieviated name of your drug plan, it has been billed to your plan.  If it says cash, or it is left blank you will know they didn’t file the claim as you requested.

Probably the best way to avoid confusion is to buy your “cash” purchases at one pharmacy and get your Part D prescriptions filled at another one.  This takes a little leg work, but it will be worth it.  Even though you are paying the lower co-pay amounts, your drug plan is dinging your account for $20, $30, even $40 or more for the generic, getting you closer and closer to the “dreaded donut hole”.  Also, you could order them at an online pharmacy.  Do not give them your Part D card and don’t even mention it, as it is not necessary they have this information if you are not billing your Part D plan.  If they ask you, tell them you are paying cash and not using a Part D plan.  Then make sure, by looking at your ticket, that they actually did NOT file a claim.

It is so not fair that the Part D plans can change the drugs they cover in the middle of the year or stop paying for a drug you need, when you can’t change drug plans in the middle of the year.  The drug plans were not written for the benefit of the Medicare beneficiary, but for the benefit of the insurance company.  So, you must try to make these plans work for you as best you can until we get some changes made.  Please take a few minutes and contact www.MedicareRights.org

and ask them who you can contact to help get these changes through to our next White House administration and your local officials.  Nothing will ever be done to get better benefits unless PEOPLE GET SOME ATTENTION AND ARE HEARD!!!!  we are marshall dvd download

For now, folks, this is all we have to get any kind of help to pay for our drugs.  I am just trying to help you get the most out of your plans through the year.  Remember, once you reach the “dreaded donut hole” you should not continue to buy your drugs using your Part D card.  You must shop around at that point to save the most money on your medications, because sometimes the insurance company inflates the prices to make up for the loses they incurred while you were paying the lower co-pay amounts. 

I hope that you will continue to write me with your comments and suggestions and stories of what is happening to you.  It helps everyone else to hear of your experiences.