My Part D USA

Everyone can complain.  That is the EASY part.  We all know that many things need to be changed about Part D plans and the advertising and selling of Medicare Advantage Plans.  If we don’t speak NOW and speak LOUDLY, the drug and insurance companies will continue to do business just as they have been doing it…and it is NOT for the benefit of the Medicare beneficiary.

PLEASE SKIP DOWN AND READ MY TOP 10 LIST OF THINGS WRONG WITH MEDICARE.

CLICK ON “SEND TO A FRIEND” AND MAKE SURE EVERYONE YOU KNOW GETS TO READ THIS IMPORTANT INFORMATION

AND THAT THEY SEND IT ON TO OTHERS.  ALSO, SEND A COPY OF THIS LIST TO ALL YOUR GOVERNMENT OFFICIALS IN YOUR STATE.  THEY ARE THE ONLY PEOPLE WHO CAN VOTE TO CHANGE THE LAWS THAT HAVE PUT THE DRUG AND INSURANCE COMPANIES IN CHARGE OF OUR HEALTH CARE.

You can also go to www. MedicareRights.org  and get involved with the reform efforts there as well. 

Every voice needs to be heard at this critical time to make real change happen for the good of every person on Medicare!!!

Let me know what you are doing….write to me at kblake@mypartdusa.org

QUESTION: I was told I could save more money on my drugs by using mail order.  How do I get the forms to get them that way?

ANSWER: Yes, many times you can save more money on your tier 2 or tier 3 drugs by using mail order.  It would depend on which drug plan you joined.  All you would need to do is contact the customer service number of your drug plan and ask them to help you get it started.  Also, ask them the prices to see how much you would save.  REMEMBER: IF YOU WILL BUY YOUR GENERICS OFF YOUR PART D DRUG PLAN AT WALMART OR OTHER LARGE RETAILERS FOR $4, YOU SHOULD DO THAT INSTEAD OF GETTING THEM BY MAIL ORDER.  THIS WILL KEEP YOU OUT OF THE “DREADED DONUT HOLE” LONGER EACH YEAR.  IF YOU WILL GET TO THE CATASTROPHIC COVERAGE OF 95%, HOWEVER, YOU JUST NEED TO APPLY ALL YOUR PURCHACES TO YOUR DRUG PLAN TO GET THERE ASAP!

QUESTION:

How will I know when I am getting close to falling into the “dreaded donut hole”?  Also, how can I see if my generics are being filed to my Part D plan or not?

ANSEWR:

You should be getting regular statements from your Part D drug plan telling you how much has been applied to your $2,700 limit before going into the donut hole.  You should also get a list of every purchase you have made for the month so you can see if the pharmacy actually DID NOT file a claim for your medications as you requested.  PLEASE READ THESE STATEMENTS CAREFULLY! Many times they can make errors and charge you for purchases you did not make and that could put you in the donut hole long before you should be, so READ, CHECK, STUDY your statements!  BE LARGE AND IN CHARGE of your own insurance claims and don’t “just assume” the drug plan will never make a mistake.  Remember the old joke:  When you ASSUME you make an ass out of u and me.

QUESTION: I am a Social Worker for a hematologist in Florida.  We have come across many issues with our patients’ that have Medicare and also have a supplemental insurance to cover the extra 20% that traditional Medicare does not cover.  It seems that in the past few months our patients’ supplemental insurance has now become their primary coverage.  They are having difficulties getting their medications paid for.  Our patients are confused about their plans as well as we are, (the nurses and myself).  I was wondering if there was some sort of educational meeting we could attend to be able to better inform our patients on what questions are to be asked when looking for the right supplemental insurance?

ANSWER: That is a great question and the answer is hidden between the lines.  Your patients have joined Medicare Advantage Plans not knowing that Medicare does not pay the claims anymore, but the actual insurance company does.  If your patient is on Medicare Parts A & B, Medicare would always be primary to pay the 80% of claims.  The Medigap/Medicare Supplement would pay the other 20%.  They would then get a stand alone drug plan to cover medications.

When your patient joins a Medicare Advantage Plan, they no longer have the same coverage or send claims to Medicare.  They would have a plan that also includes a drug plan from the same company.  Many times these drug plans are inferior, as I have said before.  Many doctors and hospitals do not accept this form of payment and will not take these insurance plans.  We can help get your patients back on Traditional Medicare combined with a Medigap plan and a stand alone drug plan that will cover all medications, just call our toll free number to speak with a Consultant that can also educate you on the differences between plans and taking away any confusion you may have.  Just read our TESTIMONIES on the right hand side to see how we have helped educate many, many people all over the USA.  Also, please read all my catagories on the left hand side where I go into much detail regarding many issues you need to know about.  I would also recommend that you go to Medicare.gov and read the many pages of info they have online as well.

Please be aware that we can help your patients apply for “extra help” programs to pay for their needed medications if they cannot afford them.  There are plans available that many folks still do not know about.  Just let me know how I can help!

THANK YOU FOR WRITING IN WITH ALL YOUR QUESTIONS!!!  I hope I helped you better understand these issues.

THOUGHT FOR THE DAY:

PEOPLE WILL BE HAPPIER FOR YOUR SUCCESS IF YOU LET IT BE THEIR OWN DISCOVERY!

THIS TIME OF YEAR MANY OF YOU HAVE DISCOVERED DIFFICULTIES ASSOCIATED WITH YOUR PART D PLANS.  YOU MAY BE FINDING OUT THAT YOUR DOCTOR OR HOSPITAL DOES NOT ACCEPT THE TERMS OF PAYMENT FROM YOUR MEDICARE ADVANTAGE PLAN.  MAYBE YOUR DRUG PLAN IS NOT COVERING A DRUG FOR YOU THAN IS NEEDED AND YOU CANNOT TAKE A SUBSTITUTE.  IF YOU HAVE GONE THROUGH THE USUAL CHANNELS, SUCH AS CALLING YOUR PART D DRUG PLAN TO GET INSTRUCTIONS OR HAVING YOUR DOCTOR FILL OUT THE PROPER FORMS FOR AN APPEAL, CONTACTING MEDICARE TO ISSUE A FORMAL COMPLAINT, BUT STILL NOTHING IS BEING DONE TO HELP YOU, GO TO THE MEDICARE RIGHTS CENTER. 

WWW.MEDICARERIGHTS.ORG   – 800-333-4114

THEY CAN GET THE BALL ROLLING IN YOUR DIRECTION AND HELP YOU GET THE PROBLEM SOLVED.  MANY TIMES PEOPLE USE THEIR FREE LAWYERS TO CONTACT THE DRUG PLANS OR MEDICARE ON YOUR BEHALF.

PLEASE CONTACT ME IF YOU HAVE ANY QUESTIONS OR IF YOU WANT TO SHARE YOUR EXPERIENCES WITH OTHERS. 

THOUGHT FOR THE DAY:   GET IN THE DRIVER’S SEAT – DON’T BE A PASSENGER IN YOUR OWN LIFE!

KARYN

WELL, I FINALLY GOT MY 15 MINUTES OF FAME, AS THEY CALL IT, OR RATHER 20 SECONDS.  WE WERE ON CNN AND HEADLINE NEWS 3 TIMES OVER LAST WEEKEND .  IT WAS EXCITING AS WE HAVE NEVER MADE NATIONAL NEWS BEFORE.

THE PIECE WAS ABOUT THE PRESIDENT OF THE LARGEST GROUP OF GENERAL MOTORS RETIREES, JACK DICKINSON, AND HOW HE IS HELPING THE OTHER RETIREES GET GOOD INFORMATION ABOUT THEIR TRANSITION TO MEDICARE.  HE ASKED ME TO WRITE A BLOG ABOUT MEDICARE ON HIS WEBSITE, WWW.OVERTHEHILLCARPEOPLE.COM.  IF YOU HAVE TIME, CHECK OUT THIS WEBSITE FOR SOME INSIDE SCOOP ABOUT THE AUTOMOBILE INDUSTRY.

AS YOU ALL KNOW, MANY OF THE FORTUNE 500 COMPANIES ARE CANCELING THEIR RETIREES’ DRUG AND HEALTHCARE COVERAGE.  WE ARE HAVING MANY OF THESE RETIREES COMING TO THE WEBSITE AND CALLING US TO GET HELP.

IF YOU DID NOT GET TO SEE US ON CNN, WE HAVE PUT UP A VERY SHORT FEED OF THE BROADCAST ON WWW.MYPARTDUSA.COM YOU CAN CLICK ON THIS AND SEE THE STORY ABOUT GENERAL MOTORS AND HOW WE ARE HELPING THEM GET TRANSITIONED OVER TO MEDICARE BENEFITS.

IF YOU KNOW SOMEONE THAT IS DEALING WITH THIS KIND OF SITUATION, TELL THEM ABOUT THIS BLOG.  EVERYONE KNOWS THAT MEDICARE IS MORE CONFUSING AND OVERWHELMING THAN ANY OTHER TIME IN HISTORY, AND IF YOU DON’T MAKE GOOD DECISIONS ABOUT YOUR COVERAGE WHEN YOU FIRST JOIN MEDICARE, YOU MAY NOT BE ABLE TO “UNDO” THE DAMAGE.

IT IS AMAZING TO ME THAT PEOPLE GET SUCH “BAD INFO” FROM SOME SALESPERSONS.  JUST LAST WEEK ONE OF OUR READERS GOT HOODWINKED BY A SALESPERSON INTO JOINING A MEDICARE ADVANTAGE PLAN

.  THE SALESMAN TOLD THEM THAT THEY WERE GOING TO SAVE $600 A YEAR IN PREMIUMS.  COME TO FIND OUT, THIS 86 YEAR OLD MAN WITH HEART PROBLEMS WENT TO HIS DOCTOR AND HOSPITAL AND FOUND OUT THEY WOULD NOT ACCEPT THE TERMS OF PAYMENT FROM THIS MEDICARE ADVANTAGE PLAN, AND ALSO THAT THE BUILT IN PDP OR PRESCRIPTION DRUG PLAN DID NOT COVER ALL OF HIS MEDICATIONS.  HE CALLED US AND WE HELPED HIM GET BACK ON HIS TRADITIONAL MEDICARE SUPPLEMENT AND STAND ALONE DRUG PLAN

THAT DID INDEED COVER ALL HIS MEDICATIONS.  FOLKS, PLEASE BEWARE AND READ MY OTHER BLOGS ABOUT MEDICARE ADVANTAGE PLANS BEFORE YOU JOIN ONE, NO MATTER HOW GOOD THE SALESMAN MAKES IT SOUND!!!

AS I HAVE TOLD YOU BEFORE, IF YOU ARE JUST GETTING ONTO MEDICARE, YOU NEED TO GET A TRADITIONAL MEDICARE SUPPLEMENT TO PAY THE 20% THAT ORIGINAL MEDICARE DOES NOT COVER IN THEIR 80%.  IF YOU JOIN A MEDICARE ADVANTAGE PLAN FIRST, YOU MAY NOT BE ABLE TO EVER GET A MEDIGAP PLAN BECAUSE YOU WILL THEN HAVE TO GO THROUGH HEALTH QUESTIONS AND UNDERWRITING. IF YOU JOIN A MEDIGAP/MEDICARE SUPPLEMENT FIRST, AND THEN DECIDE TO “TRY” A MEDICARE ADVANTAGE PLAN, YOU HAVE A 12 MONTH PERIOD WHERE IF YOU DECIDE YOU REALLY DON’T LIKE THE ADVANTAGE PLAN YOU WILL NOT HAVE TO GO THROUGH UNDERWRITING TO GET BACK ON THE BEST COVERAGE, WHICH IS THE MEDIGAP PLAN. THE MEDICARE ADVANTAGE PLAN WILL NOT TELL YOU THIS!!!!!

THEN YOU NEED TO GET A STAND ALONE PART D PLAN.  PLEASE READ MY OTHER BLOGS ABOUT HOW TO MAXIMIZE YOUR PART D PLANS, AND HOW TO CHOOSE THE BEST ONE.  YOU MUST GET A COMPARISON BASED ON YOUR INDIVIDUAL MEDICATIONS.

LET ME KNOW IF THESE BLOGS HELP YOU!  IF ANY OF YOU HAVE ANY IDEAS OR SUGGESTIONS, OR A PERSONAL EXPERIENCE YOU WOULD LIKE TO SHARE TO HELP OTHERS, PLEASE WRITE TO ME AND I WILL PUT IT UP ON THIS BLOG.

I HOPE YOU GOT A CHANCE TO WATCH US ON OPEN HOUSE THIS MORNING.  WE WILL ALSO BE ON SATURDAY AND SUNDAY, DEC. 6 & 7 AT 3:30 IN THE AFTERNOON ON HEADLINE NEWS.

WE WANT TO THANK MR. JACK DICKINSON OF WWW.OVERTHEHILLCARPEOPLE.COM

FOR GIVING US THE OPPORTUNITY TO BE A RESOURCE FOR MEDICARE.

WE HAVE BEEN WORKING WITH MANY RETIREES, NOT JUST THOSE FROM GENERAL MOTORS, BUT EASTMAN-KODAK, CONOCO-PHILLIPS, VAUGHT AIRCRAFT iNDURSTRIES, WHIRLPOOL-MAYTAG, ALCATEL-LYCENT, AND AMERICAN AIRLINES, AMOUNG OTHERS.

WE HAVE PRESENTED WORKSHOPS TO RETIREES TO HELP THEM TRANSITION FROM GROUP COVERAGE INTO THE MEDICARE SYSTEM.

IF YOU KNOW SOMEONE OR HAVE FAMILY THAT ARE RETIRING AND NEED HELP WITH THIS TRANSISTION, LET THEM KNOW ABOUT US.  WE THANK YOU FOR READING THE BLOG AND STAY TUNED……

GREETINGS TO ALL GM RETIREES!!

If you have never gone to www.Overthehillcarpeople.com

please visit the website.  They have all kinds of GM articles that I’m sure you would like to know about.  They also have Medicare information that could help you with your decisions.

www.OverTheHillCarPeople.com click here to visit

Mr. Jack Dickinson is the President and I’m sure he would be happy for you to become a member!!

Membership information is on the website or you can email him, as his email address is there for you as well.

I also have a disscussion board on the site by clicking on Bulletin Board

on the left hand side.  We would welcome you to join us for a Medicare benefits resource.

Thank you so much Over The Hill Car People

for giving us the opportunity to be a resource for your Medicare questions and concerns!!!  We are very honored to be a FREE service to you!

Last Wednesday, we had the priviledge of visiting an American Airlines group of retirees in Tulsa, OK.  We had a very good meeting talking about Medicare Part D and what they could expect from this benefit.

There are so many Fortune 500 companies that are losing their healthcare retirement benefits across the USA.  This is very unfortunate, although we try to be as helpful as possible. 

A special thanks goes out to Mr. Earl Tillery for organizing the meeting and picking us up from the airport.  If any of you that attending this meeting have any questions for us, please email me.  I will get back to you as soon as possible.

We are hearing from so many people everyday from Fortune 500 companies that are losing their retirement healthcare benefits.  It is such a shame that after you have worked all your life for a company and deserve what you EARNED, they take it away.  Especially when they continue to have record profits and the CEO’s are making inflated salaries that seem ridiculous to most of us!

We have heard from folks at:

 General Motors, Conoco-Phillips, Kodak, Alcate/Lucent, Whirlpool and American Airlines

We understand that you have never had to navigate the Medicare system and how confusing all of this is for you.  Many times the companies have contracted with Agencies to come in and enroll thier retirees on healthplans and drug plans.  Please be aware that YOU WILL NOT HAVE ANY SPECIAL OPTIONS NOW THAT YOU ARE IN THE MEDICARE SYSTEM.  No matter what agency you use to enroll, they do not have anything special or different to offer you than anyone else has. 

The only difference is, WILL THEY GIVE YOU INSIDE INFORMATION ABOUT WHAT COMPANIES HAVE BETTER SERVICE?  WILL THEY DO A COMPARISON BASED ON YOUR MEDICATIONS OF ALL THE DRUG PLANS AVAILABLE TO YOU IN YOUR STATE?  DO THEY JUST HAVE ONE PLAN TO OFFER BECAUSE THAT IS ALL THEY SELL?  WILL THEY BE ABLE TO EXPLAIN ALL YOUR OPTIONS AND GIVE YOU OBJECTIVE ADVICE ABOUT ALL OF THEM, NOT BASED ON WHAT WILL MAKE THEM THE MOST MONEY IN COMMISSIONS?

If someone tells you they know what drug plan you should join before Nov. 15th, and they do not take a list of your drugs, you are getting incorrect information.  The Centers for Medicare supplies us with the 2009 drug plan info with all the co-pays and premiums about a week or so before the 15th.  That way when you give us a list of your meds, we check against every plan (there are over 50 plans in each state) to find the one that covers your meds at the lowest prices.  Every drug plan does not cover every medication, so we check to make sure your drugs will be covered as well. 

Most of the agencies we have talked to are recommending these retirees who have been accustomed to very good benefit packages, go with a Medicare Advantage Plan with a built in PDP or Drug Plan.  This is very bad advice!  There are many hoops to jump through as I have said before.  Please read my other blogs on Medicare Advantage Plans.  The most important thing to know is if you join an MAPD FIRST, you may lose your right to a choice if you are not happy with it.  I have detailed this in a blog further down the page, so please read about this!!!!

The most horrible thing is Medicare does not have vision or dental coverage.  I’m sure those of you who have retired from these companies have had great coverage for this.  PLEASE GET ANY EYE EXAMS AND DENTAL WORK YOU NEED DONE NOW, BEFORE YOU LOSE YOUR BENEFITS JANUARY 1, 2009, OR BY THE TIME YOU LOSE YOUR COVERAGE!  Even if some salesperson offers you dental or vision insurance, please know that it is probably NOT WORTH THE PREMIUMS YOU WILL PAY!   These individual dental and vision plans do not give you much coverage and we don’t recommend them at all.

I have also written blogs about Medicare Supplements, please read these so you will understand exactly what you need.  You just need 2 things:

I hope this has answered some of the many questions I recieve everyday from those of you in this terrible situation.  I am honored that you take the time to write in to me.