Those of us on Medicare recently received the new Medicare and You 2011 booklet, which is filled with information on the new coverage under the health care reform act passed earlier this year, the various types of Medicare coverage (original Medicare, Medicare Advantage and Medigap), and the insurance plans offering coverage in the areas in which we live. I am sure I am not the only one who is finding the process of selecting the “right plan” to be more difficult each year. For the past six years, the main problem – at least for me – has been trying to find the least expensive plan with the best coverage for the Medicare Part D prescription plan.
Prior to the enactment of Medicare Part D in 2006, I had the Original Medicare plan. The cost of the plan is $96.40 monthly, which the Medicare recipient can elect to have deducted from their Social Security check. I paid for some of my medications myself, while I received the more expensive medications through patient assistance programs. When Medicare Part D went into effect, I continued to use the Original Medicare plan and selected the Humana Medicare Part D plan with a monthly premium of $24.30, a yearly deductible of $250.00, and quarterly payments of $54 for a three-month supply for each of my medications. These were added expenses, which put a strain on my limited income. The following year, Humana almost doubled the monthly premium. I switched to Blue Cross with a monthly premium of $26.40. In 2008, I returned to Humana because their premium was lower than the other plans offered in my area.
In 2009, after doing a lot of research online, I decided to sign up with a Medicare Advantage plan that also covered prescription drugs and had no monthly premium. There was a deductible of $1100.00 per year applied to my hospital stay but there was no deductible for medications. The cost of a three-month supply had jumped to $77 for each one. That plan, however, was not available in my area for 2010. Again, I had to do research online to find the best Medicare Advantage plan that fit my budget. The plan I selected had no monthly premium and the three-month supply for my medications jumped from $77 to $105 for each one. This plan also had a yearly deductible of $1100. However, unlike Original Medicare and my previous Medicare Advantage plan, this deductible applied to all diagnostic testing, including blood tests and X-rays.
For 2011, I am planning on returning to Original Medicare and picking a Medicare Part D plan from one of the insurers offering coverage where I live. Most of them have a $310 yearly deductible, and the premiums run from $14.80 up to $109.00 per month. Before I can select a plan, I have more research to do to find out which one offers the least expensive cost for a three-month supply for each medication. There are many sites, including Medicare.gov, that have “plan finders” that give a listing of all plans available in your zip code. You can select up to three plans to compare costs and coverage. However, you still have to do research on yearly costs, if your prescriptions are covered by the plan, whether or not you are required to use mail order pharmacies instead of local pharmacies, and when you will fall into the coverage gap or donut hole.
This process may be more difficult for those Medicare recipients who may not have computers to do the comparisons and research. I believe that there should be standards set that govern all insurers who offer Medicare plans regarding deductibles and premiums by tying yearly increases to the COLA Medicare recipients receive.