Thanks to the lovely ladies of the Parent Bloggers Network, I had the opportunity to be on a conference call last week with Mike Freeman of the Healthcare Leadership Council on Medicare Part D.
Medicare Part D is the federally-funded prescription drug program for senior citizens, and something my parents complain about bitterly to me nearly every time we talk. I wanted to hear what the experts had to say about this topic, so that I could help my parents find their way through the bureaucracy and establish a plan that is right for them. I'm glad I took the time to listen in and ask questions.
The main purpose of the call what to get the word out that the period for seniors and disabled individuals to sign up for Medicare Part D (their form of "open enrollment") is November 15-December 31. Mike encouraged those of us on the call to help spread the word about this benefit, which is somewhat underutilized. He also said that healthcare plans change, so some people who might not have needed the benefit last year should look into it.
Medicare has a handy "plan formulary finder" on their website at www.medicare.gov. Seniors fill in the medications they are taking, the state they live in, and the site allows them to find plans that can best suit their needs. For seniors who don't have computer access, they can call 1-800-MEDICARE to speak to someone. They should have a list of their drugs available so that the representative has all of the information they need to find the appropriate plan for them.
The thing my parents complain about isn't Medicare Part D itself, but how it works. Medicare only pays part of the costs of drugs needed over the course of a year. After you reach a pre-set limit, coverage stops until you spend a certain amount, then it resumes. This is called the "donut hole" and this donut hole drives my mom nuts. My father ends up paying thousands of dollars during certain months of the year for medication that he only pays a small co-pay for during the coverage period. For people on a fixed income, this is a hardship.
What my parents and I didn't know what that there is coverage available for an additional premium during that period. The Plan Finder helps seniors find those plans, which Mike said were much more affordable than paying out of pocket for many of the drugs. I asked him if it would be possible for me to pay their premiums, or if that would affect their coverage, and he said that was permissible. Maybe mom and dad will be getting drugs for Christmas now.
Some other interesting notes on this call:
- Medicare Part D is not just for seniors. People with permanent disabilities also qualify.
- Pharmacies are a good resource for information on Medicare Part D and prescription drug plans.
- Many low-income people can get assistance to cover nearly all their prescription drugs through PHRMA.
- 1 in 4 seniors used to cut pills in half or skip doses prior to Medicare Part D.
- The plan is underbudget for the year, so advocates are hopeful that it can be increased in the future.
Additional information on Medicare Part D can be found at the Medicare Today website.
Cross-posted at The Silent I.
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