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ZANTOO 76
3389 posts
12/28/2006 3:40 am

Last Read:
1/2/2007 8:30 am

MEDICARE PRESCRIPTION drug PLANS


Most Seniors who are senior enough to have Medicare are probably already signed up for a prescription drug plan; I didn't do so until today and felt pressured to do so as December 31st is the last day one can sign up.

Last year Congress had enacted Part D of medicare which for the first time ever included assistance with medically prescribed drugs and as usual whatever devised by Congress can be complex and confusing.

The first open enrollment was from January to March 2006. I was in Arizona at the time and did research a few "Plans", however, found out a person was required to sign up for a plan available in there "Region" residential area.

Since my home base is Oregon and I don't take any prescription drugs I chose to wait for the second enrollment period which was November 15th thru December 31st.

I still (luckily) don't take any prescription drugs, however my situation is such, if one doesn't sign up for a prescription drug program they are penalized 1% per month from the time they were eligible, so for me that means at this time I will pay the normal monthly premium plus approx. 9% penalty for signing up in December vs last Jan-March when I first became eligible.

After December 31st 2006 the next time I have to enroll is November 2007 which would cost me another 1% per month penalty to delay until that time so my decision was to sign now..

So for the past week I have been reviewing regional Oregon)Medicare Prescription drug Plans, briefly Oregon has 107 Medicare Plans and 61 have prescription drug plans and all are different?

Important concepts are...

Medicare parts A-B-C-D; HMO's, PPO's, Medigap's, Medicare Advantage Plans vs Original Medicare or Stand Alone Prescription drug Plans.

Other important terms to consider are benefit period, coinsurance, co payment, coverage determination, creditable prescription drug coverage, deductible, exception, formulary (list of covered drugs).

I chose a middle of the road type program, not the least expensive nor the most expensive.

I have noted over the past decade it's important to have a "good" doctor and if hospitalized a "good" hospital, however, it's often your insurance program who decides what level of care you receive (sad and sometimes tragic).

I've read over the formulary of several different programs, however without knowing what medications I may be needing in the future I hope I have made a "good" choice....

Be Well....

msturtlebug 74
6231 posts

12/28/2006 5:27 am

I hope you never have to use any maintaince prescriptions, but if you do, then you will find the plans are a big help.

The longest journeys begin with just one footstep


ZANTOO replies on 12/28/2006 7:09 pm:
I think if we live long enough we will be on meds of some type and good to hear you think the plans benifical...

bernie2006 65
850 posts

12/28/2006 6:18 am

hope it covers viagria?Just joking.Happy New Year


ZANTOO replies on 12/28/2006 7:24 pm:
Most programs only approve Viagra as preventive factor after a patient is hospitalized, it supposedly keeps a guy from rolling out of bed...

Roxy1946 68
16752 posts

12/28/2006 7:44 am

Interesting blog....I too had trouble deciding and chose middle of the road plan....Mary Ann


ZANTOO replies on 12/28/2006 7:29 pm:
Roxy
I'm hoping we made a good choice, I've heard both good and bad about several of the plans.

AneMac 61
17651 posts

12/28/2006 8:42 am

Oh Zantoo! The most important thing you said here is you don't take any regular prescriptions. You must have led a charmed life so far, neighbor of mine!

Isn't it ridiculous that it takes a million words to say 10 things?

Happy New Year, Zantoo!

Love is a picture postcard life.


ZANTOO replies on 12/28/2006 7:35 pm:
AneMac
Yes I feel good that I'm not taking any meds
Hope your foot is healing..

ConeyIsBabe 76
2383 posts

12/28/2006 8:43 am

Since I don't take any drugs, I've made the decision NOT to sign-up and am counting on my healthy lifestyle to maintain optimal wellness (I hope). What company did you choose?


ZANTOO replies on 12/28/2006 7:41 pm:
Coney
That's the major reason I didn't chose a plan last year, however got to totaling up what the penalty will be if I have to wait until next year..

I chose a AAARPMedicareRX plan, they offered 3 plans and if you are interested in checking them out you can do so on the internet.

Chuckasarus 77

12/28/2006 9:23 am

Since I DID (and do) need to take drugs when the program started I signed up right away at the level just above the minimum. I have completed my first year in the program and ended up in the "donut hole" in Nov. Just signed up again at the highest level because of the availability of reduced cost generic drugs even while in the donut hole. Has anyone noticed how the prices just keep going up on the drugs regardless of whether they are generic or brand names? I had to change plans once I started taking clopidogrel which is the generic form of Plavix. I couldn't believe it - Plavix costs about $125. for a thirty day supply and the clopidogrel costs $115.!!! BIG savings, huh? (Although MY cost for the drug will go down at the first of the year a person could end up paying through the nose if they didn't need drugs when the program started and maybe not for a few years after but THEN got hit with the need for drugs like plavix because you could end up paying a tremendous penalty and then having to buy a drug(s) that put you into the donut hole early and THAT could frost you really really quick, not to mention deplete your bank account at warp speed!!! Don't read this as a gripe post, just as a warning if you are not in the program but eligible. I'd be paying lots more without the program.
Stay healthy Zantoo!!


ZANTOO replies on 12/28/2006 7:45 pm:
Chuck
Thanks for the info and the heads up;
I was thinking same as you if I was to get sick and need prescription meds between now and November it could knock a big hole in my sock or monthly income..

Thanks

Chuckasarus 77

12/28/2006 9:26 am

Hi Rodale!! Good to see you, haven't seen or (or heard from you) in awhile!!


Destiny823 78
13464 posts

12/28/2006 9:32 am

I have no clue only that I have paid $353 monthly for supplemental BC/BS that includes meds for me (group plan from hubby's work place). Now I learned it is going to $393 a month. However, I don't need the Medicare drug plan so I've let it all just sit where it is at........ I have Medicare A&B......expensive also! Social Security gives us a raise, takes some back for Medicare and the extra money I had, my supplemental now has claimed....

"Every man's wisdom is peculiar to his own individuality."
William Blake


ZANTOO replies on 12/28/2006 7:53 pm:
I hear you, I took out a supplemental 3 years ago at $96 dollars a month and by this year it's went up to ------------and no benefit for meds, it's just a back-up for medicare..that's why I'm signing up for the RX plan..

GreatSmile4U 71
10675 posts

12/28/2006 10:00 am

Like Destiny, I don't have a clue except I pay quite a bit through Teacher Retirement.... going to check on it before the 31st though. thanks for the reminder, Russ.

Live simply, love generously, care deeply,
Speak kindly, and leave the rest to God.


ZANTOO replies on 12/28/2006 7:56 pm:
Maggie
Teachers usually have great medical plans mostly due to strong union organization.

Stay Well

unduplicated 76
9303 posts

12/28/2006 11:15 am

I don't need the drug plan and am very fortunate for that. I have heard of people having to pay outrageous amounts for medications and I think it is a sin that our older generation is not provided for better!

Happy New Year Zantoo!

Life is like a mirror. Smile at it and it smiles back at you.
- Peace Pilgrim


ZANTOO replies on 12/28/2006 7:59 pm:
Hopefully this plan will help many of the frail elderly, I've known some who had to decide whether they wanted food, heat or medicine..

Happy New Year to You..

BarbieRocks 69

12/28/2006 11:44 am

When I signed up, last year....(since I do take a lot of prescription drugs and many VERY expensive)....I chose the plan that covered 100% of all prescribed drugs. Not to find myself out in the cold.

Also in comparing....I saw that the ones that required -0- deductible, gave very little help...and it also had a cap. So I studied it all for a long time, did some calculations, with the deductibles in mind and finally chose one that I paid for, but in the long run, has covered EVERY prescription I needed.

I have elected NOT to choose a secondary INS. as I didn't want to have a HMO...wanted the freedom to have my own choices in Dr's. I am also happy with this choice. Sometimes the two coverages, fight with each other and the paperwork can drive you crazy. I eliminate all that.

Now, in FL, they said if you didn't make a choice...they would make it for you. In your case, not taking prescription drugs, I would have taken the least, the one that was for free with no co-pays.

For those that are low income, they will get help, accordingly. I got help. Also, with the fact that you travel, if you have your meds "mailed" it is also cheaper and it will cover the fact that you travel.

I don't know if from state to state it is different, but I studied it, made my choices and I've been very satisfied. Only this year, they have raised what I have to pay each month for it and it looks like the raise is "more" than the annual increase that SS gives you. Woe...is "us"...

Happy New Year Zantoo!


ZANTOO replies on 12/28/2006 8:15 pm:
Sounds like you have done a good job on your research which doesn't surprise me, you're way ahead of me..The only HMO I like is Kaiser and they are not available here so I stay away from HMO's also.
I think all states may vary some in their basic plans, I tried to pick one which has pharmacies in many states for when I travel..I didn't have to pick a plan now but the 1% a month penalty until I do select one can add up to considerable on the monthly premium and I expect to live a long time..

Happy New Year To You..

sassylady47 67

12/28/2006 12:02 pm

I get great insurance with my teacher's retirement and don't qualify for Medicare - thank goodness


ZANTOO replies on 12/28/2006 8:23 pm:
Sassy
You are too young for Medicare and I'm sure your teachers insurance is better anyway..

GreatSmile4U 71
10675 posts

12/28/2006 12:25 pm

    Quoting sassylady47:
    I get great insurance with my teacher's retirement and don't qualify for Medicare - thank goodness
Like Sasssy, maybe I don't qualify either. I just checked and I only pay about $70.00 per month for great insurance. All those years in the classroom makes it worth it.

Live simply, love generously, care deeply,
Speak kindly, and leave the rest to God.


ZANTOO replies on 12/28/2006 8:32 pm:
I checked your profile and you like Sassy are far too young for Medicare and oh yes liked viewing your photo's...

To be eligible for Medicare most folks need be 65 years of age unless they have a specific diagnosis which makes them eligible at a younger age.

I'm sure your best deal is to stay with your teaches insurance even when way way down the road you become eligible for Medicare..

1Glo 53
1010 posts

12/28/2006 1:01 pm

Hi Zantoo, I am saving this post in my documents, might need this as a reference for my pharm tech program. I'm still trying to reconcile providing health care into managing care..whatever


ZANTOO replies on 12/28/2006 8:34 pm:
GLO
interesting comment, if it can be done I'm sure you can do it..

Happy New Year..

bernie2006 65
850 posts

12/28/2006 7:31 pm

i take lots of vitamins,pretty healthy but a good partner should be able to do that,i would think.


ZANTOO replies on 12/28/2006 8:37 pm:
bernie

none of the RX plans I looked at paid for vitamins.

Happy New Year

GreatSmile4U 71
10675 posts

12/28/2006 8:58 pm

ZANTOO replies on 12/28/2006 8:32 pm:
I checked your profile and you like Sassy are far too young for Medicare and oh yes liked viewing your photo's...

Off the subject of Medicare; I am glad you like viewing former teacher's photos!

Live simply, love generously, care deeply,
Speak kindly, and leave the rest to God.


earthytaurus3 74
27500 posts

12/31/2006 8:15 am

I have always been smug in announcing that I will refuse to become an elderly junkie and opt for the natural to keep myself as healthy as possible and, in nature's good time, die a natural death. Who knows?? I could be unwillingly subjected, depending upon circumstances. I do always wonder, though, how it can be that we in the U.S. are the most heavily medicated society in the world. Furthermore, it scares me that it is always years after drugs are approved by the FDA that the counter-effects become apparent, that the consequence of the drug may be worse than the 'help' it may provide. As much as humanly possible, I will abide by the old standard of "Physician, heal thyself."

Because I was pretty much coerced into selecting a plan, I went with Humana.

Zantoo .... a former teacher here, too, though I left the profession long before retirement.

Also, I appreciate your comments on my blog .... they are insightful. Please revisit as I have had further words to add ... for better or for worse.


Huglight 68
256 posts

1/1/2007 11:02 pm

I am not quite there yet but you are all truly scaring me!! How do you make sense of all the details of retirement and preparing for retirement!! There seems to be too many things to think about. I think I'll keep working for awhile longer.

Happy HEALTHY New Year!! Hugs, Tee

When what you want is more important than what you have, you'll have what you want.