I sit behind the phone and talk to people all day about insurance. The links provided in these articles are all an excellent source of information. Before you compare one plan to another, list the details of your personal situation so you are better prepared to pick and choose from a variety of companies that implement a Medicare prescription drug plan. Here’s what I tell the confused folks who call me:
1) Find out if you need a drug plan or not. Does your current coverage help with your meds? Will they help you next year? If your current plan drops you next year, has the coverage they’ve given you been “creditable”? (As good as the Medicare plans.) By law, your current coverage lets you know if your coverage is “creditable”.
2) Make sure all your meds are in the plan’s formula. Simply put, are your medications on the list of “covered” drugs for the plan you’re looking at? Are your medications classified as expensive medications, or are they listed as “generic” with the plan you’re looking at. (Some companies use fancy names for expensive medications that they’ll only cover for a bit, and leave you stuck with the rest of the cost. Watch out for these! You won’t save money if the plan is only a few bucks a month, but you have to pay the cost of your expensive drug all on your own!)
3) Ask your doctor if generics are right for you. Insurance companies don’t make that choice for you. Your doctor is the only person who can safely determine if you should be on a generic version of a medication.
4) Will you reach a coverage gap at all during the year if you select a specific plan? If so, when? How much will you pay during the coverage gap? How long will you have a coverage gap?
5) Compare the total cost of the plan, any premiums, deductibles, cost of medications, cost before, during and after any coverage gaps – to what you’d pay without a prescription drug plan. Some people are better off not taking a drug plan even if the threat of a “penalty” hovers over their head until they sign up with a prescription drug plan.
6) Shop around!
Few situations are similar when it comes to getting the drug plan that works best for you. Establish yourself as much as you can, and you’ll find the best plan that you can tailor to your needs. Don’t be intimated by penalties and deadlines, and don’t be taken in by cheap monthly premiums. Write down your questions, and don’t be afraid to call back with more questions before you select a plan.