Globe Syndicate
For
release
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by Carol Abaya, M.A.
BEWARE OF MEDICARE PART D
FRAUD
lst of 2 Parts
As I talk with people across the country about the new
Medicare Part D Drug Plan, I see that there is
considerable confusion “out there.” In
this and next week’s column, I have put together some of the facts for your
guidance.
1. What is Medicare Part D? Medicare Part D covers most brand name and
generic drugs. Under the government
program, there is a monthly fee of about $38 and a $250 deductible. This means that you will have to spend about
$700 a year before the Plan starts paying benefits.
2. What happens once the deductible is reached? You will pay 25% of your drug costs between
$250 and $2,250. Medicare will pay 75%.
3. What happens after
your costs are $2,250? You pay 100%
of your medicine bills until you have spent a total of $3,600 in a year. After you have spent $3,600, you pay 5% of
the cost and Medicare pays 95% for the rest of the year. These numbers are based on calendar year
costs. NOTE: If you take a large number of medicines and
your bills are high now, realize that your yearly cost under the government’s plan
could still be $4,300.
4. Is enrollment
mandatory? No! You do not have to enroll. But if you do want to participate you need to
enroll by
5. If you have a Medigap/supplementary insurance program with drug
coverage, you can continue with that coverage. Such policies have a variable premium and
deductible. However, from day one you
may receive deep discounts on all your prescription medicines until you reach
the deductible amount. In other words,
you benefit from the beginning and do not have to wait until you meet the
Medicare D deductible of $250.
6. How do I choose a Part
D insurer? If you want to sign up
with an private insurer rather than directly with the
government program: Proceed with caution! There is a dizzying array of
drug plans being offered by companies, many of whom are newcomers to health
insurance and undercapitalized. There
are about 10 national insurers with a track record.
Advice: If you want to get Part D through a private
insurer check out the company’s stability, track record and payment
record. Do not sign up with a newly
formed company or one that services only one or a few states.
7. What about premium
cost? The federal Part D program has
a premium cost of about $38 a month. The cost will probably increase each year,
but it will be a controlled increase.
Industry experts predict that many private insurers will offer a lower
premium for 2006, but will then be forced to dramatically raise the cost in
2007. Industry experts also predict that
a number of private drug coverage companies will go out of business within a
couple of years, thus leaving those insured with major problems. This shakeout will be similar to what
happened with a number of HMOs.
More Next Week
Are you juggling doing errands for your aging parents, your children, yourself and working at the same time? Are you tired, stressed out and upset that your once vibrant parent is now frail and needy?
Do you feel alone? Rest assured you are not alone! The Sandwich Generation is dedicated to the 50 million Americans who may have elder/parent care concerns and/or responsibilities.
* * *
Do
you have a question? Send it in. Although letters cannot be answered
individually, appropriate letters will be answered in this column whenever
possible. Letters may be edited. Send letters to Ms. Carol Abaya,
mail direct to her at
Carol Abaya is an international-award-winning journalist and creator of the unique magazine The Sandwich Generation: You & Your Aging Parents.
NOTES TO EDITORS: text = 578 words; other material = 160 words
We would appreciate it if you would include the "Globe Syndicate" bug at the end of the column.