July 6th, 2010 at 2:11 am
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Signing On To Medicare Part 4: Medicare Part D and Helping Prevent Medicare Fraud

by Carol Bursack

For this final part of this series on my personal experiences in signing up for Medicare, I’ll discuss Medicare Part D, which is prescription drug coverage. Medicare Part D is much in the news these days because of a $250 rebate for people who already have the coverage and have reached the dreaded coverage gap, known as the donut hole.

Part 1 of this Medicare series addressed getting signed up for the basic Medicare Part A. Part 2 was signing up for Medicare Part B, which carries a premium. The third post is about the supplemental insurance, sometimes called “Medigap,” wanted by many to beef up coverage that Medicare Parts A and B don’t give us. So, now on with Part D, prescription drug coverage.

Prescription Drug Coverage Through Medicare Part D

When my parents had Medicare, prescription drug coverage worked just as any other insurance policy–it was part of the supplemental plan they carried. However, since 2006, when Medicare Part D went into effect, there have been many changes. Some private insurances do offer prescription drug coverage to Medicare recipients, but those are beyond the scope of this post and can be addressed by asking a trusted insurance agent, preferably one who sells insurance for many companies. You’ll get a less biased look if you chose a general agent.

For those of us who choose regular Medicare Part A coverage, plus Medicare Part B and also supplemental policies to help cover our co-pays left over from the other insurances, deciding whether to also enroll in Medicare Part D, for prescription drug coverage, is yet another consideration.

Personally, I take few medications, and I’d likely come out better financially if I skipped this coverage. For most people, this coverage will cost less than $50 a month, however, and because I never know whether I will need a round of an expensive antibiotics or some other unexpected medication, I have chosen to enroll.

When we enroll in Medicare Part D, we have to re-enroll every year during open enrollment, which is subject to change, but generally has been from November 15th to January 31st. Please check this time frame yearly to watch for changes. Also, you can enroll during a 90-day period when you first become eligible for Medicare. Again, go to the open enrollment site for more information.

Each year, during this time, we need to look at the policies offered and compare them to make sure the policy we chose last year still covers our medications, as nearly all of them add and drop medications from year to year. If we’ve added a medication, a different plan may better fit our needs.

The simplest method for computer users is to go to the Medicare site and follow the directions to compare policies and prices through their prescription drug plan (PDP) finder. Look for ratings as to how well each company pays. To me, action speaks louder than words when it comes to insurance. You can also call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

Senior Medicare Patrol (SMP) Fraud Fighters

Medicare fraud by companies, including hospitals and other providers, is costing the program millions of dollars that should go to senior care. Learn how to read your Medicare statements or get someone to help you. If you see something suspicious, check it out and report it to your state insurance office or to Medicare, by phone, or through www.Medicare.gov, so this can be investigated.

If you are an activist at heart, check out SMP, formerly known as the Senior Medicare Patrol. These strong willed seniors are actively fighting Medicare fraud and have done a lot good through their sharp reporting.

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