ElderCarelink Blog

Change is Certain

by Isabel Fawcett, SPHR
July 14th, 2010 at 12:38 pm

I still remember my last day in my former paid employment. It was election night 2008 – a night I will remember having nothing to do with political persuasion. As I walked away from my former office building for the last time, a stranger walked in the opposite direction headed toward me. Read more »

Taking on the role of medical advisor

by Devlyn Brooks
July 8th, 2010 at 4:25 pm

One of the tasks I underestimated the difficulty of when my mother moved in was becoming her health care guardian.
That’s not to say that I’ve taken over making decision about her health care; she’s still very capable of that. But I have taken on the role of advising her on medical decisions and helping her navigate the sometimes choppy waters of doctors, hospitals, medications and MediCare. Read more »

Signing On To Medicare Part 4: Medicare Part D and Helping Prevent Medicare Fraud

by Carol Bursack
July 6th, 2010 at 2:11 am

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.

Signing On to Medicare Part 3: Supplemental Policies

by Carol Bursack
July 2nd, 2010 at 4:40 am

If you’ve been following my personal journey of signing up for Medicare, your stomach may feel as though you’ve had too much alphabet soup, but please hang in. It does get easier once we get educated.

Part 1 of this series addressed getting signed up for the basic Medicare Part A. That was harder for me than most people, as I’m not retiring, but I got it done. Part 2 was signing up for Medicare Part B, which carries a premium. This third post is about the supplemental insurance, sometimes called “Medigap,” to beef up coverage that Medicare Parts A and B don’t give us.

We have many choices here. Medicare Supplement Plan A, Plan C and Plan F – G and H, I believe, are unfolding as I write – include different coverage for the co-pays left from Medicare Parts A and B. Your supplemental policy, depending on the one you choose, pays part or all of these co-pays. The least coverage, Plan A, comes with the lowest premium. The best coverage (presently) is Plan F, which has the highest premium.

Since the premiums aren’t huge, considering what I’ve paid in the past for health insurance, I chose Plan F. I won’t give you numbers here, as there are too many variables, but you can find out what you need on the Medicare site.

Plan F will cover most costs Medicare Parts A and B don’t cover, aside from prescription drug coverage which we’ll cover next in Part 4 of this series. (Please excuse me while shudder at adding more “parts and numbers,” but all of this was too much for one blog post).

You can choose your supplemental plan, which is not required, by going to www.Medicare.gov. There, you’ll put in your Medicare information and your Zip code. You’ll be taken to a page with your choices. These policies are similar across the nation, so I let my choice be governed by the ranking given to the company as to how well they pay. This is about trusting the company you choose, so choose carefully.

There is something called Medicare Advantage. This is a Medicare policy that has all kinds of perks, but is run by private companies with some government subsidies. Some people love their Medicare Advantage.

I have seen enough companies cut and run from my state to want to go that route. Medicare Advantage will likely take some cuts to subsidies, as this is an elite policy. The idea is to make Medicare a more even playing field for all. This could, in my opinion, lead to more companies discontinuing that coverage.

This information is just a personal observation, and I’m not a Medicare expert. I’m just going by observation, hearsay and newsletters from the insurance department of my state, where I’ve seen some companies go off the list through the last four or five years. Everyone’s needs are different, so you may want to ask an insurance agent you trust, preferably one who sells for many companies, for an honest look at Medicare Advantage. It could be right for you.

I’ll cover Medicare Part D, which is prescription drug coverage, in Part 4 of this series. I’ll also give you some tips about seniors who are watching out for Medicare fraud, which hurts the whole program and all seniors.

Signing On to Medicare: A First Hand Experience – Part 2

by Carol Bursack
June 22nd, 2010 at 1:01 am

Recently, I wrote about turning 65 and my foray into Medicare territory as a personal journey. Though I’m not retired, I did manage to get signed up for Medicare Part A – the Medicare we  can get at 65, which at least partially covers major medical costs. Read more »