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www.medicarerights.org | e-newsletters ![]()
Volume 4, Issue 43: Week of October 24, 2005
Welcome to Dear Marci, a free, weekly newsletter designed to keep you in the loop about health care benefits, rights and options for older Americans and people with disabilities.
Dear Marci is a service of the Medicare Rights Center (MRC) (www.medicarerights.org), the nation's largest independent source of health care information for people with Medicare. A national nonprofit founded in 1989, MRC helps older adults and people with disabilities get good, affordable health care.
For reprint rights, please contact [EMAIL PROTECTED].
Topic of the Month: Medicare Prescription Drug Coverage
Marci's Mailbox
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Dear Marci,
If I already have prescription drug coverage through a retiree plan, do I need to sign up for a Medicare prescription drug plan? How do I know which is better?
–Diana (Quakertown, PA)
Dear Diana,If you already have prescription drug coverage through an employer or union, check with your plan or benefits administrator to learn how your plan coordinates with Medicare drug coverage.
It does not matter whether you are currently working or retired.
The company or union providing your employer or retiree drug coverage will send you a notice this fall letting you know whether your drug coverage is at least as good as Medicare’s standard drug coverage (“creditable coverage”). Be sure you have this information before deciding whether to enroll in the Medicare prescription drug benefit. Contact the company's human resources department if you do not receive notice by November 15, 2005.
If you continue to have employee or retiree prescription drug coverage, you have three choices:
1. If your employer-based drug coverage covers as much as or more than Medicare's basic drug coverage, you can keep it and not buy Medicare drug coverage. You will not have to pay a premium penalty if you later enroll in a Medicare private drug plan as long as you enroll within 63 days of losing or dropping your coverage. You may still want to compare the cost and coverage of your current plan (including premiums, copayments and list of covered drugs) with those of available Medicare prescription drug plans to see which offers you the best coverage for your money.
2. If your employer or retiree drug coverage covers less than Medicare's basic drug coverage, you can drop it and buy Medicare drug coverage. If you do not join a Medicare drug plan by May 15, 2006, you will have to pay a premium penalty if you enroll later. In addition, you will have to wait until the Annual Coordinated Enrollment Period (November 15 to December 31 of every year) to enroll.
3. If your employer or retiree coverage will work with Medicare's drug coverage, you can keep it and buy Medicare drug coverage as well. (Any drug costs that your employer or retiree coverage pays will not count toward your out-of-pocket maximum—$3,600 in 2006—before the more substantial Medicare coverage—coverage of 95 percent of cost—begins.)
Note: Be sure to find out if you can drop your current drug coverage without losing your other health benefits, such as hospital and doctor supplemental coverage. Also keep in mind that if you drop your employer-based drug coverage, you may not be able to get it back.
Stay tuned next week to learn about how different states are working with the new Medicare prescription drug benefit!–Marci
Have a question for Marci? Click here to e-mail your questions. Please include your city, county and state of residence.
Spotlight on Resources
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Launched last week, the new Medicare Prescription Drug Plan Finder is not yet ready for public consumption. The information it currently offers is spotty at best, and outright wrong in some cases. While you can enter the drugs you take to see which plans cover them, it will not yet tell you how much you will actually pay for them—the most important information consumers need to make a decision. In addition, MRC has found information on the tool that conflicts with that on the web sites of the drug plans themselves. In fact, Medicare has announced that the plans have until enrollment begins—November 15, 2005—to correct their plan information in the plan finder.
Thinking about joining a plan? Before checking out your local plan options, read the Medicare Rights Center’s “How to Compare Medicare Prescription Drug Plans .”
While researching prescription drug plans, you may want to learn more about your medications (discuss anything you find with your doctor):
* Find drug information online at the National Institutes of Health’s Medline Plus—search for both generic and brand-name drugs by clicking on the first letter of the medication name.
* Although each plan must include two drugs within each class of medication, you may not find a plan that covers all of your current medications. Explore “therapeutic equivalents” (which work in the same way for the same conditions) for nine different classes of the most frequently used drugs at AARP’s Effective and Safe Prescription Drugs.
* For more research about the prescription drug industry, visit AARP’s guide to Affordable Prescription Drugs.Call your State Health Insurance Assistance Program for more information on Medicare benefits, rights and options. Call Social Security (800-772-1213) for questions about enrolling in Medicare.
Health Tip of the Week* * * * * * * * * * * *
Before the close of October, we must recognize a health observance near and dear to Marci’s heart—National Health Literacy month! Celebrate the occasion by sharing this copy of Dear Marci with a friend and making a personal commitment to continue to learn about healthy living.
Find out your risk of developing five of the most prevalent diseases in the country and get personalized prevention tips using the Harvard Center for Cancer Prevention’s Your Disease Risk interactive tool.
For an overview of health literacy and professional resources, visit the American Medical Association web site.
Survey Says . . .
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According to an annual survey released by the Kaiser Family Foundation last month, employers offering health insurance have steadily declined over the last five years as cost continues to outpace both inflation and wage growth.
The survey found that three in five firms (60 percent) offered coverage to workers this year, a 9 percent decrease in the last five years, which the survey concludes can be almost entirely attributed to small businesses dropping health benefits. The findings show that nearly all businesses (98 percent) with 200 or more workers offer such benefits.
Premiums for these health care plans increased an average of 9.2 percent in 2005, a rate of growth more than three times the growth in workers’ earnings (2.7 percent) and two-and-a-half times the rate of inflation (3.5 percent). Since 2000, premiums have gone up 73 percent.
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