Medicare Part D (Continued)
Is Medicare Part D For You?
Deciding whether or not to apply for the Part D program is a decision worth making. There are factors to consider that can help you decide what is right for you. First, assess your current situation and needs and try to anticipate what you may need in the future. And then consider the following:
- How do the plans compare? You may keep your company plan and Medicare Part D if the company drug plan is inferior to the new prescription coverage. But if your company plan and the Medicare drug coverage are the same, you will have to pick the one you want.
- What kinds of drugs do you use? Different companies will offer different drugs. Look for the companies that offer all or most of the drugs you use.
- What are your costs? The private companies will be able to assess different co-payments and if you have Medicare Part B, you will still pay a monthly Part B premium, so overall cost is a factor you may want to take into account.
- Which pharmacy do you use? Drug plans must contract with local pharmacies. If you already have a favorite drug store, you may want to be sure that store is included in any plan you are considering.
Beyond Part D
For those who may still need help beyond this program, there is federal assistance available. The Social Security Administration has online and paper applications where people can apply for low-income subsidy assistance for help with Medicare prescription drug costs. 85% - 100% of prescriptions may be paid if you qualify for extra help. Again, there are people who automatically qualify and will receive assistance. Those who have Medicaid and Medicare together and those who receive SSI are automatically enrolled and do not have to contact the Social Security Administration.
In determining who receives this federal subsidy and how much, Medicare recipients are broken down into groups. At the highest level, singles who earn less than $14,355 in income and have less than $11,500 in assets qualify for extra help. Married couples earning less than $19,245 in income and who have less than $23,000 in assets also qualify for extra help. Assets do not include your primary residence, your vehicles, or your personal possessions. However, they do include:
- Real estate other than your primary residence
- Bank accounts, including checking, savings and CDs
- Stocks and bonds, including US Savings Bonds
- Mutual Funds
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As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...