Picking a Medicare D Plan is Nearly Impossible; You Must Do Your Homework

GUEST COLUMNIST:  Steve Cohen, MD, Internist at WellStar Cobb Medical Group

Are you willing to spend less than an hour of your time so that you or your loved ones on Medicare can save hundreds to thousands of dollars every year? If the answer is yes, you need to read about www.medicaredrugsavings.org, a website reviewed by Clark Howard, where you can learn to lower your medical costs.

The Medicare Drug Law of 2006 was a boon to the Medicare population. Before the passage of this law the US government did not pay for prescriptions. Since that time people on Medicare (those over 65 as well as people with certain disabilities) have been able to sign up for Medicare D plans (which cover outpatient medicines) or Medicare Advantage plans (essentially HMOs or PPOs which pay for medicines in addition to the hospital, physician and other outpatient bills).

Under traditional Medicare, the government directly pays the provider for rendered medical services. In contrast, private insurance companies (Blue Cross, Aetna, and many others) sell Medicare D and Advantage plans to people on Medicare; the government subsidizes the premium for these plans.

However choosing the best Medicare D or Advantage plan can be next to impossible. In the Atlanta area you can choose from over fifty possible plans, which cover different medicines, and have different copays, premiums and deductibles. A 2012 study showed that the average person on Medicare D who is taking a specific group of medicines could save $368/year by choosing a different plan which covers the same medicines and that many people will save much more than this. This study found that only 5% of people chose the least expensive plan. The savings are probably greater for those who have a Medicare Advantage plans.

On www.medicare.gov you can enter your zip code and medicines and get a report showing the estimated annual out of pocket cost for all of the available Medicare D and Advantage plans. Unfortunately few people are aware of this tool and many older people on Medicare don’t have the computer literacy needed to take advantage of it.

In my job as a general internist in Austell, Georgia, I see many people who have trouble paying for their medicines. In late 2012, an elderly patient came in on the verge of tears. She was unable to pay for her food, mortgage and medicines, so she was going to move in with relatives and let the bank foreclose on her home.  After seeing this, I set up a free nonprofit educational website www.medicaredrugsavings.org. A video on the web site clears up confusing details about Medicare and shows you in a step by step fashion how to find the least expensive plan which covers the medicines which YOU are taking.   The Georgia chapters of the American College of Physicians and the American Academy of Family Physicians (the two main groups for primary care doctors) plan to promote www.medicaredrugsavings.org. The website will be updated to improve the graphics (I found that I’m better at treating diabetes than designing web sites) and provide updated information in the next two weeks.

How much could this initiative help? As noted above, the average person on Medicare D would save $368/year. Extrapolating this to the US Medicare population of 46 million people would yield an annual savings of $16.9 billion. The state of Georgia subsidizes the Medicare D and Advantage costs for the 131,231 people who are on both Medicare and Medicaid and a larger group of 304,514 people who have low incomes. If the state could help these groups find a less expensive plan, $368/person/year yields an annual savings for the state of Georgia and the federal government of $48 million for the Medicaid population and $111 million for the lower income population.

With a few exceptions, the only time to change to a new Medicare D or Advantage plan is the open enrollment period October 15th-December 7th. I hope you will take a few minutes to look at www.medicaredrugsavings.org and that it helps you save on your medical expenses. If you find it to be helpful, please pass this information onto others who could benefit from it.

A final bit of advice: when looking at Medicare Advantage plans it is important to realize that some plans only cover certain doctors and hospitals. In addition the benefits can vary from one Medicare Advantage plan to another. When comparing Medicare Advantage plans you want to ensure that the plan covers your needs.

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