Anyone here know much about the Medicare drug program?

[luvwinnie]

I found this in an article:
After an initial $250 deductible and the first $2,000 of coverage, participants must pay for the next $3,000 worth of drugs.

So the participant pays the first $250, then the next $2000 is paid by Medicare? ANd then the participant pays for the next $3000 worth of drugs?

 

[mickeyboat]

I am not sure of the numbers, but that's the gist. People are still responsible for a huge amount of drug costs on their own, in addition to paying a monthly premium for the coverage.

The information disseminated to the elderly public has been so confusing that I don't know how anyone can figure it out. The information given to employers and the hoops that we are required to go through for it have been just as confusing!

Denae

 

[Lisa loves Pooh]

No--they pay a $250 deductible..then through $2250 in drug costs they only pay a co-pay. Then up to $3600 they do pay 100%, then after that it is a small co-pay for any remaining costs.

If they are low income they can apply for subsidy assistance to at least have their portion partially subsidized or fully subsidized and the co-pays are less than on their
own.

So while not the best scenario--they do not pay the next $3000 as I think you are understanding--at least based whom I am taking enrollments for.

ETA: (the numbers are a running total of total drug costs--not additional tiers--so from $2251-$3600 is what I mean).

 

[Dan Murphy]

Not quite correct. Best is to review here, it explains it well....

http://www.medicare.gov/pdphome.asp

It is confusing, as it has been left up to the insurance providers to build their benefits/premiums, so long as it meets the Medicare minimums and passes Medicare approval, unlike Med supplements, which are all the same, plan for plan, just different in premiums. It is more confusing, I would expect a change in years to come to simplify.

To select the correct (best) plan for a participant, one really does need to go through the exercise on this site.

(Not to be considered insurance/Medicare advice)

 

[luvwinnie]

Thank you all. My dad is covered with the Teamsters, but his friend told him he DROPPED the Teamster plan for a Medicare plan...which seems nuts to me. I cannot imagine the Medicare one is better.

 

[minniecarousel]

I found out through my Mom's insurance that she pays a portion of her drugs until both hers and her insurance total $2000. After that, any part of the $2000 that she pays goes toward the next $1600. After she pays all of that $1600, her insurance kicks in with a greater amount (not sure how much, since she probably won't get there.) She has no deductible with her plan. Confusing as all get out - I don't know how most Seniors are figuring it out!

 

[Lisa loves Pooh]

Thank you all. My dad is covered with the Teamsters, but his friend told him he DROPPED the Teamster plan for a Medicare plan...which seems nuts to me. I cannot imagine the Medicare one is better.

Many different companies offer the Med plan--they are administering it on their behalf.

And it could be very possible that though they dropped the teamster plan--they still could have very well ended up with the very same company that was administering the teamster plan (Can't say more or I will get in trouble.)

Like any insurance policy you shop around for the best deal for you--so out of pocket expenses may vary based on who you go with.

Borrowing Dan Murphy's disclaimer: (Not to be considered insurance/Medicare advice)...I am not licensed, so I was not trying to offer advice--just info on what I know for what I been trained to do which is to be an information looker upper.

 

[Teejay32]

Thank you all. My dad is covered with the Teamsters, but his friend told him he DROPPED the Teamster plan for a Medicare plan...which seems nuts to me. I cannot imagine the Medicare one is better.

The best plan for your Dad might not be the best one for your Dad's friend...it will vary.

 

[Dan Murphy]

To select the 'best' (cost/benefits), one really needs to use the Medicare site linked above, put in THEIR Rx's, (brand vs generic, doseages, strengths), zipcodes, etc, it will show the 'best'.

(Not to be considered insurance/Medicare advice)