Patrick McHugh | 06/18/2013
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Importance of Knowing Where you can Save on Prescription Drugs

I read an article today about a survey that was done by KRC Research for Walgreens on prescription drug costs. In a nutshell, this survey, which included 37% of 31.5 million Medicare Part D beneficiaries, explains why it is so important to know what exactly your plan offers and how you can save on your prescription drugs.

The survey found that 1 in 5 beneficiaries have decided to delay filling their prescriptions and skip doses just so they can help control their medication costs. This type of potentially health harmful decision making can be minimized as long as you understand your plan. In my previous post I talked about prescription drug networks and how preferred pharmacies offer lower co-pays and out-of-pockets saving you potentially hundreds of dollars on your prescription drug costs. If you missed the last post, go to Prescription Drug Networks. However, this survey found only 50% of beneficiaries realize that co-pays for Part D prescriptions differ by pharmacy and whether it is preferred or non-preferred. In addition, thirty percent of people don’t know that they can change pharmacies at any point. Not only that but around a quarter of beneficiaries know that their Prescription Drug Plan offer a preferred pharmacly option.

This research study goes to show that there are ways to save money on your prescription drugs and that your costs don’t have to be as high as they are as long as you understand everything offered in your plan.

If you would like to read the full article on the research study go to Walgreens Prescription Drug Coverage Survey.

If you have questions choosing a Medicare plan that offers the coverage you need, contact us at MedicareSolutions at 1-800-328-7305 where a licensed sales agent will immediately assist you.

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Category: Medicare Tips, Prescription Drug Coverage | Tags: ,
Patrick McHugh | 06/10/2013
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Prescription Drug Networks

All Medicare drug plans and Medicare Advantage drug plans have networks, which are the composition of pharmacies, such as CVS or Walgreens, your plan has contracts with. Therefore, if you go to a pharmacy that isn’t in your Medicare drug prescription plan then your plan will not cover your drugs.  Your drug plan’s network could include preferred pharmacies, non-preferred pharmacies, mail-order programs, or 60 and 90 day retail pharmacy programs.

A non-preferred pharmacy is one that is part of your plan’s network, but is not a preferred pharmacy. For example, at a non-preferred pharmacy you may pay higher out-of-pocket fees for your prescriptions than a preferred pharmacy.

A preferred pharmacy is one that is part of a Medicare drug plan’s network. At a preferred pharmacy you pay lower out-of-pocket fees for your prescription drugs than you would at non-preferred pharmacy.

In addition to preferred and non-preferred pharmacies there are mail-order programs. These programs allow you to get Medicare plan prescription drugs sent to your home. These are a favorable way for many to get their prescriptions because they come right to you and are generally cost-effective.

Lastly, there are 60 or 90 day retail pharmacy programs, which allow you toreceive a 60 or 90 day supply of your covered prescription drugs. This allows you to have a higher supply and not constantly having to go to the pharmacy to pick them up or wait for them in the mail.

If you would like to learn more, you can go to www.medicare.gov

If you have questions choosing a Medicare plan that offers the coverage you need, contact us at MedicareSolutions at 1-800-328-7305 where a licensed sales agent will immediately assist you.

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Patrick McHugh | 06/05/2013
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Brand-Name Pharmaceutical Companies keeping Generics away

I read a really a good article in the New York times today about pharmaceutical companies and I want to share the information it provided. Brand-Name Pharmaceutical companies have always had a way at profiting big from their prescription drugs through expensive and elaborate marketing and promotion campaigns. However, they have also managed to cut off competition from generic pharmaceutical companies at the same time one way or the other. Recently, its been through the FDA’s own safety regulations.

How are they taking the generic pharmaceutical companies out of the business? Just simply by not selling their drugs to generic companies. This completely disables the generic companies from producing because they need the brand-name drug to study it and make it the correct way. Generic companies used to make purchases from wholesalers but since there is a stronger emphasis on the safety of drugs, new regulations have been put in place creating restrictions on who can buy them. Therefore, they must go to the brand name companies to buy the drugs and they are just saying no.

The reason for their denial to sell? The first and most obvious reason is that they do not want generic companies taking the business from them. If they can continue to keep the generic companies from replicating their drugs then they have the ability to keep brand-name prescription drug prices high since they are the only suppliers. This is one of the many reasons why the United States has such high healthcare costs. According to The Hill, over $1 trillion dollars has been saved from selling generic drugs over the past ten years. Therefore, if the access to cheap generic drugs is extremely limited, healthcare costs will continue to stay high.

If you want to read the full article I got this information from, you can go to Drug Makers Use Safety Rule to Block Generics.

If you have questions choosing a Medicare plan that offers the coverage you need, contact us at MedicareSolutions at 1-800-328-7305 where a licensed sales agent will immediately assist you.

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Patrick McHugh | 06/03/2013
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The Truth about Generic Drugs

There is a lot of debate about whether or not brand-name drugs are better than generic drugs and if they are of the same quality. However, there shouldn’t be because according the U.S. Food and Drug Administration (FDA) they require generic drugs to have the same quality and performance as brand name drugs. When a generic drug is approved, they must pass high standards within identity, strength, quality, purity, and potency.

In terms of production, generic drugs are required to have the same active ingredient, strength, dosage form, and route of administration as the brand name. For example, there have been 38 published clinical trials that compared a generic heart drug to its brand name and every study proved they are the same.

Many people wonder why brand name drugs are so much more expensive though, actually around 80% to 85% more expensive than the average cost of a generic drug, and try to argue that because they are more expensive they’re better. This is not the case at all. This price increase is due to a lot of the pharmaceutical companies’ marketing and advertising campaigns, which creates for high competition within the marketplace giving them the ability to raise drug prices.

It also of concern that generic drugs are not as safe. However, the FDA is actively monitoring and engaged in making sure that they are safe.

If you have questions choosing a Medicare plan that offers the coverage you need, contact us at MedicareSolutions at 1-800-328-7305 where a licensed sales agent will immediately assist you.

Below is a great chart provided by the FDA that gives facts about generic drugs.

 

 

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Patrick McHugh | 05/30/2013
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Closing the Donut Hole, What will it cost?

The Affordable Care Act, a major reform signed into place in 2010 by President Obama, is supposed to help control rising healthcare costs over years to come. One of the initiatives is to have the donut hole, a coverage gap in Medicare Part D, closed 100% by the year 2020. In 2013, you reach the coverage gap when you and your plan have spent $2970 and get out of it when you have spent $4700 out-of-pocket for your prescription drugs.

This is great news for those who reach the donut hole, around 3.4 million according to a HealthView Services article, but there are 27.5 million people every year who do not reach the coverage gap. Once the gap is closed in 2020, the 27.5 million people will begin incurring a percentage of the costs pushed off to those who did reach the coverage gap. Instead of the donut hole, there will be a 25% cost sharing for all brand name and generic drugs.

If you have questions choosing a Medicare plan that offers the coverage you need, contact us at MedicareSolutions at 1-800-328-7305 where a licensed sales agent will immediately assist you.

 

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Patrick McHugh | 05/28/2013
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The Donut Hole- Medicare Part D

Donut Hole- this coverage gap occurs when you and your Medicare drug plan have spent a set amount of money for covered drugs and you begin “out-of-pocket” paying for your prescription drug costs until you reach the catastrophic coverage point in which your Medicare drug coverage plan will begin again. In the case of 2013, once you and your Medicare drug plan have spent $2,970 on covered drugs, the coverage gap will start. You will not reach catastrophic coverage until you have spent $4700 out-of-pocket for the year.

In order to counterattack high costs during the coverage gap, the Affordable Care Act includes benefits to help make your prescription drug coverage more affordable once you are in the “donut hole”.

These are the four benefits you will receive:

  1.  A discount on covered brand-name drugs when you buy them at a pharmacy or order them through the mail.
  2.  Some coverage for generic and brand-name drugs
  3.  Additional savings on brand-name and generic drugs
  4.  Maintaining the 50% discount the manufacturers offer and increasing their Medicare drug plans cover.

If you would like to find out more about the donut hole, click this link: http://www.medicare.gov/Pubs/pdf/11493.pdf

If you have questions choosing a Medicare plan that offers the coverage you need, contact us at MedicareSolutions at 1-800-328-7305 where a licensed sales agent will immediately assist you.

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Patrick McHugh | 05/23/2013
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Understanding and Avoiding the Part D Late Enrollment Penalty

money penalty

What is the Part D Late Enrollment Penalty? Its an amount that’s added to your part D premium. You may receive the penalty any time after your initial enrollment period is over or there is a period of 63 or more days in a row when you don’t have Part D or another form of creditable prescription drug coverage. A creditable prescription drug coverage plan is one that covers at least as much as Medicare’s standard prescription drug coverage.

There are three ways to avoid the penalty:

  • Join a Medicare Drug plan when you are first eligible
  • Don’t go 63 or more days in a row without a Medicare drug plan or another creditable prescription drug coverage plan
  • Tell your plan about any drug coverage you’ve had if they ask about

The cost of the penalty depends on how long you go without creditable prescription drug coverage. Your Medicare plan will let you know if you owe a penalty once you join a Medicare drug plan.

The penalty is calculated by multiplying 1% of the national base beneficiary premium times the number of full, uncovered months you were eligible but didn’t join a Medicare plan and went without a different creditable prescription coverage.

Take for example the national base beneficiary premium of $31.17 in 2013. If you had been eligible for a Medicare drug plan for 15 months, your penalty would be 15% (1% for each of the 15 months) of $31.17, which comes out to be $4.68. This amount will be added each month in addition to your monthly premium in 2013.

If you have questions choosing a Medicare plan that offers the coverage you need, contact us at MedicareSolutions at 1-800-328-7305 where a licensed sales agent will immediately assist you.

 

 

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Patrick McHugh | 05/22/2013
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Understanding Medicare- Part D

Part D- This is a prescription drug coverage plan created to help cover most or all of you prescription drug costs and that is offered to anyone with Medicare . There are two ways to get coverage and they are by getting a Medicare Prescription Drug Plan (PDP) or through Medicare Advantage plans such as a Health Maintenance Oranization (HMO) or Preffered Provider Organization (PPO) plan. If you get it through a Medicare Advantage Plan, you get all of your Part A and Part B coverage along with Part D.

With a Medicare drug Plan payments include:

  • a monthly premium
  • yearly deductible
  • copayments
  • costs in the coverage gap
  • costs if you get extra help
  • costs if you pay a late enrollment penalty

Your actual drug care plan costs vary upon:

  • the drugs you are taking
  • the plan you choose
  • whether or not you go to a pharmacy in your plan’s network
  • whether or not your drugs are on your plan’s list of medications covered within the benefit plan

If you have questions choosing a Medicare plan that offers the coverage you need, contact us at MedicareSolutions at 1-800-328-7305 where a licensed sales agent will immediately assist you.

 

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Patrick McHugh | 05/21/2013
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Understanding Medicare- Part C

 

Part C- Medicare Part C, otherwise known as Medicare Advantage is a program that allows you to enroll in private health insurance that offers both Medicare Part A and B benefits. These are separate health insurance plans rather than supplemental insurance. Medicare Advantage can also include prescription drug coverage in addition to vision, hearing, and dental.

There are many different options for Advantage plans including:

1. Health Maintenance Organizations (HMO) – These plans are required to cover both Part A and Part B healthcare, but can also offer additional benefits. You are limited to physicians and hospitals that are within the network except for emergency care. These plans can lower costs making them less expensive than traditional Medicare plans

2. Preferred Provider Organizations (PPO)- These plans allow you to use doctors, hospitals, and specialists within the network but unlike HMOs you are allowed to use health providers outside the network at an additional cost to you without a referral.

3. Private Fee for Service (PFFS)- With this plan you can use any physician as long as they abide by the terms of the PFFS. This plan chooses how much it will pay for the services and you can spend more or less on PFFS plans than on the traditional Medicare Plans.

4. Medicare Special Needs- These plans are limited to people with certain diseases, disabilities, or other health needs and are customized to the needs of that specific group, for example those who have diabetes. These plans also include the Medicare Part D prescription medication coverage.

In addition to these plans, if you enroll in a Medical Savings Account you do not have to pay a monthly premium because you pay a high deductible. Once you pay for the Medicare Part B premium, pay for Medicare covered services, and reach the deductible, the plan will pay for Medicare services. These accounts do not include prescription drugs.

If you have questions choosing a Medicare plan that offers the coverage you need, contact us at MedicareSolutions at 1-800-328-7305 where a licensed sales agent will immediately assist you.

 

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Patrick McHugh | 05/20/2013
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How to control retiree healthcare costs

Retirement is supposed to be a time of freedom from decades worth of hard work throughout your career and a point in your life where you feel financially secure. However, over the years we have seen healthcare costs rise dramatically, obscuring the image of a stress free retirement. According to an article by Fidelity, a couple retiring in 2013 is expected to need $220,000 to cover health care costs in retirement. While this is a big chunk of change for anyone to undertake, there are several ways you can manage your health care costs and feel comfortable as you approach retirement.

The first way in which you can manage these healthcare costs is knowing what is available to you in terms of health insurance coverage. You need to know what you need, where you can get it, and the cost of the coverage your looking into. Once you figure out your options you can start to answering these questions.

If you don’t have employer-based insurance, Medicare, a government-based insurance program is a great option to look at. There are four different parts (A,B,C,D) and you automatically qualify for Part A at the age of 65, which is hospital insurance, if you paid Medicare taxes throughout your career. The second part, part B includes outpatient care and is paid by a monthly premium. Lastly, part C and D are supplemental coverage plans that fill in the gaps not covered by A and B and include prescription drug coverage.

A second way in which you can manage your healthcare costs is deciding whether or not your going to be retiring early, or before the age of 65 when you start qualifying for Medicare. If you do retire early some of your options include: Medicaid if you qualify, paying to continue your employer based insurance, or purchasing an individual policy.

Due to the fact healthcare costs are one of the biggest expenses people now face it is a good idea to factor in these expenses into your income planning. According to an article in Fidelity, current retirees are now spending more on health care than they do on food. You can start figuring these numbers in your budget once you know how much the options your looking into cost. Its also a good idea to take into account your current health status and your family’s history of health as this information will help you determine what health issues you may encounter as you get older.

Another great way to counteract these upcoming healthcare costs is by setting up a health savings account or HSA by annually setting money aside for future expenses. These accounts are not subject to the if you don’t use it, you lose it rule making them very accountable. As a result, there are many ways to prepare and be ready for the healthcare costs you are about to encounter.

If you have questions choosing a Medicare plan that offers the coverage you need, contact us at MedicareSolutions at 1-800-328-7305 where a licensed sales agent will immediately assist you.

Citing: Fidelity Viewpoints. “How to tame retiree health care costs”. Medicare Solutions Blog. Admin. May 15, 2013. May 20, 2013.

 

 

 

 

 

 

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