cjnewland Asked April 2011

My mother needs Medicare Part D. Does anyone have experience with this?

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My mother needs Medicare Part D to help pain for her prescription medications as there are many! I was told to go online and "choose" an insurance company. I tried this, and there are many to choose from. Does anyone have experience with this? Or can tell me which one they chose and why or why not? I need help!

Thanks!

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EXPERT Carol Bradley Bursack Apr 2011
I have some experience with this. Type in all of your mother's medications and the list will likely get much smaller. Then, where she lives limits even more. It's quite controlled by Medicare, but there are differences in prices. Word of mouth is good, too, if you have lots of choices, but if you are like my community, you may end up with only a couple once you've narrowed it with medications. They don't all cover the same medications.
Also, if most of her meds are generic, she may do better with one company. If most are brand only, she may do better with another. The thing to remember is that you can change during open enrollment which is within 90 days of turning 65 (the site explains open enrollment if you look for a link), or mid-Nov through, I believe (it changes) the first of each year. You have the chance to change policies every year.
Good luck. I know it seems like a maze. If you really get confused, call Medicare and be prepared for a menu, and wait time, but they will help.
Carol
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EXPERT Ross Blair Nov 2011
Hi cjnewland,

I'm sorry I'm just seeing this now, but I hope you are aware that the annual enrollment period (AEP) for Medicare is well underway for the 2012 plan year and ends three weeks early on December 7th.

The AEP allows you to review your mother's coverage and make sure she's still in the plan that best first her needs.

This is incredibly important to do this, and every year. Here's why.

- An analysis done by Avalere Health found that, while average premiums across all Medicare prescription drug plans (PDPs) are decreasing by approximately 4 percent next year, six of the top 10 plans are actually having premium increases.

- Increases among the top 10 plans range from a high of 14 percent to a decrease of 11 percent. And, the premiums are not the only thing you have to consider when picking a plan.

- It's also critically important that you make sure all of your mother's drugs are covered by her plan. A survey we ran from last year's AEP found that 34 percent of our customers had at least one drug that would not have been covered by their existing plan heading into 2011.

- PDP plans are only required to cover two drugs in each category and class, which means some drugs are not covered on each plan.

If your mom's prescribed medication isn't covered by her PDP, she would pay 100% of the cost for that drug out of her own pocket. And, the money she spends on that drug would not count toward helping her reach the Medicare donut hole, or the catastrophic coverage limit.

For that reason, we encourage people to double-check their drug coverage once a year during the AEP. Medicare.gov and PlanPrescriber.com both have tools that allow you to do this fairly quickly.
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