Medicare
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Original Medicare or Medicare Advantage?
There are two ways to get your Medicare, either through Original Medicare or through a private insurance company that takes over your Medicare benefits.
Drugs are very expensive for seniors and the Prescription Drug Benefit has been of great help, but how do you select the appropriate plan for your specific list of drugs? Nursing care is expensive and no one wants to get stuck in a nursing home environment. But does Medicare pay for home care? What kind of nursing care does it cover?
How to Choose the Appropriate Medicare Prescription Drug Card
Do you feel television commercials and postcard mailers know your specific drugs, dosage, and frequency?
How can you get the right drug card where all your drugs are in the formulary?
Would you like a good estimate of how much you will pay per year for your specific drugs, including deductibles, co-pays and even premiums?
The only way to do this is to use the Medicare Drug Finder – not by watching the television ads during the annual election period or responding to those ads received in the mail, and perhaps not even by selecting one of the plans an agent has (most agents represent a limited number of plans).
Once you go through the Medicare Drug Finder, you’ll be set up for next year as well because all your prescriptions are saved so you can edit them, add more, or delete those you no longer use.
How To Use the Medicare Drug Finder
- Go to www.medicare.gov and click “Find health & drug plans”
- On the next screen use the General Search and put in your zip code and click “Find Plans”
If your ZIP Code spans multiple counties you will be prompted to select which county you live in.
- You are now at Step 1 of 4 where you answer how you get your Medicare coverage and if you receive any help in paying for drug costs. These are designed especially for those who are on some form of low income assistance.
Call me if you happen to be in that situation and I’ll help you with the Drug Finder. Most of the time my clients select “Original Medicare” and “I don’t get any Extra Help” and click “Continue to Plan Results”.
- Step 2 of 4 is where you type the name of your drug. As you type you will see potential matches pop up. Select one of these and up pops “Dosages, Quantity, Frequency, Pharmacy Type”.
These are pretty easy to fill in. Make sure your quantity is in batches of 30 (30, 60, 90, 120) because Medicare doesn’t work with odd-days supplies like 31 days.
- Once you input your first drug then you will see on the right-side box a Drug List ID and password date.
Write this down, because next year all you have to do is get to this point and re-enter your ID, Password Date, and ZIP Code and your entire drug list will come up!
- When your list is complete, click “My Drug List is Complete”.
- Step 3 of 4 is where you select a pharmacy or two you might use. This is because some pharmacies may be in a special network with discounts on certain drugs. Then, “Continue to Plan Results”.
- Step 4 of 4: We only want to look at “Prescription Drug Plans.” This is because you have a supplement or Medigap policy, not a Medicare Advantage Plan.
If you want to look at Medicare Advantage Plans with or without drug coverage then click the appropriate box. But if you are only looking at Drug Cards then check the box and click “Continue To Plan Results”.
- Finally we see the recommended drug cards! On this screen you’ll see all the available Prescription Drug Cards within your zip code sorted by lowest annual costs.
Do you see the little blue question marks? Click on them if you have a question as to what a column means. For example, Estimated Annual Drug Costs is a total of all the co-pays and coi-insurance for your specific drugs, plus the insurance premium and deductible (if any), plus the cost of any drugs on covered in the formulary (if any). This is very helpful in selecting a drug card. As you go down the list you’ll see the annual cost continue to increase. Importantly, since the Card’s premium is included in the annual total you might see that a more expensive card actually has a lower annual cost.
- When you decide which card you want to enroll in for the next calendar year, click “Enroll” and go through the enrollment process. At the end you’ll get a confirmation number and can print your confirmation, even have it emailed to you.