Am I Required to Buy a Medicare Drug Plan?

Am I required to buy a Medicare drug plan? What if I don’t take drugs? Can I wait until I need a plan? GA Medicare expert Bob Vineyard explains.

Is Medicare Part D required by law? What is the best 2019 drug plan? Is there a penalty if I DON’T buy a prescription plan? Is Part D optional?

required to buy medicare drug plan
Required to Buy a Medicare Drug Plan?

Medicare Part D

I don’t take any prescription drugs. Why must I buy something I don’t need or want?

You are not REQUIRED to buy a prescription Medicare drug plan. But if you don’t enroll in a plan when first eligible you will pay a penalty.

And the penalty is payable for life. It also increases every year.

So . . .

Am I Required to Buy a Medicare Drug Plan?

Where Can I Find the BEST Plan?

Finding the best Medicare drug plan isn’t easy. Part D is the most confusing part of Medicare. How do I find the RIGHT plan for me?

You could get lucky this time, but what about next year?

Is there a GUIDE to Medicare Prescription Drug Coverage? Yes, and it is only 88 pages . . .

The best drug plan is the one that is right for you. Do the following before enrolling.

  • Use the Medicare Drug Plan Finder
  • Enter all your current medications
  • Choose a pharmacy. Look for the one with the lowest copay’s.
  • Make sure all your drugs are on the formulary
  • Consider buying generics with cash or a discount card
  • Look for plans with a deductible
  • Enroll in a plan with the lowest total out of pocket cost

You can do all this by yourself.

Or you can ask a Medicare expert to help. I am always willing to help my Medigap clients. If you are not a client, please don’t ask. It’s not personal, it’s just business.

Why is Medicare Confusing?

Seniors often buy the wrong drug plan and spend too much on their prescription plan. Seniors on Medicare spend an average of $263 per month on prescription medications.

Lower your medication bill by only using your drug card when necessary. The right drug plan will save a lot on brand names but you will almost always pay MORE for generics.

Consider paying cash or using GoodRx instead for maximum savings. Also look for a Medicare drug plan with a deductible. https://youtu.be/LaA9NnFeBXI

You have questions? I have answers. Call or email.

#MedicareDrugPlan #MedicarePartD #GAMedicareExpert

Medicare Things You Don’t Know

Medicare things you don’t know (but wish you did). Questions you never asked because no one told you. And you will pay dearly if you are not prepared.

There are things about Medicare that will trip you up when you least expect it. Not so much with Original Medicare, but there are things about Advantage plans no one mentioned. Medicare things you don’t know. Stuff like access to care and prior authorization.

Medicare Stuff About Advantage Plans

You may think you understand Advantage plans but my guess is there are things in this video that will shock you.

Almost everyone LOVES their Advantage plan until they have to use it. I get calls all year long from folks who say they can’t afford their Medicare plan and want a supplement.

Most GA Medicare Advantage premiums are $0. If they can’t afford their plan there’s a good chance they are incurring hundreds or even thousands of dollars out of pocket for claims.

I have a friend that has been bragging about his plan ever since he went on Medicare. He thought I was foolish for paying “all that money” every month for a Medigap plan.

A few years ago a cancer diagnosis was a shock. His provider had grant money to pay for his treatment so his out of pocket was minimal.

Now the Cancer is Back

Gary is learning things about Medicare he did not know. Such as prior authorization.

Before he can have a test ordered by his doctor, the carrier must APPROVE the test. It’s all about the money.

His oncologist wants him to have proton therapy but his plan will only pay for a less expensive protocol. Dollars drive many medical decisions when an insurance carrier controls your benefits.

Proton Therapy – It Helps Only a Few at a Wildly Extravagant Cost MedPage Today

All he wants to do is get well but his Advantage plan is running interference. His carrier is interested in saving money. THEIR money. Not his.

It’s all about the dollars. Just another Medicare thing he did not know.

What is Prior Authorization?

According to the Kaiser Foundation “80 percent of Medicare Advantage enrollees are in plans that require prior authorization for at least one Medicare-covered service“.https://www.kff.org/medicare/issue-brief/prior-authorization-in-medicare-advantage-plans-how-often-is-it-used/

Prior authorization is more frequently imposed for HIGHER COST services.

Reading further . . .

A potentially overlooked consideration is access to covered services; specifically, how prior authorization may affect beneficiaries’ access to covered services.

Medicare Advantage plans can require enrollees to get approval from the plan prior to receiving a service, and if approval is not granted, then the plan generally does not cover the cost of the service.

On the other hand, Original Medicare does not require prior authorization for most services.

There are probably many things about Medicare Advantage plans you did not know. Limited access to care because of prior authorization requirements is probably just one of them.

#MedicarePriorAuthorization #MedicareAdvantage #GAMedicareExpert

Medicare Drug Plan Fail

Medicare drug plans fail when you least expect it. I remember it well. It was sunny and warm. After leaving my dermatologist and stopping by the drug store to pick up my new prescription my Medicare drug plan failed me.

Right there in the pharmacy. I was betrayed by my Humana drug plan.

It was humiliating. Medicare drug plan fail

Trusting my Medicare drug card was a costly mistake. It had never let me down before but today was different.

I felt cheated.

I followed all the rules. Used generic medications to save money vs. brand names. Every year during Medicare open enrollment I faithfully checked to see if I had the best Medicare Part D. The one with the lowest drug out of pocket cost.

This was a new prescription for a medication I use only when needed. It is only filled once a year or so. In the past the medication never cost more than $20, but today it was $92.

I had the money, but I knew something was wrong. Had my drug card gone over to the dark side? Was I being ripped off?

I walked out without my prescription.

 

When Your Medicare Drug Plan Fails You

Prior to 2006 Medicare beneficiaries usually had to pay full price for their prescription drugs. Then things changed.

For some people, Medicare Part D was a godsend. For others it was the work of the devil.  These are times when your Medicare drug plan can fail you.

  • Many PAP’s (Patient Assistance Programs) are not available if you have a Medicare drug plan
  • You take a brand name drug and a generic is available, your drug plan probably won’t help
  • Your doctor prescribes a new drug in the middle of the year, you may be paying too much for your new medication
  • You fill a prescription that you only take once in a while
  • You assume all pharmacy’s charge the same price
  • You buy an OTC medication with a prescription
  • When you are not aware of the best price available
  • You assume your Medicare drug plan is giving you the best price every time

Too often retirees automatically use their Part D card and never consider they might be paying too much. They don’t know where to look or don’t bother to research. They assume they are always getting the best price.

Some drugs are covered by Medicare Part B. If you have original Medicare and a good Medigap plan your out of pocket cost could be $0 instead of hundreds or even thousands of dollars each year.

Most people we talk to are paying too much for their Medicare supplement plan. With over 240 different Medigap plans you probably didn’t see the best pricing.

Georgia Medigap Rates - Instant Quotes

Regardless of the excuse, they are wrong and are spending money that could have been kept in their pocket.

 

Medicare Drug Price Transparency

Unlike most other health care, prescription drugs have almost 100% transparency.

If you know where to look.

Here are some general tips for controlling medication costs.

  • Run a free Medicare drug report every year when you receive your ANOC (annual notice of change)
  • Consider using a different pharmacy and if possible, use only preferred pharmacy’s
  • Learn how to manage your drug costs and avoid the donut hole
  • Ask if you qualify for Medicare Extra Help
  • Consider using a discount drug card
  • Save money by using mail order, especially from Canadian pharmacy’s
  • Never fill a new prescription without first checking prices

Medicare Part D is the most complex and confusing aspect of Medicare. If you don’t understand your plan, and how to use it, you will definitely pay too much.

 

How I Saved Over $60 on One Medication

I run reports for my Medigap clients all the time. Almost every time we find ways to save hundreds, or even thousands of dollars over the course of a year.

Some clients have been taking OTC medications for years but paying a pharmacist to fill their prescription. On more than one occasion clients are paying over $100 per month for a cholesterol medication that could be bought off the shelf or online. A years supply of this drug is available from Amazon for less than $30. Compare that to paying over $1500 per year for the exact same medication.

Others will needlessly go into the donut hole. Had they managed where and when they bought their prescription the donut hole could have been avoided completely.

In my case the $92 fill at CVS was available across the street for $27.

When will your Medicare prescription drug plan fail you?

 

#MedicarePartD #DrugDiscountCards #CanadianPharmacy

Don’t Buy a Medicare Drug Plan

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Don’t buy a Medicare drug plan. Don’t buy it from Blue Cross, AARP, Humana or any other carrier. Don’t buy a drug plan from a company website. Don’t buy Part D from an agent. Not any agent.

And that includes me.*

don't buy a medicare drug plan

don’t buy a medicare drug plan

But you should allow me to review available drug plans (there are currently more than 20 of them) and suggest the best drug plan / pharmacy combination that produces the lowest out of pocket cost to you.

We recently showed 2 different clients how to save over $4,000 per year

by switching plans AND pharmacy’s.

 

Don’t Buy a Medicare Drug Plan That Has a Deductible

Unless you understand how much money you could save.

Drug plan deductibles are confusing to consumers.

But many agents also don’t understand them.

So we made this video just for you.

 

We Shop – You Compare

How easy is that?

I will also shop the market for you and suggest the best GA Medigap plan. With more than 170 different Medicare supplement plans in Georgia, you will be overwhelmed and confused.

I can distill your options down to a handful of plans and carriers to consider in less than 10 minutes and show you why some plans deliver the best value while the rest really stink.

Click now to shop and compare GA Medigap quotes now.

Your information is never sold.

 

Don’t  buy a Medicare drug plan direct

Depending on where you live in Georgia, there could be as many as 30 different Medicare drug plans offered by over a dozen different carriers.

atlanta gaMonthly premiums start in the mid teen’s and your annual projected drug costs could be anywhere from a few hundred dollars to tens of thousands of dollars.

Don’t buy a drug plan direct from a carrier.

If you call Blue Cross, or Humana, or Aetna or any of the other carriers offering drug plans what will you get?

A sales pitch about their plans.

They won’t tell you about plans from other carriers that might be better. They may even forget to mention other ways to save money on your prescription drugs.

Of course you can always just shop online at the carrier sites.

Click to find the drug plans.

Click to enter your medications and dosage.

Click to pick a pharmacy from the preferred list.

Click to review plan options and drug costs.

Then when you are through go to another carrier site. Wash. Rinse. Repeat.

How much fun is that?

John C. of Atlanta saved over $500 per year by purchasing his Medigap plan through Georgia Medicare Plans

 

Don’t buy Medicare Part D from an agent.

Never buy your drug plan from an agent.

Not any agent.

bob on fbIncluding me.

Why?

Legally, an agent can only tell you about plans they are certified to present. Most agents are only approved to discuss a few plans from maybe 2 or 3 carriers.

Out of 20+ drug plans that may be in your area most agents can only legally discuss maybe 3 or 4.

What about the other plans?

Medicare does not allow them to tell you about better plans, only the few they are approved to offer.

The same rules apply to Medicare Advantage plans.

When an agent tries to sell you an Advantage plan they can only discuss the ones they are approved to offer. And they are not allowed to compare one plan against another.

Currently Marietta, Georgia has 11 different Advantage plans from 6 different carriers. It the agent that is hoping to sell you a plan is only appointed with two of the carriers, not only can they not compare the two plans for you but they can’t tell you about plans from the other 4 carriers.

There are over 240 different Medigap plans in Marietta and I am allowed to discuss any or all of them and give your rates on any of them by phone or email.

Doesn’t that make more sense?

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Where should you buy a Medicare drug plan?

Don’t buy it from a carrier.

Don’t buy it from an agent.

The only place you will get information on EVERY drug plan in your area is at 1-800-MEDICARE (1-800-633-4227)

The people that answer the phones can tell you about every plan available to you, even the ones that don’t pay a commission to an agent.

You can buy a drug plan at 3:00 AM or 3:00 PM.

Seven days a week.

24 hours a day.

Except on federal holidays

You can get informed and unbiased information on Medicare Part D prescription drug plans.

The best time to call is usually after 7:00 PM week nights.

Here is what you will need:

  • The exact name and dosage of each medication
  • How often refilled
  • Drug refill quantity
  • Retail or mail order
  • Preferred pharmacy

But let us help you with your Medicare supplement options AND show you how to save money on Medicare Part D year after year

Here’s why.

 

Do not buy a Medicare supplement plan from Medicare

You certainly can if you wish. But consider this.

  • Medicare.gov only gives you premium ranges, not exact rates
  • Medicare.gov only has a few carriers and most of the information is outdated
  • You won’t learn who is new to Georgia and who has been writing business for years
  • You won’t learn which carriers are pulling out of Georgia
  • You won’t know about past or future rate increases
  • You won’t learn which plans were dropped by carriers
  • You won’t learn which carriers stopped writing business under an old name and started with a new one
  • You won’t learn about average annual rate increases
  • But you can buy a plan 24/7 if you are in a hurry and don’t care about any of the above items

When you allow Bob Vineyard at Georgia Medicare plans to assist, you get the benefit of 40 years experience in the health insurance business.

Or you can buy from a carrier or Medicare.gov and hope the person answering the phone can really answer your questions.

We can discuss all of the 240 Medigap plans, tell you which ones are due for a rate increase, which have a history of huge rate increases and which carriers don’t yet have a track record. We will provide you with rates by phone and email.

Click to shop

 

#MedicareDrugPlans #MedicarePartD  #Don’tDoDrugs

Aetna Medicare or First Health Part D Plan?

If you have an Aetna Medicare Advantage plan, Aetna or First Health Medicare Part D plan you may be in for a big surprise. Medicare Part DThe preferred pharmacy’s listed on Medicare.gov for these plans and carriers was not completely correct. As a result, when you fill your prescription at a non-preferred pharmacy you may pay a much higher price for your medication.

This alert published today on California Health Advocates and applies to retirees in all states including Georgia.

(If you have an Aetna Medicare or First Health plan) you may find that your pharmacy is no longer a network pharmacy. Pharmacies that are not in your plan’s network can charge you more, even full price, for your drugs.

CHA was alerted that incorrect information was posted on the Medicare Plan Finder and other Aetna sites during the last Annual Enrollment Period, aka Open Enrollment. Pharmacies no longer contracted with Aetna as network pharmacies were incorrectly listed as such. Beneficiaries may have relied on the incorrect information and enrolled in an Aetna Medicare or First Health Part D plan. Medicare is allowing beneficiaries affected by the incorrect information a Special Election Period to change plans. An estimated 50,000 beneficiaries may be affected.

Using your Medicare Part D plan at a non-par pharmacy means you will pay a much higher price, even possibly full retail. You should take advantage of this special enrollment period to evaluate your Part D coverage and consider making a change to a different plan.

Georgia Medicare Plans routinely reviews drug plans for our Medigap clients and makes recommendations that often save our clients $1,000 per year or more in out of pocket drug costs.

Even if you are not a current client but would like an independent review we are glad to assist. You are welcome to call or email your request.

We often find that many people are overpaying for their Medicare supplement plan. It is not unusual to find savings of $450 per year by changing carriers without losing coverage. If you have plan F we can usually show you even greater savings from plan G if you are willing to consider nominal cost sharing.

If you qualify for a special election period we can help. CMS has granted this exception for those with Aetna Medicare Advantage or Aetna and First Health Part D plans where the information on Medicare.gov was misleading.

Free instant Medigap quotes.

Georgia Medicare supplement rates