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

Medicare Advertising – What is Legal?

Medicare advertising kicks into high gear in the fall because of the annual open enrollment period. This year you open enrollment begins on October 15 and runs through December 7. You can expect your mailbox to be stuffed with all kinds of medicare mailmansolicitations and advertisements. Your email volume may pick up as well with promises of better coverage for less money.

How much is real? What is a come-on? Are some of them scams? Are insurance companies legally allowed to offer Medicare advertising for enrollment purposes?

Most of the people we talk to, that already have Medicare, are in the wrong plan, paying too much, or both. It doesn’t matter if you are turning 65 and going on Medicare the first time, or have been covered by Medicare and just got bad advise. We can help.

We offer instant online Medigap quotes. No tricks. Compare plans and rates side by side. Your information is never sold.

Medicare shop and compare

We have rates on more than 170 different Medicare supplement plans and will always give you the lowest rate by phone.

 

 

Medicare Advertising

I have been in the insurance business for 40 years and am always interested in staying on top of what is going on around me in
“my world”. I read news articles daily, subscribe to information on Medicare and Social Security, and continuously scour the web for anything that might be of interest to my clients.

have I got a deal for youJust today I received the following in a newsletter published by an “independent” Medicare adviser. Normally their information is spot on but this was just wrong on so many levels.

Dear Marci,

Last year around this time I started receiving a lot of notices in the mail advertising different health insurance plans for my Medicare coverage. I was overwhelmed by the amount of information I received, and I don’t want to experience that again. How can I sort through these notices and make sure that I am not being taken advantage of? How are insurance companies allowed to market their plans?

– Naomi (Pittsfield, MA)

Marci’s response follows in part.

Dear Naomi,

You are not alone—this is a common concern among beneficiaries. October 15 marks the beginning of Fall Open Enrollment, which is the time during the year when Medicare beneficiaries can make changes to their health care coverage. Starting October 1, Medicare Advantage Plans will start advertising their offerings for next year. While most plans abide by the marketing rules set forth by Medicare, not all plans do.

Some of Medicare’s marketing rules for plans are:

  • Unless you are already a member of a plan or have given permission, plans are not allowed to contact you in any way other than through the mail.
  • Plan names cannot suggest that the plan is preferred or endorsed by Medicare.
  • Plan representatives cannot approach you in public places, such as parking lots of malls. In health care settings, plans can only advertise in common areas such as cafeterias. They may not advertise in waiting rooms.
  • If you schedule a time to speak with an insurance broker about Medicare Advantage options, they cannot try to sell you products other than a Medicare Advantage Plan, such as a life insurance policy.
  • Plans cannot offer gifts worth more than $15. Further, they must provide the gift even if you do not sign up for the plan.

In addition to being aware of these rules, you should consider these tips to help avoid becoming the victim of marketing fraud:

  • Always verify all information you receive from an insurance plan representative. If a representative says that a particular doctor is in network, you should call the practice to confirm with the doctor.

  • Be aware of your right to choose how you receive Medicare coverage. Medicare Advantage Plan representatives should not tell you that Medicare Advantage is your only option.

  • If you are feeling pressured, you can tell the plan representative that you will follow up at a later date. This will give you time to make your decisions.

  • Use government websites and official sources of information.

All of the above is good and helpful information, except it is not 100% correct.

The marketing rules above apply only to Medicare Advantage and Medicare drug plans.

Medicare advertising for supplement plans (Medigap) or about Medicare in general are not subject to the same rules and guidelines.

That being said, just because governance over Medigap advertising is somewhat relaxed does not mean carriers and marketers are free to say anything they wish.

 

Medicare Open Enrollment

Does the Medicare open enrollment affect you?

In some cases, yes.

If you have a Medicare Advantage plan or Part D prescription drug plan, welcome to open enrollment. In most cases you can change your Advantage plan without medical underwriting. There is never any underwriting for Part D.

Medicare supplement plans can be changed ANY time, not just during open enrollment. Unless you are a new enrollee, you will probably have to pass medical underwriting before you can make a change.

Just about everything you need to know about open enrollment can be found in our featured post, Medicare Open Enrollment 2015.

I suggest you click the link and take notes.

 

Are You Being Scammed?

Is the Medicare advertising misleading? Maybe, maybe not. Use common sense.

While perfectly legal, the Medicare Advantage literature quite often makes a big deal about $0 premium but (in my opinion) falls short in explaining the true cost of MA plans.car salesman scam

Advantage plans are great until you use them, then they can get quite expensive. That is usually when I get calls from people who say they can’t afford their $0 premium plan any more.

What they are really saying is they can’t afford to pay their medical bills. Unfortunately when it gets to that point they probably can’t qualify for a Medigap plan.

Here are a few things to watch out for if you are enrolling in Medicare for the first time or considering making a change.

Medicare Advantage –

  • Look for your doctors and hospitals in their provider directory
  • Find out if you need a referral to see a specialist
  • What is the penalty for using out of network (non-par) providers?
  • What is your in-network maximum out of pocket?
  • What is your out of network out of pocket maximum?
  • Do your drug copay’s change?
  • Are all your drugs on the formulary?

Medicare Part D –

  • Do your drug copay’s and deductibles change?
  • Are all of your drugs on the formulary?

Medicare supplement –

  • Don’t buy plan F
  • Don’t cancel any existing coverage until you know you have been approved by your new carrier
  • Don’t buy a Medigap plan based on price alone
  • All plans with the same letter pay claims and pay them on time
  • The only difference is the premium you pay
  • Never buy direct from the carrier
  • Use a local Georgia agent that knows the market

When shopping online bear in mind that most of the sites you go to are marketing sites. They gather your information and sell it to multiple agents.

When you get a quote from Georgia Medicare Plans your information is never sold. You get instant, online Medigap quotes. You will also get one phone call from me, usually within 48 hours.

I only call once. I will answer your questions, give you the best rates on plans in your area and give them over the phone.

No pressure. No tricks. Shop and compare now.

Medicare shop and compare

 

 

#MedicareOpenEnrollment #MedicareAdvertising #MedicareAdvantage #MedicareSupplementInsurance

 

Don’t Buy a Medicare Drug Plan

shopCompareBig_new2

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?

shopCompareBig_new2

 

 

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

4 Mistakes Retirees Make in Choosing a Medicare Plan

What are the 4 mistakes you can make in choosing a Medicare plan? Do you understand the difference in original Medicare and private Medicare Advantage? medicare shockDo you assume the plan your friends bought is best for you? Did you ask a knowledgeable agent to help or just shop online to find a plan? Have you budgeted for the total cost of health care? Don’t make the same mistake Tony made.

Many consumers start by shopping online, which is not a bad way to go as long as you understand the results. Others ask their friends about the kind of coverage they have. Nothing wrong with that as long as your friends researched and understood their options.

Sadly, too many end up repeating the same mistakes their friend made an only realize when it is too late to make a change.

Shop and compare over 170 different plans in the comfort of your home.

 

Medicare vs. Medicare Advantage

You might be surprised at how many fail to understand the difference in original Medicare vs. a private Medicare Advantage plan. They think their Advantage plan is a supplement to Medicare.

say whatIt’s not.

Medicare annual open enrollment is when everyone can make changes in their plan.

Nope.

Medicare and a supplement is more expensive than Medicare Advantage.

It depends.

Original Medicare allows you to use any doctor, lab or hospital without penalty. You can travel anywhere in the country and have the same level of coverage as you have at home. You can keep the same plan, and doctor, from year to year.

Medicare Advantage picks doctors for you. If you use someone that is not in network, you pay a penalty. Your doctor can be fired from the plan in the middle of the year. United Healthcare has made headlines because they told participating doctors they were no longer needed, leaving patients high and dry.

Can you afford to make that mistake?

 

Letting your friends pick a plan for you

Have you ever had a friend set you up for a blind date? Oh, they mean well, but most of the time you will smile and be pleasant while inside you are saying to yourself “What were they thinking?”. blind date

One of the 4 mistakes many people make is buying the same plan a friend has. If you follow this philosophy you will probably buy a $0 premium Medicare Advantage plan or buy Medigap plan F from United Healthcare (AARP), Blue Cross or one of the current Mutual of Omaha companies.

What could be better than $0 premium? And your doctor(s) are in network so is there anything else to consider?

Or plan F pays 100% of my health care costs. It must be a great plan, right?

The $0 premium plan with $0 deductible might be just right, but did you estimate what your health care costs will be?

And about that plan F.

Depending on your age, gender and zip, Medicare supplement plan rates vary considerably. I recently ran a quote for a female, age 65, in Conyers. The United Healthcare (AARP) plan F was 19th on the list of plans ranked from lowest premium to highest. Blue Cross was 23rd.

If you are really sold on plan F you could have saved $350 a year (or more) if you had purchased from someone OTHER than the name brand carrier.

You would have saved even more, almost $600 a year, by choosing plan G ………. a plan not offered by United or Blue.

 

Shopping online

Amazon is the worlds largest retail shopping mall. You can find almost anything you want. Sometimes it is a good price, sometimes not. When the purchase arrives, if you don’t like it you can return it.

Buying a Medicare plan online isn’t the same thing.

Too often you won’t know if you like the plan until you actually use it. By then it may be too late to exchange it.

If you go to Medicare.gov there is a lot of information about Medicare Advantage and drug plans, but almost nothing usable when it comes to Medigap.

A common piece of advice on Medicare Advantage is to make sure your doctor is in network but how many times do you stop to check your medication list?

Most people don’t, especially the DIY crowd.

Big mistake.

The biggest hassle in online shopping is landing on a site that will sell your information to dozens of insurance agents. Your phone won’t stop ringing and your email will be stuffed with “buy me” notices.

Georgia Medicare Plans never sells your information to anyone. We call once. That’s it. You decide if you want more information.

Shop and compare now.

medicareplansgeorgia

 

Tony almost made a $6,000 mistake

Tony is turning 65. Like everyone else he is bombarded with information about available plans. And Tony has asked friends which plan they have and would recommend.

But Tony also likes to do his own research. That’s how he found me.

bag_of_moneyMost of his friends have a $0 premium Medicare Advantage plan. Tony has a chronic condition that is under control and he has doctors he trusts. He wants a plan that includes his current doctors.

Tony was proactive and asked his doctors which plans they accept.

“All of them”.

That’s when he found my site. And then he called.

We talked for a few minutes and discussed the differences in original Medicare and a supplement plan vs. Medicare Advantage. Tony was not aware that doctors can be dropped from an Advantage plan in mid year. He also was not aware of the out of network restrictions and penalties. We discussed out easy it is to slip out of network, especially with P.A.R.E. claims.

Then we talked out Medicare and Medigap plans. We also looked at his expected annual cost of health care.

Failing to consider your cost of health care is one of the 4 mistakes almost everyone makes.

But it was the discussion about his meds that brought things to a head.

Tony takes two specific medications to keep his health in control. One is relatively inexpensive, the other is not. He gave me a complete list of his medications and I ran a prescription drug report for him.

After looking over the list I decided to do something I rarely do. Medicare drug reports are quite detailed, and confusing. I normally just show clients the top two plans rather than sending them 20 or more to review.

I repeated the process for the $0 premium Advantage plan he said he wanted.

Then I compared the results.

The Medicare Part D plan with the lowest annual drug costs would result in $3,000 in out of pocket costs for his medications.

The $0 premium plan would have him spending almost $9,000 for the exact same medications.

If Tony had taken the advice of his friends and purchased the $0 premium Advantage plan he would have made a $6,000 mistake.

Can you afford to make that kind of error?

Give us a call to discuss plans that fit your needs AND budget. Or you can start the process by using our online instant quote engine.

 

 

 

#MedicareAdvantage #Medicareannualopenenrollment