Seniors, can we talk?
How many times have you heard your friends say “I’m not really happy with my prescription
card but I don’t know what to do about it?” or “I’m not happy with my Medicare Advantage plan
because my doctor does not accept it any longer. Wonder what I can do to change plans?”
Well, now is their (and your) chance! Every year between October 15 and December 7 (the open
enrollment period) Medicare beneficiaries have the opportunity to review their prescription card
and/or Medicare Advantage plan and make changes. If your plan is “not working for you”, you
can change plans. Regardless of how many medications you take or what kind of medication you
take, you can change prescription plans – you are guaranteed to be accepted. Same thing with a
Medicare Advantage plan (except if you have end stage renal disease - ESRD).
This year Ruth has decided to take David (Betty’s charming cousin) under her wing during this
enrollment period. David has never enrolled in a prescription plan or Medicare Advantage plan.
He never felt the need until he started taking some “high dollar” prescriptions and started having
a lot of doctor visits. Between October 15 and December 7 he can enroll in a prescription plan or
Medicare Advantage plan even though he currently does not have a plan. David must have
Medicare Part A and Part B, live in the county or zip code that the plan is offered in and cannot
have ESRD. All companies do not offer plans in every county or zip code in the state. Someone
who lives in Jackson County, for example, may not be able to enroll in a plan that’s available in
Independence County. (If you do have ESRD, you may be able to enroll in a “special needs
plan” designed specifically for people with ESRD.)
To further “muddy the water” for David there are more than 27 prescription plans available in
Arkansas. Each plan has a different premium. Each plan may cover different prescriptions. Each
plan has different co pays and the co pays vary based on the pharmacy you use. And the
deductibles vary but cannot be more than $340. Wow! So how will David know which
prescription plan meets his needs and covers his prescriptions? If he likes computers, he can go
to Medicare.gov, insert his information and try to maneuver through the website. Or he can sift
through the piles of mail that he’s getting. Or he can call a certified agent who represents lots of
companies and ask for help in reviewing the plans available to him (that may be the easiest way).
What about Ruth? Even though she already has a prescription plan, we will still review her plan.
Her prescriptions have not changed but the drugs her plan covers may have changed. Every
January 1 plans change.
Do you have a prescription plan? Need help? Get your
prescriptions together and feel free to call me at 501-868-6650 and say “Caroline, can we talk?