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Aging Well
Medicare Rx - What's in it for You?The new prescription drug plan is complex. Here are a few pointers…It won’t be fully up and running until 2006, but there’s already plenty of confusion about the new $500 billion Medicare prescription drug benefit. Many aspects of the legislation have yet to be worked out. However, there are some things to think about now, say APPRISE* counselor Neil Powell and registered pharmacist Jay Needle of Lehigh Valley Hospital and Health Network.First comes the discount card, which may or may not help you. This year and next, you can buy a card for about $30 that could save you an average of 10 to 15 percent (higher in some cases) on brand-name drugs and more on generics. If you’re low-income, you’ll get additional help. The new card may not be better than the various discount programs already out there, especially PACE (for low-income Pennsylvanians age 65 and over). But give it a look, Powell says. More than one company will offer the card, and competition could mean better deals. Then comes the big choice: whether to go with the new Medicare drug plan in January 2006. You’ll need to balance the cost of the plan (monthly premiums of about $35, plus a $250 deductible and co-pays) against what you spend on prescription drugs. You’ll have six months to decide, and a range of options—including at least one that isn’t a managed care plan—to choose from. Some issues to keep in mind: If you say ‘no,’ it will cost extra to say ‘yes’ later. The longer you delay, the higher the monthly penalty added to your premium in all future years. So think carefully. Your drug costs may be low now, but could rise later. Your drugs may not be covered. Each company offering the new plan can decide what drugs to put in its formulary (list of covered medications). Do your homework and talk to your doctor about your options, including generics. There’s a gap in coverage. (See What the New Plan Covers, in the sidebar.) If you’re on a company drug plan, it’s probably your best bet. As of 2006, your company will only be required to give you coverage comparable to the Medicare plan—but Powell believes some companies will decide to keep their more-generous benefits in place. So, is it a good plan? For very low-income people, the answer seems to be yes. “Overall, however, I think this plan is poorly constructed, and it seems to favor big business without giving much of a break to the consumer,” Needle says. “The biggest issue for me is the cost to future generations, because the plan doesn’t address the larger issue of funding Medicare.” He and others acknowledge that the new legislation may be reshaped in the next two years. “Educate yourself,” he urges, “and share your opinions with your congressman.”
Want to Know More about the details of the new Medicare plan, or about other drug discount cards? Click here or Call 610-402-CARE. This page last updated 2/12/08 04:08 PM
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