Medicare ensures that senior citizens have basic health care insurance. Many choose to supplement that with an additional plan. Part D covers prescription drug costs, but with so many different possible plans to choose from, it can be daunting. Get help with the Medicare maze in time to sign up for Part D for next year.
Guest: Gina Upchurch, RPh, MPH, is the founding Director of Senior PharmAssist, which promotes healthier living for Durham seniors by helping them obtain and better manage needed medications and by providing health education, community referral, and advocacy. Gina holds adjunct appointments in the School of Pharmacy and the School of Public Health at the University of North Carolina at Chapel Hill. 2008, Gina received the NC Health and Wellness Trust Fund’s Power of Prevention Award for Advocacy in Public Policy and in 2009 she received the Jim Long Outstanding SHIIP Service Award and the AARP North Carolina Advocacy Award. The website is www.seniorpharmassist.org.
The podcast of this program will be available the Monday after the broadcast date. Podcasts can be downloaded for free for six weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

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  1. BobK
    Reply

    beau10:
    No you are NOT dumb as a brick. Searching out all the plans is very cumbersome as each company covers different drugs differently. Copays are different and companies have different rules for brand and generics. Go to the Internet and do a search of “Medicare Part D”. You will find many sites that will narrow down your options in terms of where you live and I’m told that there are some utilities out there offered by pharmacies that will take your drug list and give you a list of the 5 or 10 lowest price plans.
    Other than that just go through each plan starting with the price per month as that varies quite a bit. Then take this list and go to their web sites (or call them) and see what it will cost you for the drugs you take and IF they will even cover your drugs. Some brand name drugs are not covered by certain plans at all. I spent several weeks getting to a reasonable plan. However, once in the plan there are still surprises when a doctor writes a prescription for a new drug. It IS a hassle. Good luck.

  2. beau10
    Reply

    Today I accessed info re Part D online and discovered I must be dumb as a dumb brick. I do not understand how this thing works and what is the best program to implement it. I can’t believe how frustrated I feel after truly trying to understand it.

  3. BobK
    Reply

    My wife and I are on Medicare Part A & B and Plan D. Bottom line is we love Medicare, but Plan D is always a problem. First there is no standard coverages for prescription drug coverage so the searching process from the many, many plans offered is difficult.
    One company will cover certain drugs where as another company will cover other drugs so you have to review many, many plans to see what best fits your individual needs. Once you select a particular plan that seems to cover your CURRENT drugs (and it can be different for me and my wife) and then during the year you may need a new drug it may or may not be covered properly under your current plan.
    Also, we never get any questionable letters about Medicare payments (Part A & B). They are always on time and never a problem. However, I can’t say that about the Part D. There always a hassle every time we go to the pharmacy. Pre-authorization seems to be a norm rather than an exception anymore with the Part D plans. It truly is a pain.
    Plus these companies always want to push generics rather than brand products. Sometimes the generics work and sometimes they don’t. But the cost of brand names is significantly higher so one is usually caught between a rock and an hard place between drug effectiveness and cost.
    So we are totally happy with Medicare Part A & B but Part D could be significantly better. But then again this is the problem with the private sector of the medical insurance industry and why there is need for a change to the current process/coverage.

  4. beau10
    Reply

    I wish someone could provide simple explanations for all the ins-and-outs of medicare and the potential minefields to avoid. Anyone with any suggestions?

  5. NJ
    Reply

    As much as I appreciate (and have for 25 years) the People’s Pharmacy, I was disappointed with this show. Ms. Upchurch failed to mention the $310 deductible that has been added to Medicare Part D this year nor did she mention the penalty for choosing not to have Part D. I take one generic drug which makes my pharmacy costs or co-pay $5 a month. I, therefore, considered not having the insurance this year but found out that should I sign up again next year, I will be penalized with higher premiums for the rest of my life. I would have liked to hear about this aspect of Part D.
    Where on earth is there a $30 premium for Part D and a $90 premium for Medicare Supplement for 2011? My Part D premium is increasing from $28 to $52. That is more than a 50% increase. I have compared costs in my state and there is nothing as low as stated on the show. Thanks so much.

  6. mary ann c.
    Reply

    My husband is on Medicare Disability and My health Ins. now. My Ins. is Cobra, (SSI disability) and the incentive is over 11/10. I will pick up 1 month at the regular price for 1 month of my HealthINS, Family Plan.
    My Health Ins said this is OK. I have a Medicare card starting 1/1/11. I am on disability now. I was going to keep my husb. on my Private Ins. until 1/1/11, and both of us will go on some Ins. Advantage or Supplement. My husband is a sick person.
    He received a kidney in 2006, and has a leg amputation in 6/10/10. He is hosp. now and the prosthetic leg is ready but not picked up due to his hospitalization. My Heatlh Ins. said I can keep him on my Family Policy until I change. Do you think this is safe?
    Is he better to be on a supplement (our HMO does not offer Supplement) but I would consider changing Ins. co). My husb. was 65 on 10/12. and I will be 65 2/1/11. He will require Sub. Acute Care at a facility. Poss. he will not be able to be well enough to receive his leg at this time. He is on Immune Suppressants for the kidney and some run $800/month. How do we survive this mess? Thank You,
    Live in NY state
    PEOPLE’S PHARMACY RESPONSE: PLEASE GET IN TOUCH WITH THE STATE HEALTH INSURANCE PROGRAM (SHIP) FOR NEW YORK AND GET SOME PERSONAL ADVICE FOR YOUR COMPLICATED SITUATION.

  7. Thanks, Jean, for posting your frustrations. As you probably know, the supplemental plans have nothing to do with the original Medicare program. As you stated accurately those plans do not provide seniors with affordable coverages.
    Yes, it is ludicrous that Medicare Part D is so complex. I will never forget when I attended a meeting of a social worker at a nursing home as part of Medicare Part D being implemented. Many of those elderly did not understand the Part D due to its complexity.
    Yes, there is a much better way. It’s for the USA to implement a health-care-for-all system. Our Improved Medicare for All system will be one of the simplest (least complex!) in the world and will be the best due to our size, resulting in excellent, low drug prices.
    See Medicare for All.

  8. Jean
    Reply

    Thank you for today’s program. I was especially happy to hear Joe let out a low roar as Ms. Upchurch rattled off information about supplemental medicare plans. As a hospital social worker (MSW) for over 20 years, I do not believe that the different supplemental plans will provide seniors and the sick with affordable coverage. It is ludicrous that medicare part D is so complex.
    Your guest spoke of benefits that will be available in 2020 and I wonder how she can keep a straight face when alluding to benefits 10 years away. The other point of contention is that the $250 check going out for prescriptions to medicare recipients should be considered a cheap bribe!
    All insurance is based on the fear factor ~ trying to anticipate what calamity might happen in the future. Having to check with doctors, hospitals, and other health care providers if they will accept a specific plan certainly feeds fear and anxiety. There must be a better plan.

  9. JoAnn W.
    Reply

    The speaker did not much about Medicare Advantage, no mention of the $0 monthly fee (they take part B payment from Medicare), she spent some 20% of her time saying uh, umm, aah

  10. steve
    Reply

    The most frustrating thing about Medicare is that it allows insurance companies to sell policies to people who don’t need them, like your caller who talked about being covered by a plan from her employer (the NEA) and a Medicare Advantage HMO, which she really didn’t need. This practice should be banned. Insurance companies know full well what coverage you have with other companies because they track co-ordination of benefits very closely. To sell someone redundant coverage is wrong. To take advantage of the elderly in this way is despicable.

  11. NND
    Reply

    Very informative presentation by Ms. Upchurch

  12. LS
    Reply

    Great broadcast as it gave concise info. Timely. My husband has never made a change in 6 years. Now he will take responsibility of researching his options every November. Thanks, everyone!

  13. Virginia
    Reply

    My current provider for Part D will not be carrying two of my medications in 2011 and has increased the premium to a point I can not afford.. I will be changing to another provider as a result of this change. After Nov 15, do I need to notify my current provider that I will be dropping them or will it be done automatically when I enroll with the new provider?

  14. Peppy
    Reply

    I’m not to the point where I need to use Medicare and supplements but our parents are and it is daunting for them. I know quite a few seniors are just throwing up their hands and going for the $4 meds. Of course, some friends have to have Plavix after stenting and did not know upfront that they would have to have this drug for a lifetime and how expensive it is. Insulin seems to be a problem too with costs. It is causing much worry and stress to afford their meds and their bills. Very sad.

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