This month, October, is going to be a busy month for seniors and other Medicare beneficiaries. October 15 through December 7, 2013, is the timeline to check out the Medicare Part D prescription drug program to see how the insurance companies are going to be treating us for the next year.
By Sept. 30, you should hear from the company whose plan you are on with information about what changes they are planning in the cost of your monthly premium, deductible and formulary, as these may change from year to year. If you need to change your plan or company, you must do it before Dec. 7, as you will not be able to do it after that, unless you are also on Medicaid or new to Medicare.
The average Medicare Prescription Drug plan premium will remain around $30. The formularies (list of covered drugs) often change from year to year. Drugs and restrictions can be removed or added. Check to see how the medications you currently use will be affected.
When you reach the “Doughnut Hole,” the time when the companies will not be paying for your medications, there will be a 50 percent manufacturer’s discount for brand name drugs and a 2.5 percent government discount for a total of 52.5 percent. The discount for generics during the “Doughnut Hole” will increase from 21 percent to 28 percent.
If you need help, you may make an appointment to see me at 276-1059. If you do not live in Anchorage, I will be able to help you by phone, and if you are in another part of Alaska, call me toll-free at 1-800-478-1059.
Health Insurance Marketplace
By the time you are reading this, the Health Insurance Marketplace will be open and you will be able to see all the new health plans and decide if you want to change from the health insurance plan you now have, or if you can find a plan that might be better than the plan you already have. These plans from the Marketplace or Exchanges are called Qualified Health Plans (QHPs).
If you like the health insurance you have, you do not have to do anything. You will keep your own health care insurance.
The Health Insurance Marketplace is only for the people who do not have insurance or who are dissatisfied with the insurance they already have. In order to view the plans, you will have to be on the Internet at http://www.healthcare.gov. Or call 1-800-318-2596 and speak to a person called a “Navigator,” who will be able to assist you.
If you do not have any health care insurance now, you have until March 31, 2014, to buy insurance. You may think you are young and healthy now, but please believe me, stuff happens and things change quickly.
I know that when I was young and healthy, I never dreamed that I would live to be as old as I am now, or I would have taken better care of myself. But even if I had taken better care of myself, I could not foresee the health issues I have now or the odds of being in an accident and not have the means to pay for health care.
Without insurance, if you should get into an accident or have a debilitating health issue, the costs could be enormous and you could go bankrupt trying to pay for your care.
You will not be able to get insurance at the Marketplace again until 0ct. 1, 2014. However you will still be able to get private insurance, but you will be subject to the financial whims of any agency that is not in the Marketplace.
An easy way to find out what you are eligible for is to use the Internet at http://www.benefitscheckup.org. If you do not have access to the Internet, most libraries can give you access to theirs or you can call me and I will be able to help you. The program is easy to use. You just input the information it asks for and you will get a print out of all the programs that you are eligible for.
If you have any questions or opinions about anything you see in my column, please contact me.
Correction
Some people have been confused by the term “under insured,” which I used in my September column. To be underinsured means that there are certain things that your insurance company will not pay for even though Medicare will pay for them. It does not mean that you are under income limits or you are low-income. Certain state employees or retirees are considered under-insured because their insurer, AlaskaCare, will not pay for the Zoster vaccine for shingles, even though Medicare will pay for it. I hope this clears up any misunderstanding I may have caused.
Rita Hatch volunteers for Older Persons Action Group’s Medicare Counseling and Assistance program. Call her at 276-1059 in Anchorage, or toll-free statewide outside of Anchorage at 1-800-478-1059. Her e-mail address is ritaopag@gci.net.
