Health & Medical

I Find Plan D’s Recommended Companies Change by the Week

While your description of the new Medicare part D drug program is quite descriptive, your overall experience with Medicare on this sounds worse than my experience.

When the web site first came up I went on and tried to determine the superior plan for myself and my wife. After supplying all the information I was allowed at the time, it was recommended that we go with Blue Shield for my wife and a plan I cannot recall for myself.

I revisited the site numerous times over the next several weeks and found that the recommended plans changed at least once a week! Early on I could find no plan claiming to eliminate the doughnut hole. However, after several weeks and supposed corrections to eliminate problems with the program, they seemed to stabilize at the Humana Complete plan for my wife and the Humana Standard plan for myself. Since that time they’ve only changed on time when another plan showed a dollar cheaper for the year and lost it the next week.

Based on the figures I’ve been able to extract from Medicare and the Humana web sites it would currently appear that I will benefit about $1,924 for a year of my prescriptions. My wife stands to benefit about $4,000. This means that this program will either be increased in cost substantially in 2007, their formulary will change radically throughout the year or there will be substantial increases anywhere allowed by the law in order to recoup this expenditure.

According to my research, the Humana Complete plan is the only plan eliminating the doughnut hole. We could well lose that benefit this coming year if it costs Humana. Other plans are a myriad of variations on the basic 250, 75%, 2,250 and 3600 with some plans eliminating the deductible or reducing it and making various adjustments on their drug prices and formularies that we might be sufficiently confused. We each take one drug which is not currently on their formulary and is not available from Canada.

Because of my experience with the internet and my broadband connection I’ve helped others work their way through the maze and it seems that frequently Humana Complete is the best dollar value for persons using extensive drugs while those with lesser needs will fare better with Humana Standard or some other competing program.

One thing the Medicare site does is to compute the cost of drugs from each plan based on their formulary and your needs, together with the cost of the drugs for the remaining year after you have expended your $2,000 benefit and after the deductible and then compares the total, including premiums and deductibles from one company to another. This does not preclude the company from changing it formulary or its “Tier” to cut its costs if needed.

For myself, I’ll use as much as is available and try to direct most of it to drugs which I currently cannot get at a better deal out of Canada, such as insulin, narcotic drugs and emergency prescriptions for infections, etc., throughout the year. I’ve saved substantially on Canadian drugs over the past couple of years and any person not on Medicare who has any difficulty paying for drugs would be well advised to consider this route regardless of horror stories from the drug pushers greatest spokesman, George Bush.

I didn’t try to go through the telephone route for information as I like to see what I’m being told, not just hear it. My past experience in getting a discount drug card for my wife over the phone was excellent and the Medicare representative was patient, knowledgeable and eager to assist. This make me wonder about the lady who could not tell you what that status of the doughnut hole was and who insisted that you would be punished if you did not sign up before January first. You have until May 15th to sign up without penalty (or to change plans one time).

Humana’s web site has a link letting you enter your meds and doses, then showing what you would pay under any plan each and every month throughout the year. If you have all meds refillable for three months, there will be months shown with no drug expenses at all and other months reflecting a three month expenditure for drugs.

My sister attended a sales session provided by a Humana representative and though she is 74 years old she is just as bright and intelligent as ever and has good hearing. She was repeatedly put down and insulted by the salesman to the extent that after he left the hostess for the meeting commented “he was mean to you”. While he was pushing the Humana Enhanced plan for everyone her end decision was that if she bought Humana it sure wouldn’t be from him. It would appear that the salesman had less knowledge on what was best for anyone than the average knowledgeable person with a computer and the willingness to do the study the salesman hadn’t!

I’d like to say that its bound to get better but when it is a plan put together initially be people who don’t believe in Medicare or Social Security, and was actually assembled by a “committee” of insurance companies who went out of their way to make it confusing so you would rely on their salesman, I can’t help but feel it may get worse instead of better!

We senior citizens have one ray of hope in that we may not live long enough to reap the “benefits” this administration would dump on us. The younger persons of our society will have to live with it!


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