During its brief four-year history, Medicare’s Part D program, designed to subsidize the cost of prescription drugs for Medicare beneficiaries, has been the subject of much debate. On one side, proponents have touted the plan’s ability to expand access to prescription drugs to seniors; on the other, critics have long questioned its design and user-friendly appeal.
Now, a report published by the New England Journal of Medicine indicates that, overall, Medicare Part D is producing favorable results. In fact, by the beginning of 2009, about 60 percent of Medicare beneficiaries were actively participating in a Part D plan. But, despite these findings, professionals in the healthcare sector cannot help but point to the large number—roughly 4.5 million—of Medicare beneficiaries who remain without much-needed drug coverage. It seems undeniable that something is standing in their way when it comes to enrolling for Medicare Part D.
“While progress has been made in terms of the accessibility of prescription drugs to seniors, there are still some inherent flaws in the Medicare Part D program that are preventing older adults from signing up for a plan,” said Roger Ebert, branch manager of the Peoria sales office of Bankers Life and Casualty Company. “In particular, the process of picking the best-suited and economical option remains a daunting task.”
Recent research funded by the Robert Wood Johnson Foundation confirms Ebert’s point. Findings from the work show that when choosing Medicare drug coverage, it is common for older adults to think they have chosen the lowest cost plan when, in fact, they have not. Additionally, researchers found that an increase in the number of insurance plans available reduced the likelihood of picking the plan with the lowest annual costs.
“Medicare prescription drug plans vary a great deal, and the sheer number of choices can be overwhelming,” said Ebert, who suggests that older adults in the Peoria area take the following points into consideration when choosing coverage:
- First and foremost, remember that you can constantly review plans and switch plans from year to year. If your prescription needs change, so may the type of coverage you need.
- If possible, sign up during your initial enrollment period, which is the three months before and the three months after the month when you turn 65. If you enroll later, you may pay a penalty in the form of higher monthly payments.
- If you already have standalone prescription drug coverage from an employer or a union, you should compare your current policy with the available Medicare plans. Just remember that if you drop your current plan, you might not be able to get it back.
- Securing a low premium is not always your best bet; focus instead on the total cost of coverage.
- Be aware that not all drugs are covered by the plans, and some plans only cover certain dosages of prescriptions. Always make sure you will be compensated for your essential drugs.
“We encourage seniors to be proactive when choosing coverage for their prescription needs,” said Ebert. “There is the possibility that they can literally be saving hundreds of dollars every year.
“Although Medicare was established to help pay basic healthcare needs for people ages 65 and older, it was never intended to cover all medical expenses,” added Ebert. “Programs such as Medicare Part D can help seniors cover more of their expenses.” iBi