Elder Care Expert Provides the Solution to Selecting a Medicare Prescription Drug Plan

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The Annual Election Period for the Medicare Prescription Drug Program begins on November 15. To select the best plan, seniors need their web-savvy Boomer children to use the Drug Plan Finder at http://www.MEDICARE.gov.

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What you need to focus on is total estimated annual cost

As the November 15th beginning of the Annual Election Period for the Medicare Prescription Drug Program nears, many seniors and their caregivers are still in the dark about how the program works and how to make the most of it. It's something Esther Koch, gerontologist and elder care expert, sees every year and she says that it's costing seniors and their families. "Many seniors in the U.S. are spending more money on prescriptions drugs than they have to because they're confused about the basics of the Medicare Prescription Drug Program," she says. And in the current economic downturn this can really have an impact.

When it comes to prescription drug coverage seniors fall into 4 groups: seniors with employee or retiree drug coverage; those in Medicare Advantage Plans with drug coverage; those in low income subsidy programs; and seniors who are in stand-alone Medicare Prescription Drug Plans or have no prescription drug coverage.

It's that last group that needs to act, and Koch offers this essential guidance for them.


Why? Because even if their medications haven't changed it's almost certain that their plan's formulary of drugs covered and pricing have. Medicare contracts with a variety of insurance companies to cover drug costs. "What few seniors or caregivers know is that these insurance companies submit new plans to Medicare each year," says Koch. Last year's plan is not this year's plan and that means that it's unlikely that the best plan for you last year is still the best plan for you this year. In fact, Koch says, "I have yet to have a client whose optimum plan choice remained the same each year."


It seems logical that choosing a drug plan with a higher premium is going to give you more benefits, but when it comes to Medicare Prescription Drug Plans this simply isn't true. "What you need to focus on is total estimated annual cost," notes Koch. This takes into consideration all the variables including the plan's formulary of drugs; individual drug classifications and pricing; monthly premiums; deductible amount; whether donut hole coverage is provided; and when catastrophic coverage is triggered.

Koch likens the process of choosing a Medicare Prescription Drug Plan to comparison shopping for holiday gifts. "If you can buy the same gifts at Store A for 50% cheaper than at Store B, the smart person would buy them at Store A. The same principle applies here. "You need to compare the total estimated annual cost of your parents' specific drugs by plan and then choose from amongst the least expensive plans," she says.


If choosing the right plan sounds like it requires sifting through a lot of information, it does. Luckily, the government offers a powerful online tool that makes this process easy to manage. "Web-savvy Boomers can help their parents compare stand-alone drug plans by using the Medicare Prescription Drug Care Plan Finder. By entering their parents' ZIP code, drug names, dosage information, and 30-day supply amounts, Boomers can obtain a prioritized list of drug plan options sorted from the least expensive to the most expensive plan based on total estimated annual cost. The 5 least expensive plans will show up initially. You can display all plans, do a side-by-side comparison of 3 plans and drill down to obtain specific information on how to lower drug costs. The drug list can even be saved for later reference.

An added benefit of this is that the children of senior parents become informed of their parents' medications, health conditions, and insurance coverage. "This is a wonderful opportunity for Boomers to be there for their parents and to take an active role in their healthcare. They need you!" says Koch.

The Annual Election Period for the Medicare Prescription Drug Program runs from November 15th to December 31st.

Esther Koch is a gerontologist and elder care advisor based in San Mateo, California. She is the founder and CEO of Encore Management, which provides personal and corporate corporate advisory services and educational products to assist Boomers with the range of issues associated with caring for an aging parent and their own aging. Koch is a Medicare Aging Network Partner with the Administration on Aging and the Centers for Medicare and Medicaid for the Medicare Prescription Drug Program. She was also a delegate to the most recent White House Conference on Aging.

Koch received her graduate degree in gerontology from USC and is a member of the National Association of Professional Geriatric Care Managers, the Business Forum on Aging of the American Society on Aging, and AARP. In addition to being a Stanford MBA, she is also a CPA and former Chief Financial Officer and PricewaterhouseCoopers tax professional. She left corporate America to pursue her passion for eldercare advocacy. Since then she has helped hundreds of private and corporate clients navigate the physical, emotional and financial challenges of aging. She has been interviewed on TV and radio, and in print media. Visit her at http://www.ENCOREmgmt.com.

Lorna Garano
lorna garano @ gmail.com


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