Money in the Middle

Sandwich Generation Talking About Money Up, Down and Across Generations

Posts Tagged ‘Medicare part d

Get Ready to Help with Medicare Insurance Decisions

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This is the time of year when people on Medicare prepare for open enrollment.  And you thought you were done with that when you left the workforce.  But, Medicare has an open enrollment period each year for Medicare beneficiaries who want to enroll or change Medicare Advantage and Medicare Part D plans.

 For many of us in the sandwich generation, it’s a time when we lend a hand to an aging parent or family member to figure out if they need to change plans – either for cost reasons or because their medical needs have changed.  It can be pretty confusing no matter what your age.  But it really is worth taking the time to compare plans and make sure you’ve got the right plan and the right price.

 The good news is that prices for Medicare Advantage and Medicare Part D plans won’t be changing much from 2010 to 2011. 

Plan prices will be about 1 percent lower, according to the Centers for Medicare & Medicaid Services. 

You may still have to shop for a new plan during open enrollment – if the plan has changed benefits, health care needs have changed or the plan is exiting the business. It’s also smart to check and make sure the plan you’ve got is still the right plan.  During this special period you can switch plans without having to worry about health conditions limiting your choices.  This period doesn’t apply to Medicare Supplement Plans.

 Those who have Medicare Advantage plans or Medicare Part D plans can change their plans during the Annual Enrollment Period (AEP) from Nov. 15 – Dec. 31. 

Longevity Alliance, a national insurance brokerage, is offering an AEP Reminder service.  You can sign up to receive an email when most of the 2011 plan information is available.  That way you won’t have to keep calling to find out about rates for 2011 and you won’t let it slip!  You can sign up for the free service by clicking here.

Rate and plan comparison tools are available at  But the 2011 rates usually aren’t loaded into the system until mid-late October.  So keep checking back and make sure you are looking at 2011 rates. 

“Even with the lower costs, all beneficiaries should take time this Fall to compare their current health and drug plan coverage with what’s available and best meets their needs for next year,” said Jonathan Blum, deputy administrator and director of CMS’ Center for Medicare.  “Medicare will continue to provide a wide-range of consumer tools to help beneficiaries make the best possible choice of coverage.”  

Rates and benefits for specific 2011 plans are generally released between Oct. 15 and Nov. 1.  The government rules say you can’t buy a plan until Nov. 15, but you can start shopping and comparing rates so you don’t end up in a last-minute rush.  And you’ve got to shop to save and/or make sure you’ve got the right plan for your current medical needs.

 Don’t wait too long. The companies handling this business get very busy.  You’ll get more attention and assistance, if you need it, if you look early in November and apply as soon as you can – November 15.  And make sure you compare plans and fully understand the co-pays and network limits since a low-cost premium may just shift costs  and you’ll find you’re paying more at the doctor and the pharmacy.


Written by Laura Rossman

September 23, 2010 at 1:17 pm

Preparing for the Medicare Shopping Season

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Medicare Part D Covers Prescription Drugs


Medicare Part D Prescription Drug plans will cost about the same in 2011 as they did in 2010 according to information released yesterday by CMS (Centers for Medicare and Medicaid Services).   

Good news for Medicare beneficiaries.  And good news for sandwich generation adult children who assist senior family members or aging parents with making Medicare plan selections. Maybe fewer will face the confusion of changing plans.   

But don’t assume the 2010 plan is still the best plan for your health care needs.  You’ll still want to shop and compare plans – and watch out for changes in the co-pays that can boost out-of-pocket expenses.     

This announcement marks the start of the Medicare shopping season also known as Annual Enrollment Period (AEP).  Medicare beneficiaries can change Part D and Medicare Advantage plans only from Nov. 15 – Dec. 31 for plans effective in 2011.  You can’t do much with the information yet.  But come mid-October there will be specific plan information available on the government website so you’ll be able to compare you current plan with 2011 plans.  

Here’s the schedule leading up to AEP:   

September –Information about premium and benefits for each Part D and Medicare Advantage plan  

October – More detailed plan information is available so that you can begin comparing plans  

Nov. 15- Dec. 31 – applications for plans effective in 2011 can be accepted  

 Here’s the statement from Medicare on part D premiums for 2011.   

 “Most Medicare prescription drug plan premiums should remain relatively stable next year, and all beneficiaries should compare their coverage under their current plan with the plans that will be offered in 2011 when that information becomes available in October,” said Jonathan Blum, deputy administrator of CMS’ Center for Medicare. “The Affordable Care Act improves the value of drug coverage people with Medicare will receive next year, providing discounts on brand name drugs and coverage of generics in the coverage gap, or donut hole.”

Written by Laura Rossman

August 19, 2010 at 3:33 pm

Compare Medicare Part D Costs Before the Deadline

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We’re coming to the end of the Medicare Part D open enrollment period for prescription drug coverage.  If you or an elder you are watching out for has a Medicare Part D plan or a Medicare Advantage Plan with prescription drug coverage, the Dec. 31 is coming soon.

 I help my mom with her coverage and to tell you the truth I didn’t think there was any reason to make a change this year.  At least until she got her bill yesterday for 2010. 

The premiums almost doubled!  And while she does not take a lot of prescription drugs, I thought I better do what I tell others to do and check the options available to her.

I was surprised to find out how much the Medicare Part D landscape has changed.  Fewer plans, higher rates, shifting tiers (the level of payment the plan will cover according to it’s formulary).

I see the TV ads promising average savings of $400, $600 and wonder how can that be.  Well, now I see and it doesn’t take long to add up.  An increase of $10-15 per month in the cost of the plan, a shift in the formulary leading to even just $10 more per month adds up in no time at all.

 So, if you haven’t done it, take the time to compare.  Don’t assume the plan you have is the best value for 2010. And don’t get caught feeling bad for switching.  Even Medicrae tells you to shop and compare!

Go to prescription drug comparison tool and take the time to put in the prescriptions that you or the person you are helping is currently taking (you’ll need the name of the drug, the dosage and frequency).  If you have their Medicare number you can have it compare against the current coverage.

You can purchase directly from the site, go to the health care plan itself or an insurance agent or broker who handles that plan.

If you aren’t sure, try a insurance broker that represents a number of companies and offers to help you compare plans.  The only caution here is if they are commission based, remember that they may receive more if the plan they sell you is more expensive.  So ask.  Some companies pay their agents a flat fee no matter what plan is selected which helps assure that your interests and theirs are aligned.

Looks like we’ll save about $300 by switching to a different part D plan.  Not that we were unhappy with them — just didn’t make financial sense to stay.  Nice way to start 2010.

Did you have a similar experience with part D this year?

Written by Laura Rossman

December 15, 2009 at 5:03 pm

Switching Medicare Plans? Get Info Now!

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Even if you aren’t eligible for Medicare, you know that something is going on with the volume of advertisements about Medicare Advantage and Medicare Supplement plans.  It must be about every other ad on cable TV.

What’s going on?

We are in the annual enrollment period for Medicare Part D Prescription Drug plans and Medicare Advantage plans. Marketing started October 1. Plans can be switched from Nov. 15 to Dec. 31.

So if you’ve already got coverage, why would you want to switch or help your elder change plans?  Because the marketplace is changing – and will probably be changing some more if and when the health care reform bill passes.

While many have found Medicare Advantage to be cost effective and packed with extras (gym memberships, vision and dental discounts), but the product is changing.  So read your benefits carefully.

Some insurance companies have cancelled Medicare Advantage plans leaving policy holders to find new coverage.  Others have increased premiums or co-pays.  So that now the price difference between a Medicare Advantage plan and some of the Medicare supplement plans may not be as great.

It’s not clear what we’ll see in the future, but many of these plans may look much different from when you shopped them two or three years ago.

Here’s a good article from the NY Times about examining your Medicare health plan options.

I’d add to their recommendations to make sure you get quotes from a couple of different companies.  For example, Medicare Supplement plans are standardized which means plan benefits are the same no matter what the company.  But the prices sure aren’t. Over a year you could be paying hundreds of dollars more from one company than another.  So shop and compare Medicare health plans. 

If you’ve had retiree insurance from your employer and this is your first venture into the Medicare health plan maze, you might want to work with a broker who specializes in Medicare health plans.  Make sure they are experienced and can show you a couple different companies and plans.

And Part D plan formularies – the list of drugs that are covered at what rate – change too.  So if your medications have or will be changing, you might want to look at other part D plans to see if the one you have is still right for your needs.

And always check with your doctor accepts the plan you are considering.

So don’t delay. the sooner you get the information, the sooner you can make a decision and not get caught in the last-minute chaos of getting your application in on New Years Eve.

Written by Laura Rossman

November 4, 2009 at 8:05 pm

Manuevering the Medicare Open Period

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Take a deep breath.  It’s the one time of year when you can change Medicare Advantage or Medicare Part D plans. That can be good news, but it’s not stress free.

This year is even more stressful for thousands of people who are receiving notice that their plan is being discontinued and they have to select another Medicare plan.   If you or a family member whom you are assisting is in this position, start looking at options right away.

Here are some things to consider:

  • If you have been in a private fee-for-service plan that has been cancelled and want to move to original Medicare (Part A and Part B) and purchase a Medicare Supplement plan and Part D plan, you probably won’t have to go through underwriting.  But ask, and make sure you know the deadlines by which you need to apply.
  • Medicare Part D – most plan price increases have been modest, but if your health condition has changed during the past year and your medications have changed, it might be worth comparing your plan to others.  One key is the “formulary” that is the list of drugs and how the insurance plan covers each drug.  The differences can be dramatic.  The site has a part D plan comparison tool that can be very helpful in deciding whether to change plans.
  •  Don’t just look at the premium.  Look at out-of- pocket costs, deductible and co-pays – especially for Medicare Advantage and Part D plans – when you are doing your comparisons
  •  Remember, if you have just Medicare part A and Part B that will only cover about 80% of your health care costs.  A Medicare Supplement Plan and Part D close that gap. Generally, you have a wide choice of doctors and hospitals who accept these plans. 

Medicare Advantage plans wrap Part A., Part B and Part D (Usually) together.  The premiums are usually lower, but you’ll be restricted to a network of doctors and face more out-of-pocket co-pays.

 There’s no right or wrong plan—it depends upon your health care needs and preferences. That makes it harder, but also more important to take the time to look at options.  Given, the escalating cost of health care it’s more important than ever to make sure you have the best plan for your health care needs.

As the end of the year deadline approaches, it can be harder to reach companies for information.  So start now.

Find more resources at

Written by Laura Rossman

October 12, 2009 at 2:00 pm

Get info on Medicare Plan Changes: Don’t Delay

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If you are a Medicare beneficiary, or helping a Medicare-aged person with their finances, this is the time to shop and compare Medicare Part D and Medicare Advantage plans.  

So make sure you read the Notice of Annual Change – that comes from the insurance company.  Look for changes in premium as well as changes in co-pays and benefits – since it is the total of these changes that will impact your costs of health care.

Or, if your health has changed or your medications have changed, this is the time to look at options and see if the plan you have is right for you now.

Here’s how this works:  marketing begins October 1.  that gives you six weeks before you can apply – time to be spent shopping and comparing whether the plan you have is the right plan.  Beginning Nov. 15 – Dec. 31, changes can be made to Part D plans.  If you are in a Medicare Advantage plan you have until March 31, 2010 to switch to another Medicare Advantage plan. 

If you’ve got a Medicare Supplement plan,  you aren’t impacted by the open enrollment period unless you want to switch into a Medicare Advantage plan. 

Medicare said that rates on Part D plans are up only slightly over last year.  But, rates on some Medicare Advantage plans are changing a lot and some plans, especially Private-fee-for-service (PFFS) plans, are being eliminated.   

The website has information as well as comparison tools to help you figure out potential options.  You should also consider speaking with your insurer to see what options they may have and to a broker who represents a number of companies so you can compare rates and benefits among companies.  Try a site like where you can get comparisons and the assistance of an agent.

 Like open enrollment for healthcare at an employer, these dates are firm.  So make sure you take steps now to compare plans and prices to make sure you’ve got the right plan for 2010. 

Here are the upcoming deadlines for Medicare Part D and Medicare Advantage plans:

  2010 Medicare Advantage & Part D Prescription Drug Enrollment

October 1 – Marketing begins for 2010 Medicare Advantage & Part D Rx Drug plans

 November – Medicare and You” 2010 arrives in the mail

November 15th – Annual enrollment begins for Medicare Advantage & Part D Rx Drug plans

December 31 – Enrollment deadline for 2010 Part D Rx Drug plans.

March 31 – Enrollment deadline for switching Medicare Advantage plans for remainder of 2010

 Resources: open enrollment information and phone numbers

Written by Laura Rossman

October 5, 2009 at 7:22 pm