To All Senior Citizens:
Seniors may see their Social Security increases next year trimmed back by higher prescription costs unless they shop for a Medicare drug plan this fall that better fits their budget.
Social Security beneficiaries will get an average of $63 more each month, but part of that increase may be claimed by higher premiums and out-of-pocket costs in their drug coverage.
Plans change premiums, deductibles, co-payments and the drugs they cover each year, so the best choice for someone one year may not be the best the next year.
Insurers were required to notify their customers by last week of any changes planned for 2009.
The financial crisis has made it especially important for seniors to check the cost and coverage of their drug plans during this year's six-week enrollment period beginning Nov. 15 thru Dec. 31 to be effective Jan 1.
If consumers remain in their current Medicare drug plan, they'll pay an average of 24 percent more in premiums next year. Consumer advocates say the motto for this fall’s enrollment period should be “Shop til your drug costs drop.”
The highest-priced plans offer the broadest coverage, such as help with generic drugs in the "doughnut hole," where beneficiaries with standard coverage bear the full cost of their prescriptions.
Thirteen plans in
The hole will be larger in 2009. Seniors without gap protection will pay the full price of their prescriptions after their total drug expenses reach $2,700 next year, up from $2,510 this year.
They are then on their own until their out-of-pocket expenses hit $4,350, compared with $4,050 in 2008. At that point, catastrophic coverage kicks in, and Medicare pays 95 percent of the bills.
Seniors need to consider more than premiums, Premiums are only one component. Even more important are the costs of the drugs and the co-payments or coinsurance amounts that beneficiaries must pay.
A number of insurers are trying to gain a competitive edge over the $4 drugs at discount stores by promoting no co-payments on popular generics.
More assistance
Government officials are stepping up efforts to encourage low-income Medicare beneficiaries to apply for extra help with drug costs.
Eligible seniors can get help paying for their drug plan's monthly premiums, annual deductibles, co-payments and any costs they may have in the doughnut hole.
The amount of extra assistance depends on your income and assets. Single people can qualify with annual incomes below $15,600 and resources under $11,990. Couples must have incomes below $21,000 and resources under $23,970.
Many people have paid needlessly for their prescription coverage because they aren't aware of the extra help.
After beneficiaries complained of high-pressure sales tactics by insurance agents a year ago, Medicare revised the rules that insurers must follow in marketing their plans.
If a sales agent comes to your door uninvited or calls without your asking, he's breaking the law. Don't let him in or talk to him. Medicare can be confusing and many seniors appreciate getting their questions answered face to face.
Medicare's improved plan finder now rates plans on the quality of their customer service, the accuracy of their drug price information and their responsiveness to customer complaints. The ratings range from one star, for poor, to five stars.
Get help with your choices – call me today at 903-583-0010 to go over your coverage for 2009 RX plans and see if you have the best plan for RX and MEDICARE SUPPLEMENTS.
Changes for 2009
Drug plans sold in Texas
2008: 56
2009: 53
Plans with no annual deductible
2008: 33
2009: 30
Plans that cover generics in the gap
2008: 16
2009: 13
Annual deductible for basic plans
2008: $275
2009: $295
Paula Galyon
Galyon Insurance
393 CR 1433