Posted 2:47 p.m. Wednesday Updated 6:19 p.m. Wednesday By
Liisa Ogburn
Each year, from Oct. 15 to Dec. 7, the 64 million Americans
enrolled in Medicare can change their Medicare plans - including Medicare
Advantage plans, prescription drug plans, and if qualified, elect a Medigap or
Supplement plan without penalty. While doing so can save some seniors hundreds
or even thousands of dollars, only 10 to 15 percent choose to do so each year.
In fact, in a program that helped University of Southern
California retirees navigate finding the best Part D plan, participants saved
on average $1,104 in 2015 and $1,066 in 2016.
Why don't people take advantage of this potential savings? It's
daunting and often people don't make a change until there's suddenly an obvious
and dramatic increase in costs.
The Senior Health Insurance Information
Program (SHIIP), an independent program funded by federal agencies,
is not affiliated with the insurance industry. Its counselors provide free,
unbiased and factual health insurance to North Carolina residents.
Van Braxton, N.C. SHIIP director, stated,
"(In 2017), SHIIP counseled more than 105,000 NC Medicare beneficiaries
and helped them save $44.3 million dollars. SHIIP also served almost 21,000
Medicare beneficiaries with disabilities, and more than 29,000 with incomes
below 150 percent of the poverty level."
Earlier, when I was a volunteer with SHIIP, a
senior who I'll call Alice, told me that her drug costs for five prescriptions
had skyrocketed over the past year by more than $300 per month. She said she
had stopped taking everything.
Alice is not alone. A survey by the National
Center for Health Statistics found that from 8 percent to 14 percent of
patients don't take their medications due to expense.
Having seen some of the costs while helping
people enter their drugs into their Medicare.gov record, I'm honestly surprised
it's not higher --especially given that, according to a 2009 Alliance for Aging
Research report, individuals 65 to 69 years old take nearly 14 prescriptions on
average per year, while individuals aged 80 to 84 take an average of 18 prescriptions
per year.
The interesting thing is that the costs for
medications can fall all over the map and vary dramatically between drug plans.
While a senior might assume that they can simply not afford their drugs, that
might not be the case if they look to other plans.
Each year, insurance companies revise
formularies, deductibles, co-pays and premiums. While a drug might be covered
by a plan one year, it might not the following year. Likewise, an individual's
medication list might also change drastically. Some particularly expensive
drugs are not covered at all.
In the case of Alice, a polite but flustered
73-year-old grandmother who had worked many years, we did find a plan for a
considerably lower annual cost. Her out-of-pocket cost for the premium, deductible
and drugs would be around $2,200 annually; whereas on the older plan, she would
pay almost $4,800.
Unfortunately, the $2,200, after she paid for
her Part B and Supplement plan, was still beyond her reach. However, Alice
learned she qualified for Extra Help, which is a federal subsidy that helps
people on limited income pay for their Medicare Part D drug plan. She also
received help paying for her Part B costs.
Only around one in 10 Medicare recipients
bother to assess whether they should change plans each year. While not all of
those who do compare plans find such a significant cost savings, according to
U.S. News and World Reports, there is an average overspending for those who do not
switch of $373 per year.
How do you switch? To begin, go to Medicare.gov and select "Find plan."
You'll be asked to enter your Medicare information, your current drugs (levels
and amounts) and preferred pharmacies.
Once everything is entered, the site generates
a list of plans, ordered by cost. You can choose which plans to compare
side-to-side. If you are satisfied that you have found the best plan, you can
enroll right from the site. The insurance company for your new plan then
informs the company for the older plan of the change.
The change goes into effect on Jan. 1.
However, if you would prefer to get help, call
SHIIP at (855) 408-1212. You can ask questions by phone or you can schedule an
in-person meeting with a volunteer counselor. To find a volunteer SHIIP
counselor who you can meet with in-person, visit here on the Department
of Insurance website.
Don't delay. That Dec. 7 deadline will be here
before you know it.
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