Posts Tagged ‘what is supplemental health insurance’

postheadericon Do Medicare Supplement Plans Help Seniors With Prescriptions?

Despite the good news that average Medicare Advantage plan premiums will decrease by four percent next year, there is distressing news for Medicare beneficiaries. According to a recent study by Avalere Health, co-payments for brand-name drugs will increase in 2012. Co-pay is a specific amount that your health insurance plan may require that you pay for a specific medical service or supply. For example, your health insurance plan may require a $25 co-payment for an office visit or $35 for a brand-name prescription drug, after which the insurance company often pays the remainder of the charges. Co-pays for preferred brand-name drugs will increase up to 40 percent, while non-preferred brand name drugs will increase by 30 percent, on average. Preferred brand-name drugs are usually drugs for which the prescription drug plan has negotiated a discount with the manufacturer. As for preferred generic drugs, copays will remain unchanged. For non-preferred generics, co-pays are expected to drop by 43 percent.

Medicare beneficiaries are also expected to pay a bigger share of the cost of specialty drugs, which can exceed $1,000 per prescription. Specialty drugs include most of the newer treatments for chronic diseases such as multiple sclerosis and rheumatoid arthritis. New anti-cancer drugs that come as pills are also considered to be specialty drugs.

Can Medicare Advantage Plans Or Medicare Part D Prescription Plans Help?

Most Medicare Advantage Plans help with some, but not all, prescription drugs. The same is true for Medicare Part D, so you don’t need both an Advantage plan and a Part D plan. Always check which medicines are covered under each plan. Medicare announced that Medicare Part D plan premiums would remain unchanged in 2012. Premiums still average about $30 per month. Based on the Avalere study, plans with the lowest monthly premium may not always be the best deal. Dan Mendelson, Avalere CEO, said, “Seniors need to look beyond the premium to understand their drug benefit. The more the cost burden gets shifted onto the patient who needs the medication, the more important it is for seniors to understand that next level.”

According to Medicare officials who read the study, the broad averages of prices charged by prescription drug plans do not determine what an individual beneficiary will end up paying. Jon Blum, Medicare deputy administrator, said you cannot draw a general conclusion because everyone’s drugs needs are individualized. You need to consider the particular plan and drugs that the individual is taking.

Is The Health Care Overhaul Beneficial For Seniors?

As Blum had pointed out, the health care overhaul law is helping beneficiaries with high drug costs save money. For those who fall under Medicare’s “donut hole” coverage gap, beneficiaries can get a 50-percent discount on brand-name drugs. About 47 million disabled people are benefiting from Medicare, and about nine in 10 beneficiaries have a prescription drug plan. Medicare Part D plans have different levels of coverage. The most common plan has five levels which are preferred generics, non-preferred generics, preferred brands, non-preferred brands and specialty drugs.