Prescription drug insurance

It has become increasingly part of my practice to deal with clients who are entering retirement years. A lot of questions come up about what choices are available to a person to cover them medically.

I am going to go over some of those choices.

Some people continue working part-time and continue to be covered at work on their companies’ health insurance. Sometimes this is the best choice, but I doubt it is in most cases.

A person can enroll in Medicare. It used to be simple, but has grown more complex. Let me try to break it down. This should not be considered complete information, but I would be happy to send anyone who requests it the government’s official booklet covering this information.

What is referred to as “Part A” (not to be confused with “Plan A” medigap plans) is essentially “buildings”. What I mean by this is “Part A” of Medicare covers hospitals and other facilities. This is why I use the word “buildings.”Its places that provide medical care, not persons. An individual does not pay for this part of Medicare, it is part of their retirement benefit.

“Part B” of Medicare covers “people”. That is, it pays physician charges, etc. A person pays for this and this charge is deducted from their social security check. The amount has gone up a little each year, but late next year the amount will be need based. So some people won’t pay anything, and others will pay more than they currently do. Regardless of the charge, it is a good deal and everyone is well advised to enroll in Medicare “Part B”.

Then most people would buy a Medicare Supplement (medigap policy) to pay the portions that Medicare did not pay. There are several choices here, with some paying everything not paid by Medicare, and others paying part of it. (Medigap policies only pay on charges that Medicare pays something on). They do not pay things Medicare does not pay on.

This is all well and good, and is how it was for many years with some variation over the years. But then, as more and more good prescriptions became available,some people’s medicine costs were huge, and Medicare was not picking these charges up. Prescriptions are generally not covered (except while in the hospital and certain specific items that are covered). So Medicare “Part D” was established. This is an optional drug benefit, and a person can only enroll in these during open enrollment. There are many plans available at a low cost. Which is best depends on a person’s prescriptions. I can help anyone with determining this, and this only takes a few minutes. Ask me about it if you’d like help with this.

At the same time, Medicare “Part C” was established. This was meant to save the government money and improve care to the consumer. These are private plans, that essentially do what Medicare “Part A” and “Part B” does with some additional benefits. These plans are also referred to as "Advantage Plans." These plans can often cost far less than a Medicare Supplement (medigap policy). There are pluses and minuses to these plans. Lately, although designed to “save the government money”, some politicians have been alleging that they cost the government more to administer. Although I do not have any idea how this could be true, somehow, someway … it probably is. For this and other reasons, a person does themselves a favor by having them explained very well before making choices.

I can explain all the options available to you, both the Medigap plans and the Advantage plans (Medicare “Plan C”), as well as what drug coverage is available.

Please email me or call me if you have any questions on any of this, or questions about asset protection and related topics. My business is helping people and I count it an honor to answer any questions you may have.