Of all the myriad concerns surrounding senior health care, there are a few that consistently rise to the top of the list for us. One is the overall level of coverage that standard Medicare insurance plans can provide and the potential for additional coverage in Medigap plans. Another, is the current state and future state of Medicare Part D prescription drug plans. While Medicare as a whole remains under the scrutiny of government as well as the seniors who rely on it, Medicare Part D prescription drug plans continue to be a major expense for seniors, and the future (as well as the benefits) of such plans seems to be continually in question.
In a recent letter to the Joint Select Committee on Deficit Reduction from four representatives, some of the concerns about Medicare Part D prescription drug plans were brought to the fore:
Since the enactment of the Medicare Modernization Act, which created the Medicare Part
D program, the federal government has been prohibited from directly negotiating with
pharmaceutical companies for lower prescription drug prices for the 28 million seniors
and individuals with disabilities who participate in Medicare Part D. If Medicare
negotiated directly with drug manufacturers and was able to bring drug prices down to
Medicaid levels, a 2008 report by the House Committee on Oversight and Government
Reform found taxpayers would save $156 billion over ten years. Moreover, Medicare
beneficiaries could save up to $27 billion over the same period of time.
The issues with current many Medicare Part D prescription drug plans aren’t all financial, though. Along with the high cost to seniors across the U.S., many Medicare Part D plans have been viewed as unsatisfactory when it comes to quality and options. Recently, the Centers for Medicare and Medicaid Services (CMS) changed the criteria they use to evaluate Part D plans. These new criteria were developed to focus on the quality of specific plans. This meant looking at formal complaints from those who use specific plans, the number of people who bowed out of plans, and the consistency with which people kept up with their medication for major or long-term health issues. Needless to say, the new criteria did not bode well for a number of Part D plans:
“Nationally, federal officials have given negative assessments to more than a quarter of Medicare’s rated prescription drug plans that will be available to seniors in 2012.” (from Federal officials target Medicare’s poor-performing drug plans)
Choosing the right Medicare Prescription Drug Plan
While federal officials and representatives fight for change or voice their concerns, many seniors still have to find an effective Part D prescription drug plan that will work for them. Even if changes are on the horizon, many of us have to deal with what’s happening right now. So, if you are in search for a Part D plan in 2012, US News & World Report has a few tips for choosing a prescription plan: Weigh your options, consider monthly premiums, determine copayments and coinsurance, “deduce the deductible,” examine the formulary, don’t delay signing up, and “mind the gap.”
“Minding the gap” is always good advice. Part D prescription drug plans have coverage gaps (some of which are set to close). Of course, there are “gaps” throughout Medicare coverage. In order to see what your options are for making sure you’re covered on all your healthcare needs, it’s a good idea to talk to a professional who can break down all of your Medicare Medigap options. This will give you a chance to break down the current state of Medicare insurance plans, as well as some of those changes that might be coming soon.
Medicare supplement professional dedicated to helping people on Medicare access quality healthcare. Also, part of Medicare Supplement Info which offers rate and Supplement Medicare Plan Comparisons of Medigap insurance. My belief is that all seniors and those with disabilities should have complete access to our healthcare system without restriction and without insurance companies standing between them and their doctors.