Sunday, November 30, 2008

Keeping the cost down

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, he said, so the best choice for someone one year may not be the best the next year. If consumers remain in their current Medicare drug plan, they’ll pay an average of 24 percent more in premiums next year, according to an analysis by Avalere Health, a health care consulting firm.

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. 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.

Yocum said 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.

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.
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Many of us use a HMO plan and we should check our plan including drug coverage for the new year. - Bill