Medicare Drug Plan = confusion
I get more questions on a daily basis about the medicare drug plan, and it’s sad to say that I’m almost as confused as everyone else.
The intended benefits of the plan are to provide a more affordable away for seniors to obtain medications. I think one of the confusions about it is it is done in a tiered approach.
A plan for example may have a $250 annual deductible. Then after you pay your deductible:
- You pay 25% of the cost for medications when your totals are between $250-$2,250 per year. (the plan pays 75%)
- You pay 100% of the cost of your medications when your drug costs are between $2,251-5,100.
- After you have spent $5,100 on the cost of your medication will be between $2.00-$5.00 (generic vs brand name medication) or 5% (which ever is higher).
That is called the Standard Plan. Each company that is offering a plan will have some slight variation of this. They can have a deductible that is lower, your co-pay higher, etc.
When reviewing my Mother’s plan (Kaiser), the structure was similar though the amounts different. Please note: as with her plan, it varied from each Kaiser district. I would expect it would be the same depending on which Blue Cross plan (for example) you were enrolled with.
Where can you get more information?
- Medicare
- AARP
- your individual insurance company
- your specific state Dept of Social and Health Services (DSHS). For example, here is the one for WA State
I doubt it will get any less confusing; however, it’s important that you make a choice before the deadlines.
You’ll find a complete article on OlderWiserWomen:Â Medicare Drug Plan - A Primer.
