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Re: Alternatives to Part D Medicare

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So much for being healthy - exactly.

 

I don't know of any insurance program that makes you pay a penalty for not signing up. I do not have to pay auto insurance just because I have a driver's license. I get that insurance when I need it. I do not have to pay for homeowners or renters insurance just because I could live in, or rent, some form of home or apartment. I get that when I need it, also.

 

But, the lovely government and it's mandated medical insurances charge a fee for not using their service in the past? Ridiculous.

 

My Mom was assessed 'the penalty' when she signed up after my Dad died. She was covered on his insurance, but it was not considered 'good enough' and so there was a government-calculated gap in their budget to fill. Now and forever, she is paying a premium and a penalty for a service that literally provides no value to her at all. She pays out of pocket for everything and at the current level of need, will never meet the maximum out-of-pocket for her prescriptions each year and will never have any prescription paid for by Part D, even in part.

 

I hate to say it, but I hope she has some VERY expensive prescription needs in the future so we can back the premiums, fees, and out-of-pocket costs for the years we have been paying and receiving nothing. 

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Re: Alternatives to Part D Medicare

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@cecilia1149 wrote:

Does any one know if there are prescription drug insurance plans that are independent of Medicare part D?  The penalty for part D makes it very expensive to get. So much for being healthy!

 


There are many "independent" drug plans but not every one qualifies. Only about 30% of people on Medicare use Part D (see Note). Another third or so get drug coverage from a Part-D-like plan that is built into public Part C Medicare health plans (see Note). The most common "choice" for people who are not in one of the two groups mentioned in the previous sentence is to get drug coverage through supplemental insurance from a former employer. Another common choice is to get drug coverage through the Veterans Administration.

 

As for a penalty, Medicare does call it a penalty but what it really is the right to buy-in to drug coverage at any age with any drug need (no matter how expensive the drugs you now need are) even if you have gone years without drug coverage. They call it a penalty but it is actually a helluva deal... assuming you now need drugs.  For example, if you could have signed up in 2006 but waited to this year and now you need thousands of dollars worth of drugs, you can buy a policy now (or could have until December 7, 2015) for about $40 more a month than someone who has paid for a Part D policy every one of the 120 months that you paid nothing.

 

Note: Many of these people are actually getting their drug coverage through the Social Security Extra Help/LIS program, which is tracked as part of Part D and acts like a Part D policy but which costs nothing or almost nothing and provides drugs at a nominal co-pay of a couple of bucks. If you qualify for Social Security Extra Help/LIS there is no penalty assessed.

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Re: Alternatives to Part D Medicare

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Any insurance plan, even Medicare Prescription Drug Program, not only gives you some cost benefits now but also into the future.  You might be healthy now and take no or few medications but that could change rather unexpected.  Remember this is a shared benefit between all Medicare beneficiaries - you help them and they help you, premium-wise - when you do not enroll on a timely basis, you are assessed a lifelong penalty.

 

I know of no individual private insurance policy that offers ONLY a prescription drug program for those already medicare age.  In fact, that is the purpose of the Medicare Prescription Drug Program.

 

This is the only alternative to coverage to avoid the penalty.

 

Medicare Part D

The government requires seniors to have either Medicare Part D, which covers prescription medications, or creditable prescription drug coverage from a current or former employer or a union. A plan is considered creditable if it is as good as or better than Part D coverage; ask your insurance company if your plan qualifies. If you don’t have either of these, when you later enroll in Part D, you’ll face a permanent penalty, as with Part B. The other way to get Part D coverage is through a Medicare Advantage plan that offers drug coverage (not all do).

 

If you retire and lose your creditable prescription drug coverage, you can sign up for Part D during a special enrollment period and avoid penalties. If you have a COBRA plan with creditable coverage, you can keep using that until it runs out. The key is that you can’t go without either Part D or creditable coverage for more than 63 days or you’ll incur the penalty. This rule means you’ll probably need to enroll in Part D well before those 63 days are up since your Part D coverage won’t begin until the first of the month after you sign up. Make sure to keep proof of creditable coverage to show your new Medicare Part D plan so you won’t have to pay the penalty.

 

Since you can get Part D coverage from lots of different insurance providers who offer different benefits, Part D premium costs vary. As a result, the Part D penalty is calculated as a percentage of what Medicare calls the “national base beneficiary premium,” which is a confusing way of saying the average cost of a Part D prescription drug plan. In 2016, that premium is $34.10. The penalty is 1% of this amount times the number of months you didn’t have either creditable coverage or Part D. So if you went uncovered for 12 months, your penalty for 2016 would calculate to 12% of $34.10, or $4.09 per month. However, Medicare rounds this amount to the nearest 10 cents, making your actual penalty $4.10 per month, or $49.20 for the year. You’ll keep paying that penalty in subsequent years and it will be calculated on the new national base beneficiary premium each year.

 

You must have Medicare Part A or B to enroll in Part D. If you miss the initial enrollment period for Parts A and B and sign up during general enrollment, which is January 1 through March 31 each year, you can enroll in Part D during a special enrollment period from April 1 to June 30 and start getting coverage July 1. By doing so, you could face a lower Part D penalty than if you had to wait until the usual Part D open enrollment period, which runs from October 15 through December 7 each year and gives you coverage beginning January 1.

* * * * It's Always Something . . . Roseanne Roseannadanna
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Alternatives to Part D Medicare

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Does any one know if there are prescription drug insurance plans that are independent of Medicare part D?  The penalty for part D makes it very expensive to get.

 

So much for being healthy!

 

 

 

 

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