Re: Medicare part D - OT - Extra coverage question

[Guest guest]

Poncho and

I read that if you DO NOT select a plan by the cut-off date of Nov.

15, 2006, you will be penalized 1% of the actual monthly cost of the

plan that you DO select for every month after Nov. 15, 2006 until the

date you do finally select one. Does that make sense? In other

words, say you don't decide until Sept. 15, 2007 that you want this

coverage, and the plan you select originally has a monthly charge of

$42.50. You would have to pay an additional amount of $ 4.25, (.42

1/2 cents. @ 10 months), or a premium of $46.75 each month.

I " think " this is the way it works. Confusing, for sure.

My question is pretty straightforward. Right now my husband's group

employee insurance with BC/BS through the company he works for pays

for 80-100% of our medical and pharmaceutical costs. He pays a hefty

monthly premium to his employer for this insurance that covers him and

his spouse. So Medicare is considered my " secondary " insurance.

Because our primary insurance is already with another company, it's my

" understanding " , (and I put this in parenthesis because I'm not sure),

that I DO NOT have to chose another Medicare approved prescription

insurance company. This whole November 15th Medicare decision doesn't

effect me, unless I " choose " to find different medical coverage.

Can anyone tell me if this is correct?

TIA, if anyone knows.

With love, hope and prayers,

Heidi

Heidi H. Griffeth

SC State & SE Regional Rep

PAI

Note: All comments or advice is based on personal experience or

opinion, and should not be substituted for consultation with your

medical professional.

poncho wrote:

> 5. I have heard that if you don't choose a plan this year, of course

you must be medicare eleigible, there is a penelty to choose a plan

later, and that depending on the state, the penelty can be sever.

[Guest guest]

Heidi,

You are correct about the May 2006 date however since I don't have any

other coverage I'm not sure off the top of my balding head how to

answer your question. From what I've read so far you are advised to

sign up for a minimum, bare bones, Cheap plan anyways to avoid the

penalty, if for some unknown reason you have to say a year from now go

for a good part D plan. The penalty is like 1% per month after the

cutoff date applied to your premium if I've read it right. The reason

for all my caution is cuz I've been reading Soooo much stuff about

this that I'm a little overloaded just tryin' to figure out my own

choice. In my case I fall into the catastrophic range of coverage. For

me, if I take everything I'm supposed to, like, ENZYMES (sheesh !) I'm

lookin' at over $16K/year for meds. Then I have to negotiate the donut

hole in the coverage..... as you can see it's complicated. I'll read

up on your issue and get back to you but my gut feeling is like I

said. You should go for a cheap, basic plan, just to get your foot in

the door.

Back at ya later,

Chris

[Guest guest]

Prescription coverage...

Wasn't there something about coverage up to say... $2,500... then no

coverage.... then coverage again when your prescriptions reach $5,000

or so.

Did I understand that correctly?

I am waiting to enroll until they work out all the bugs in the whole

process. Kinda like filing your taxes on April 14th!

Dick

>

> Heidi,

> You are correct about the May 2006 date however since I don't have

any

> other coverage I'm not sure off the top of my balding head how to

> answer your question. From what I've read so far you are advised to

> sign up for a minimum, bare bones, Cheap plan anyways to avoid the

> penalty, if for some unknown reason you have to say a year from now

go

> for a good part D plan. The penalty is like 1% per month after the

> cutoff date applied to your premium if I've read it right. The

reason

> for all my caution is cuz I've been reading Soooo much stuff about

> this that I'm a little overloaded just tryin' to figure out my own

> choice. In my case I fall into the catastrophic range of coverage.

For

> me, if I take everything I'm supposed to, like, ENZYMES (sheesh !)

I'm

> lookin' at over $16K/year for meds. Then I have to negotiate the

donut

> hole in the coverage..... as you can see it's complicated. I'll

read

> up on your issue and get back to you but my gut feeling is like I

> said. You should go for a cheap, basic plan, just to get your foot

in

> the door.

> Back at ya later,

> Chris

>

[Guest guest]

Dick,

You are correct, it's being refered to as the " donut hole " in the

coverage. For the life of me I don't understand it. The one thing I've

read is that " some " plans will offer some type of coverage that will

cover part or possibly all of the hole portion. Naturally this will be

reflected in the amount of the premium. I haven't examined any

specific plans yet so, that's about all I can tell you. I think the

hole goes from around 25-$2600.00 to around $3600 or so. Don't quote

me but that's approx. If you currently have medicare parts A and B you

should have rec'd a wonderful gov't book which details it. I will look

it up in a while and post the " donut hole " specs.

If I can help in any way, I'll try'

Best of luck,

Chris

[Guest guest]

Dick,

I just checked a Chicago Sun-Times article dated 11-14-05 and it DOES

say the " doughnut hole " is from $2250 to $5100. I stand corrected, my

apologies. After $5100 you are in the " catastrophic " range and it says

no matter which plan you pick, you will only pay 5% of the price of

the drugs over $5100.

Regards,

Chris