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Are your docs and drugs covered?

By Jennie L. Phipps · Bankrate.com
Monday, November 4, 2013
Posted: 4 pm ET

There's about a month left in Medicare's open enrollment, which runs through Dec. 7. If you haven't reviewed your current Medicare Part D or Medicare Advantage plan, now's the time.

Ignore all the hullabaloo over the Affordable Care Act's broken website. The Medicare site, Medicare.gov, is working just fine.

Sometime in October, you should have gotten an "Annual Notice of Change" in the mail that lists the changes in your Medicare Advantage or Part D prescription drug plan, including any increases in premiums and co-pays. It also compares the benefits you got in 2013 with what the benefits will include in 2014. Be sure to pay attention to the list of prescription drugs. HealthPocket.com, a technology company that compares health care plans, reports that in 2014, on average, Medicare Advantage plans will include 1,492 drugs on plan formularies and Part D Medicare prescription drug plans will offer 1,456. That's a lot of drugs, but it still pays to make sure that the ones you take are on the list. If your drug isn't on your insurer's formulary list, you'll have to pay its full cost, which could be a blow to your retirement planning budget.

HealthPocket also urges Medicare drug users to go one step further in analyzing their plans. Even if your drug is on the formulary, your plan can restrict access by limiting the quantity, requiring prior authorization or mandating a step therapy process that could require you to start by taking a less-costly drug until you prove that you really require the more expensive one to get better. Read the fine print to ensure that the drugs you take aren't restricted in this way.

It is also important to verify that the physicians and other medical professionals you use or might want to use are participating in your Medicare Advantage plan. If your network has been narrowed or your doctor has changed his mind, you might want to consider a switch. A Medicare supplement, or Medigap, plan is simpler -- any doctor who accepts Medicare is automatically on the list.

If you have questions and you are computer-savvy, go to Medicare.gov. If you feel more comfortable getting information the old-fashioned way, you can call 1-800-MEDICARE (800-633-4227).

Be prepared. Medicare is warning about long hold times. What else do you have to do in retirement but wait for this important information? It pays to be patient.

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12 Comments
Vito LaNave
November 05, 2013 at 1:17 pm

I have Humana HMO Gold Medicare Avandage Plan It is wonderful. It is not a crock like the one lady said in her comment. I worked and paid in Social Security for 57 years and I am not sponging off taxpayers. I paid SS taxes foe 57 years. It is not Obama Care. I resent what Sue Baranchik said in her comment. If you have a problem with Obama Care don't mix it up with Medicare advantage

robertdo
November 05, 2013 at 1:14 pm

do all dem-senator knew about Obamacare problems now all people
got delay web and insurance cancellation ,so they are so quite about??? what happen in their mouths ,stuck food in there

robert

Sue Baranchik
November 05, 2013 at 1:01 pm

Thanks for allowing people to voice their frustrations!

Sue Baranchik
November 05, 2013 at 12:56 pm

Medicare advantage plan is a crock! It is terrible insurance. Obama should not have stolen medicare funds to pay for a bunch of illegals to get freebies. Obama has no use for seniors as he told a lady that she would have to take more pain pills then get a hip replacement and other nasty remarks. So what do we do if we need rescue inhalers? Or, for that fact, inhalers to live with COPD, not die from COPD because no one in Washington cares. No president should rob Peter to pay Paul. He's not a president, he is a king or dictator with lavish vacations at tax payers expense and the expense of the elderly.

Russell Smith
November 05, 2013 at 12:18 pm

You may think medicare and the part D and advantage plans are safe, but they are not. Just received 2 letters from my advantage plan dropping 2 of my doctors from their network. And the doctors are given NO reason as to why they were dropped. Hold onto your seats because it will only get worse.

wenD
November 05, 2013 at 12:14 pm

@ PAUL - what's happening and been happening with Medicare has nothing to do with ACA and no one "stole" a penny from Medicare for ACA. Go back and think about things before Medicare Part D was pushed through. That's when things started getting really expensive.

Paul
November 05, 2013 at 12:09 pm

The beginning of the stealling of 716 billion dollars begins in 2014 as the $2970.00 that used to cover Brand drugs in 1/1/14/w/b $2850.00 JUST THE START OF OBAMA CARE RAIDING MEDICARE

Alice
November 05, 2013 at 11:37 am

Anna, rescue inhalers used to be inexpensive til the environmentalists stuck their big noses in & said the inhalers weren't environmentally safe so here came the HFAs at a much higher cost...pretty great for folks like us who have breathing problems, huh? too bad we need to breathe with help...

Robert Checketts
November 05, 2013 at 11:22 am

Medicare as it is and the advantage plans suck big time they raised my costa 29.00 this year and give less coverage we need complete socialized medicine. these people rip us all.Robert G Checketts

Anna Norred
November 05, 2013 at 11:17 am

Have not found any medicare partd plan that covers rescuce inhalers, these are used by so many people every day but no one wants to cover them. I go through about one each week at around $40 to $55 for them.