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With the December 7 deadline for Medicare enrollment quickly approaching, local pharmacist Danny Cottrell took the time to warn people about much of the noise being seen and heard on television ads.
“People need to be careful about what they are seeing on TV,” Cottrell said. “Those ads about free groceries and other things can be deceiving. Advantage plans are good for someone who is as healthy as a horse, but otherwise, unless it’s all you can afford for premium costs, there are a lot of risks going with an advantage plan.”
Cottrell said those with drug plans may not be aware of changes made in those plans for the coming year.
“A lot of companies change drug plans,” Cottrell said. “Drugs covered one year may not be covered the next year. It’s a good idea to check to see if your drugs are still covered. The company should notify you if they make changes, but with all the junk mail folks receive, the chances of seeing that notification is slim.”
When choosing an advantage plan, Cottrell said considering a supplement instead may be the best option.
“For most people, if they can afford it, a supplement usually works better than an advantage plan,” Cottrell said. “Supplements, on average, are about $175. The premium is usually all they pay other than the approximately $180 in deductibles. There may be a few other fees here and there, but that’s about all they are going to pay. That covers the 20 percent that Medicare doesn’t pay. Part A only pays for hospital stays and Part B only pays for x-rays, labs, etc.”
Cottrell said a Part D supplement will help when it comes to purchasing prescription medication.
“In order to get help with drug costs, a Part D supplement will help with that if you have it on the side,” Cottrell said. “Some people in Alabama have been on Exlir RX and that has been cancelled in Alabama. Anyone on the plan needs to get something else. They have been notified, but with so much mail, it’s easy to miss. Some people went with a plan last year called Clear Springs. They were sanctioned by CMS, so they may want to double check to make sure that plan is still good this year.”
Cottrell said that even with the changes this year in coverage, there still are some good things that have come out of all the noise.
“One of the positives this year is the $35 per month insulin,” Cottrell said. “Even when they get in the doughnut or into catastrophic status, it would still be just $35 per month. We are hearing a lot about negotiating drug prices, but that won’t start until 2026. Another thing coming in the future will be a maximum out of pocket expense of $2,000. Any deductibles and co-pays will go toward that amount.”
Open enrollment ends December 7, but Cottrell said there may be some options for particular situations.
“Folks that are considered Medicaid eligible or low income, may have some extra time to make changes in their coverage,” Cottrell said. “Medicare will usually allow a longer window of opportunity if you’re choosing an advantage plan. Someone that turns 65 has 60 days from that month to sign up. If you lose your employment, you’ve got 60 days to choose. If you lose your insurance or retire, there are some windows that will allow changes.”
Cottrell said that even though there are windows of opportunity past the December 7 deadline for some people, now is the time to make certain any changes are made that are needed.
“If you’ve been on Medicare for a while and are not low income, any changes that need to be made during this period,” Cottrell said. “the time for making sure you are covered is now.”
To contact Cottrell with assistance in making a choice for advantage plans or supplements, call his office at 251-868-2001.