NP'S Survival

Thursday, November 24, 2005

More on Pharm D

Patti: November 24th, 2005 at 7:11 am -->
You are right the pharm D plan is complicated and confusing. I have 2 Associates degrees, 2 Bachlors degrees and an Masters degree and I spent days trying to figure out what to advise my patients to do. Don’t you love it when Medicare says “speak to you medical care provider for assistance” and then does not tell your medical provider any more than they tell you? The short and long of the story is that every insurance approved by your state is in the process of trying to out do the others. So do not sign up for anything before the Middle of December. It is a work in progress. Take your time and find out what is best for you. With the advise that if you do not sign up, you will be penalized 1% of the premmium, per month for each month you do not sign up ( starting in May I beleive). If you are on Medicaid and Medicare you will get a letter in the mail telling you that you will be placed in xyz program until the next open enrollment, a year later. But if you do not like the plan they put you in, you are the only one’s who will not be penalized, if you decide to change. If you already have a script plan, by the end of the month, they are required to tell you in writting, if their insurance is the same as or better than medicare’s program. So if it is as good or better keep it. You can still sign up, with no penilty, if they cancel your plan at a later date. Your choice should be based on what will stretch the given amount, before the donut whole gets you, the longest for you. Some plans have out of pocket some do not. Some have co-pays and some do not. Some cover you in the donut hole and some do not. Some cover generics only and some cover both. Some cost as little as 10.95 a month and will wave the monthly fee meet their standard of low income. If you are low income you can apply for more assistance to help cover those co-pay and out of pockets. All in all I found that the computer is smarter than I am and that if you go to and either call them or put your meds into the computer at their site, they will let you know what program will stretch your money the farthest and cost the least over all. They use a computer to figure it out. Beware the most costly plan may not save you the most. Generics do save you more. You will be getting print outs to let you know how much you have spent and how much you have left. If you have more than 185.00 per month you will hit the donut hole sooner each year, it changes. A hint is that the Humana plans seem to be popping up more frequently than others and one starts as low as less than 11.oo a month. But again do not go by the cost. I am in the process of waiting for an answer for one of my pt’s. I called her meds in to the site and they will email me an answer. That way I know how long it takes to get an answer. Even if you do not pick the best plan for you, do not worry, open enrollment comes a year later and you can change then. Take your time and choose well.
Patti: November 24th, 2005 at 9:01 am -->
For more input on Pharm D, contact me at my e-mail address Patti, ARNP

Medicar Phar D

Don't you hate it when Medicare tell people to" ask their healthcare professional about pharn d" when they do not explain pharm d to the medical professional?