Showing posts with label Medicare. Show all posts
Showing posts with label Medicare. Show all posts

Monday, October 17, 2016

Medicare Open Enrollment Tips



Are you ready for Medicare Open Enrollment? If not, you need to get ready! Open Enrollment is only October 15 through December 7, and there are penalties for missing the window; it’s worth a few minutes of your time today to prepare yourself. Open Enrollment can be confusing, so we’re sharing seven tips to help you understand what your Medicare options and requirements are.

Open Enrollment Tip 1 — Don’t Just Re-Up but Re-Evaluate

Even if you’re already enrolled in a Medicare health plan, it’s important to understand that the Open Enrollment period is largely about reevaluating your current Medicare Advantage or Part D plan, or both.

The big question you should be asking yourself is, “Do I need to change my plan or should I stay with my current plan?” The answer to that question begins with finding the answers to these related questions:
  • Has anything changed in my life?
  • Has anything changed in the plan I’m on? 
  • Has anything changed in the other plans available to me?
If nothing has changed significantly in any of those three areas, then your best strategy might be to stay with your current plan. Odds are though that at least one of these three things has changed. Take the time to go through the plans, looking for the option that best meets your needs.

Open Enrollment Tip 2 — Check Your Health

When you previously selected Medicare coverage, your health was a major factor. If you experienced a change in health status during the past 12 months, you’ve likely put your insurance plan to use, giving you a chance to evaluate the out-of-pocket costs and the quality of care you received. If it was not satisfactory, you should look for a plan that would offer improvements.

Open Enrollment Tip 3 — Evaluate Cost vs. Benefit

Oftentimes a more expensive plan comes with a wider range of benefits. This may have been appealing if you were thinking, “Better safe than sorry.” But that plan’s monthly payments may have proven to be more of a cost burden than you expected, especially if any of your other expenses have increased. Or, maybe you selected a lower-cost plan and now feel you’re feeling burdened by co-pays. In either case, a plan change may be exactly what you need.

Open Enrollment Tip 4 — Verify That Your Plan Features Match Your Lifestyle

There are measurable cost differences between Original Medicare and Medicare Advantage plans. Medicare Advantage plans (also known as Part C plans) are more affordable, but come with more restrictions, such as being more geographically localized to your home area. If you plan to spend a lot of time away from home (think snowbirds), you may be better off with Original Medicare rather than a Medicare Advantage plan.

Open Enrollment Tip 5 — Look at Prescription Drug Coverage

Many factors influence your choice for prescription drug coverage. These include:
  • Choosing no insurance because you feel you can cover the cost of your prescription drugs on your own
  • Enrolling in a Part D drug plan 
  • Choosing a Medicare Advantage plan that already includes drug coverage 
  • Getting your coverage through an employer or via your VA benefits 
  • Using a state-based Prescription Assistance Program, if available in your state
Keep in mind that you’re a year older now than when you last evaluated your options. As we age, the likelihood of needing prescription drugs goes up, and often substantially if, for instance, you develop a chronic condition that requires ongoing medication. So, if you are not already covered adequately to meet a changing medical status, use Open Enrollment to fix that.

Open Enrollment Tip 6 — Take a 1-Minute Quiz

Are you still feeling unsure and overwhelmed? Before making any decisions about switching your coverage during Open Enrollment, take this short Medicare Questionnaire, created by The National Council on Aging (NCOA), one of our partners. It gives you advice about how to choose the best plan for your needs, and about whether to change your Medicare plan during Open Enrollment.

Open Enrollment Tip 7 — Beware the Donut Hole!

The “donut hole” is a coverage gap in certain Medicare Prescription Drug Plans that begins after you reach a certain dollar amount for covered drug purchases in a calendar year. This gap can significantly affect your prescription costs. But you can lessen its impact on your wallet by using the FamilyWize Prescription Savings Card. It’s free and anyone can use the card – insured or not. There are no qualifications to use the card, and it can save you an average of 43% off the cost of your prescription medications.

All you have to do is show the FamilyWize card (or app) to your pharmacist the next time you pick up a prescription and ask them to compare the discount offered by the card to the price you would pay otherwise. In many cases, the FamilyWize price proves to be the better deal.

And don’t forget to comparison shop. You can check the price for your prescription at all participating pharmacies in a selected region using our Drug Price Lookup Tool, available on our website or through our app (just search "FamilyWize" in your smartphone's app store). Then you can fill your prescription at the most affordable location.

With a little bit of effort, you can confidently manage your Medicare plan and prescription coverage. Take the time to do your research and prepare – especially during Open Enrollment!

Tuesday, November 24, 2015

Your Complete Guide to Medicare Open Enrollment

Choosing your own health plan can be an intimidating and often confusing process, particularly for those who are already enrolled in Medicare but are interested in how other plans on the market compare with Medicare Advantage or Medicare Part D.

With Open Enrollment season ending December 7th, time is running out to select the plan that fits your needs along with your budget. Fortunately, our friends at My Medicare Matters have developed a guide to help you through it.



The Complete Guide to Medicare Open Enrollment gives you an overview of the essential facts of the Open Enrollment period, including when it starts and ends, which parts of your Medicare plan you can change, and when your new coverage will begin. It also lets you know who should consider changing their coverage during this period; for example, certain people may find plans that offer better prescription drug coverage than their current plan, while others may need to switch in order to keep their doctor in-network. You can also sign up for reminders by email to learn more about when Open Enrollment starts and ends.

Not sure how your current Medicare plan stacks up? Use My Medicare Matters’ short Medicare Questionnaire. By answering a few simple questions, you will be provided with an online price comparison tool that will allow you to do your own research and find the plan that is right for you.



We’ve partnered with My Medicare Matters because like us, they are dedicated to offering free, easy ways to help people save money on their health. Together with our free Prescription Savings Card, which saved an average of 42% off the retail cost of prescription medication in 2014, there are more options than ever to help people, insured or uninsured, save on the rising cost of proper healthcare.

Friday, June 29, 2012

Options for MediCare Part D Prescriptions

Working at FamilyWize really gives me assurance that there are always options when it comes to getting needed prescription medicine - even those of you in the donut hole who are probably asking, "Now what?" 


medicare prescription assistance programs
Light on the other side of the Donut Hole.
If you are new to Medicare and the Part D prescription coverage gap, then there are a few things you need to know:
  1. There is a temporary gap in prescription coverage depending on the plan you've chosen so your monthly prescription medication costs may rise.
  2. Whether or not you enter into the coverage gap is based on your drug plan spending for those drugs that are covered.
  3. Once you enter whether or not you will exit the donut hole additional funds and qualify for catastrophic coverage for the remainder of the year is based on your out of pocket expenses while in the Medicare coverage gap.  
Confusing? For more information or help go to www.medicare.gov or call 1-800-MEDICARE or check with your pharmacist.


If You Calculate That You Won't Spend Enough Money Out of Pocket to Qualify for Catastrophic Coverage... Then Here Are Tips to Make the Best of the Coverage Gap While You Are In It



If you do enter the coverage gap, as promised from last week's blog "The Dreaded Medicare Donut Hole"; here are some options and resources on how to land softly and survive the donut hole dunk! 

If you think you will spend enough to get out of the gap - DO NOT use these options.
  1. Compare, Compare, Compare - If you are not going to spend enough to get out of the donut hole, say it with me-COMPARE!  There are many options from manufacturer rebates to store programs that may be able to help you save a chunk of money.
  2. Chat with your Pharmacist - Your pharmacist is aware of different programs that can be used in conjunction with Medicare Part D insurance.  Talk to your pharmacist to see which program would work best for you based on the medications you are prescribed.
  3. Talk to your Doc - Your doctor doesn't necessarily know what health insurance you have because there are medical billers whose jobs are to handle insurance matters.  (I know this because a good friend is one!)  Let your doctor know that you are a Medicare Part D recipient and have fallen into the donut hole. See if your brand-name prescription medications have generics that could be just as effective.  Your doctor might have some other tricks like changing your medication's strength or dosage to save you money or even hook you up with some samples to get you through to the other end of the gap.  Who doesn't love samples! 
  4. Resources - National Council on Aging (NCOA) is a non-profit and advocacy organization that works with various organizations to help seniors find jobs and benefits, improve their health, live independently, and remain active in their community.  It offers a free service called BenefitsCheckUp.  After you answer a series of questions, it creates a personalized report of the programs that may be able to assist you in areas such as medication, food, and housing.  You can also view different State Pharmaceutical Assistance Programs put together by Medicare.gov that may be able to give you a hand.
  5. Talk it Out - Check out message boards or blogs to connect with people who are in the same boat you are.  It might make the process a little bit easier.  Online support can be a great resource.
  6. FamilyWize - We can help Medicare recipients who have fallen into the donut hole.  If you know you won't get out, you can use FamilyWize FREE discount prescription drug card to save up to 75% on your generic medications.  FamilyWize can be used for FDA-approved medications in and out of the gap that aren't covered by Medicare when purchased at a participating pharmacy.
Whether you are in the donut hole or are able to spend enough to get catastrophic coverage,  we want to help you find options!  If you know of options that are not listed here, please share!

Krysta W.

Friday, June 22, 2012

'Much A Do'-Nut About Nothing

Ahhh - TGIF! As I pondered the topic of today's blog - I switched gears.  I decided it would not be serious, because sometimes life just needs to be NOT serious!  Plus, we gave you much to think about yesterday with "The Dreaded Medicare Donut Hole."  The Medicare Donut Hole is one donut hole that cannot always be avoided, but over the next couple of weeks, but we hope to point you toward some resources that might help with Medicare Part D.

Now - on to more pleasant topics - the actual donut.
Medicare part D health articles
The donut dilemma: Medicare donut hole or actual donut hole can cost you.

Although I am typically not a partaker of donuts, the fact that I will be traveling across the wonderful state of Pennsylvania this weekend got me thinking to my destination and what awaits on the other end.  There is a small place - what some would consider "a hole in the wall" back in a small town in Western Pennsylvania that offers up the most delicious doughnut that I have ever tasted.  The homemade kind that is soft and light and airy.  My favorite is the cinnamon coffee roll that is bigger than my hand with a maple glazed icing that is to die for.  These creations of Clark's Donuts are definitely 'Much a Donut about Something.'

 But, I digress.  Typically a health conscious woman except for the occasional Clark's donut, I decided to see what the Web and research had to say about donut nutrition facts and health.  Of course there were health articles and blogs and more of those touting the goodness of donuts, while others like Carla Wolper, a nutritionist at the New York Obesity Research Center who had this to say about the donut, "When it comes to health, the only thing good about them is the hole."

Donut nutrition facts
Krispy Kreme glazed donut = 237 calories.
I also discovered that the USDA 2005 dietary recommendations gave a thumbs up on "discretionary calories".  So what does that mean for you?  If you eat a 2,000 calorie a day diet, then you can have 237 discretionary calories, which is almost the calories in a Krispy Kreme glazed donut (according to the CalorieLab website).  Although portion control is recommended on any diet by doctors and dietitians, I would venture to guess that an occasional donut will not harm you.  A donut a day however is not what the doctor ordered. 

Which led me to a search on donuts and medicine.  This merely resulted in a listing of donut stores in several towns called Medicine (Medicine Park, OK and Medicine Lodge, KS).

Try, try again.  What I did discover was research from the Journal of Humanpsycopharmacology suggesting that "the synergistic effects of caffeine and glucose can benefit sustained attention and verbal memory." (Copyright 2010 John Wiley & Sons, Ltd.) A good thing right?  Good food equals good thoughts?  Not sure that this is what it meant, but if you want to read more go to the Wiley Online Library where the study is printed.

Of course, you can counter that with a study published by the Public Health Nutrition Journal and the US National Library of Medicine, regarding a study by the University of Las Palmas in Gran Canaria and the University of Navarra, that assessed the relationship between fast foods and processed pastries to a 37% risk increase for depression.  

So before you have your Saturday morning run to the local bakery for donuts and coffee, consider this blog.

Today was just some "food for thought."  (I couldn't resist.)  But you must make your own determination of whether or not when it comes to the illustrious donut, if there is 'Much a Do'nut about Nothing.

Donna Cornelius
Online Marketing Manager

Thursday, June 21, 2012

The Dreaded Medicare Donut Hole

Donut hole:  I love donuts! Mmmm what a sweet circular treat and breakfast staple.  Chocolate, glazed, cinnamon, powdered sugar--there is a plethora of flavors. 

But...from a personal experience here in the call center, I can tell you there is ONE donut hole flavor that doesn't taste or look appetizing at all for people on Medicare Part D.  This time of year, we get so many calls from people falling into the ominous Medicare Donut Hole. 

Can you imagine what it is like to be on a fixed income?  Watching gas prices go up and down, worrying about unexpected expenses, and waking up one day to find that instead of paying 25% for your medicine, it's now 100% out of YOUR pocket!?

For those who aren't familiar, Medicare is a federal health insurance program for Americans 65 and older, people with end stage renal disease, and younger people with disabilities. 


medicare part D
Nothing sweet about the Medicare donut hole.
There is an optional component to Medicare, called "Part D," which is a co-pay prescription coverage plan offered at an additional cost to help people pay for their prescription medications.   However, every year, Medicare Part D recipients fall into a coverage gap (aka donut hole). 

What happens in the donut hole?  Nothing sweet.  

All of a sudden, individuals with Part D go from paying a 25% copay for their much needed medications to paying full retail price. 

Here are a few tips to prepare yourself: 

1. Read the fine print.  I once read somewhere, the only constant thing about Medicare is change.  I couldn't have said it better myself! Make sure you read your coordination of benefits agreement. Read the fine print to make sure everything is in order and if you have questions, ASK!  Also make sure all your medications are covered. Just because your medications were covered last year, doesn't necessarily mean they are covered again this year. 

2. Plan ahead.  If you know you are going to hit the donut hole, ask your pharmacist early in the year what the monthly payment for your current medications will be once you are in the donut hole, including the rebates for brand names and generics.  See if that will be enough to get you out of the donut hole and qualify you for catastrophic coverage.  

If you aren't sure you will hit the donut hole, ask your pharmacist to help you calculate your prescription costs to see if you will or will not. 

3. Be aware of your calendar. Open enrollment for Medicare usually begins every October. Leave yourself enough time to review each plan to see which one is better tailored for you.  

4. Don't be shy. Always consult your pharmacist or plan provider should questions arise. For specific questions, you can call 1-800-MEDICARE or visit the official U.S.  government site for Medicare at www.medicare.gov

Visit our blog next week to look for what options and resources you have once you or loved ones have fallen into the dreaded Medicare donut hole.

Krysta W.