Does Medicare Supplement Plans assist Seniors With Prescriptions?

Despite the good news that average Medicare Advantage Plan premiums will decline by four percent next year, there is worrying news for Medicare beneficiaries. According to a recent study by Avalere Health, branded drug co-payment was predicted to increase in 2012.

Co-pay is a certain amount that your health insurance contract may need to pay for a particular medical service or care. Take for instance, for an office visit, your health insurance could need a $ 25 co-payment or $ 35 for a prescription drug brand, the insurance company will typically pay for the balance needed to complete the fees.

Co-pay for preferred branded medicines will increase by up to 40 percent, while non-preferred branded medicines will increase by an average of 30 percent. Preferred branded medications are usually medications for which the prescription drug plan has negotiated a discount with the manufacturer. As far as preferred generic drugs are concerned, the copays remain unchanged. Non-preferred generics are expected to reduce their co-payments by 43 percent.

Medicare beneficiaries are also expected to pay a larger percentage of the cost of specialty medicines, which may exceed $ 1,000 per prescription. Specialized medicines include most of the more recent treatments for chronic diseases such as multiple sclerosis and rheumatoid arthritis. New anti-cancer drugs that come as pills are also considered as specialized medicines.

Can Medicare Advantage Plans or Medicare Part D Prescription Plans Help?

Most Medicare Advantage Plans help with some, but not all, prescription drugs. The same goes for Medicare Part D. So you do not need an Advantage Plan or Part D Plan. Always check which medicines are covered under each plan.

Medicare announced in 2012 that Medicare Part D plan premiums would remain unchanged. The premiums are still around $ 30 a month. Based on the Avalere study, plans with the lowest monthly premium may not always be the best solution.

Dan Mendelson, CEO of Avalere, said: “Seniors need to look beyond the premium to understand their benefit, and the more the cost burden is shifted to the patient who needs it, the more important it is for senior citizens to comprehend the next level.”

According to Medicare officials who read the study, the broad average prices of prescription drug plans do not determine what a single beneficiary will end up paying. Jon Blum, Deputy Medicare Administrator, said that one should not draw a general conclusion because the drug needs of each individual are individualized. You have to be aware of the particular plan and the drugs the person is taking.

Is overhaul in health care advantageous for seniors?

As Blum has emphasized, the Health Care Overhaul Act helps to save money for beneficiaries with high drug costs. For those who fall under Medicare’s “Donut Hole” coverage gap, beneficiaries can receive a 50 percent discount on branded medicines. Approximately 47 million disabled people benefit from Medicare, and about nine out of ten beneficiaries have a prescription drug plan.

Medicare Part D plans have different coverages. The most widely used plan has five levels: preferred generics, non-preferred generics, preferred brands, non-preferred brands and specialty medicines.