MAJOR heads-up for Medicare D patients and their families

by Caleb Reading

The Medicare D standard Initial Coverage Limit for 2009 is $2,700.   Meaning once the total retail cost of your meds hits the coverage limit, you go into the dreaded donut hole and have to pay 100% out of pocket until you get out of your plan’s coverage gap.

BUT . . . plans are allowed to set their own Initial Coverage Limit, and change it from year to year.  READ THE FINE PRINT.  Many plans are going to have a lower initial coverage limit for 2009.

While you’re reading the fine print, don’t just look at the monthly payment.  Look closely at what the copays are going to be next year.  Some plans are changing those drastically.  And CHECK THE FORMULARY LIST to see if all your meds are still covered in the same way.  If you’ve added new meds in 2008, it may be worth shopping around for plans based on your current medications.

Oh, and one more thing.  Deductibles still exist.  They haven’t gone away.  The Medicare D deductible for 2009 is $295.  About half of plans have this deductible.  ASSUME YOU WILL HAVE ONE.  If you go into the store and there is a deductible on your medication, STOP SCREAMING AT US.  Do you think a clerk making seven dollars an hour with no health insurance wants to hear your snideness because you have a deductible on your ridiculously-good prescription coverage?  Just slap her in the face.  Slap her and get it over with.

Every single day in January at least one person will yell at us that they have never had a deductible and we’re just making that up because we’re theiving scumbag liars.  Every single day in January I recall having this exact same argument with that exact same person last year.  They don’t remember that argument from last January, but I do, because I make a mental note of who is a jerk and who isn’t.  Guess who gets first dibs on any coupons or other deals around here?