Medicare Put's Gag on Walgreen's

Washington has slapped the hand of Walgreens pharmacist's for providing assistance to Medicare beneficiaries looking for Part D help. According to Suntimes, the drug finder on Walgreens site is inaccurate. Humana also claims their site incorrectly lists drug prices that are higher than actual costs.

Walgreens pharmacists are no longer giving customers advice on which Medicare Part D plans best work with the customers’ prescriptions by the Dec. 31 deadline, and a Medicare spokesman says that’s a good thing.

People should get help with their Part D plan choice by calling the Medicare help line at 1-800-MEDICARE (1-800-633-4227) or by getting counseling from AARP or their local State Health Insurance Assistance Program (SHIP), according to Medicare, because pharmacies get rewarded for putting or keeping customers in plans or prescriptions administered by so-called Pharmacy Benefit Managers, or PBMs.

I can't speak to the accuracy of the Medicare site, but I do know that other government sites on health care issues have inaccuracy's and can be both confusing and misleading. Something about "I am from Washington and I am here to help you" that just doesn't produce warm fuzzy's.

And why include AARP in that mix? They promote a Part D prescription drug plan as well AND they benefit from every sale, so why are they promoted as unbiased?

I have no opinion on using the Walgreen one way or another. My personal opinion is Part D is over-hyped and for most people just an added expense that is not needed. There are plenty of ways to find low cost or even free prescription medications without buying an insurance product.

Georgia Insurance Shop has helped many clients save thousands on out of pocket prescription drug costs over the years when Rx coverage was not an option.

We also are one of only two agents in Atlanta approved to offer the lowest Medicare supplement rates in Georgia. In most cases, our Med supp rates are lower than AARP, Blue Cross and others. Ask for a comparative Medigap quote.

Medicare, First Avastin, Now Provenge

Avastin has been considered a miracle drug because of its' ability to battle certain cancers, including colon cancer, lung cancer, kidney cancer and breast cancer. But the FDA is close to rescinding approval for the drug for treatment of breast cancer. Due to the cost ($8,000 per dose) and the fact that patients given the drug live an average of 4 months longer, the FDA does not consider the drug to be "cost effective".

If the FDA decides Avastin cannot be used to treat breast cancer, Medicare will not cover the drug and neither will PDP (prescription drug plans).

Now the Washington Post reports Provenge, a drug to treat prostate cancer, may be on the chopping block.

The Centers for Medicare & Medicaid Services, which dictate what treatments the massive federal health-insurance program for the elderly will cover, is running a "national coverage analysis" of Provenge, the first vaccine approved for treating any cancer. The treatment costs $93,000 a patient and has been shown to extend patients' lives by about four months.

Although Medicare is not supposed to take cost into consideration when making such rulings, the decision to launch a formal examination has raised concerns among cancer experts, drug companies, lawmakers, prostate cancer patients and advocacy groups.

"Not supposed to consider costs", but . . .

The review comes as the Food and Drug Administration considers withdrawing an approval for another expensive cancer treatment- Avastin for metastatic breast cancer – which triggered a similar debate even though the FDA too is not supposed to factor costs into its analyses.

I believe we see a pattern here.

"The men most impacted by prostate cancer are African American men. If CMS doesn't approve this, then this treatment becomes an exclusive kind of treatment for men who can afford it out of pocket," said Thomas Farrington, president of the Prostate Health Education Network.

Well there you go. Now this is not only a financial evaluation but a racial one as well?

You decide.

Affordable Medicare Supplement Plans for Georgia Seniors

If you are a Georgia senior looking to buy a Medigap plan, ask for a competitive quote. We have rates from AARP, Blue Cross and all the major Medicare supplemental insurance companies in Georgia.

 

AARP Drug Tool

The folks at AARP have a new prescription drug savings tool on their site that is pretty nifty. Using the link, you enter the name of your drug and hit "Find Drug". I typed in Lipitor since this is a relatively common drug used by Georgia seniors.

The next page wants to know why I take Lipitor. I select "to reduce LDL at least 30% then hit Find Drug again.

This takes you to a page listing information and approximate pricing on the brand name drug as well as a generic alternative. This information can be printed out and discussed with your doctor.

Georgia seniors on a fixed income should avail themselves of this tool.

Many are spending way too much on prescription drugs and, in many cases, Medicare Part D as well. Most PDP (prescription drug plans) are confusing at best and of little or no value to Medicare beneficiaries. The alluring $0 premium drug plans as well as the new Wal-Mart/Humana $14 PDP generally do not deliver much in the way of value. The marketing gimmicks designed to lure you in and trap you in a low premium plan can leave you with high out of pocket costs once you discover the medications you need are not on their formulary.

The popular PDP plans rely on the same tricks that Medicare Advantage Plans (MAP) use. The low or $0 premium plans look nice until you use them. That is when you discover copay's, coinsurance and out of pocket that usually does not exist when you have traditional Medicare and a good Medigap plan.

I compared the AARP drug savings tool pricing for Lipitor to Blue Sky Drugs and here is what I found. 

The AARP site quotes a price for 30 tablets of 20mg Lipitor as $161. The generic Simvastatin is $70.

But at Blue Sky Drugs you can get a 3 month supply (90 tablets) of Lipitor for $126 and generic for $49 (100 tablets). 

Would Georgia seniors on a fixed income rather spend over $1800 per year for brand name Lipitor or $500?

I think the answer is obvious.

Affordable Medicare Supplement Insurance

Georgia seniors who want to save money on prescriptions drugs should consider ordering from places like Blue Sky Drugs. If you want to save money on Medigap plans, ask the professionals at Georgia Insurance Shop to provide you with a quote. We have rates from all the low cost Medigap carriers and can show you the best total value for your money.

What is a Medicare Drug Formulary?

In 1967 Mr. McGuire had one word for recent graduate Benjamin Braddock.

"Plastics".

Today, 43 years later, Mr. McGuire might have a different bit of advice for good old Benjamin. As Benjamin is turning 65 and looking over all the Medicare Prescription Drug Plan (PDP) options, I can imagine Mr. McGuire looking at him and saying this.

Mr. McGuire: I want to say one word to you. Just one word.
Benjamin: Yes, sir.
Mr. McGuire: Are you listening?
Benjamin: Yes, I am.
Mr. McGuire: Formulary's.
Benjamin: Just how do you mean that, sir?

For a Georgia senior trying to pick the right PDP, or even decide if they need any plan at all, the choices are mind boggling.

Some have prescription drug deductibles, some do not.

Some have copay's, some do not.

Some penalize you if you don't use certain drug stores or mail order drug fulfillment services.

And then there are those formulary's.

Is this drug covered or not? What is my copay with carrier ABC vs plan XYZ?

If you pick strictly based on the cost of the plan you will most likely have more out of pocket than if you had opted for a higher premium PDP.

This is like comparing Medicare Advantage Plans to Medigap plans.

MAP's usually have a lower premium but much higher out of pocket than a good Med supp plan.

One PDP that is being heavily promoted right now at Wal-Mart and Sam's Clubs is a PDP for only $14.80 per month. The price may be right but
does the coverage match your needs?

Before buying ANY Medicare PDP use the prescription drug finder at Medicare.gov.

If Benjamin were in Wal-Mart right now he might be saying, "You're trying to seduce me, aren't you?".

And then Wal-Mart would reply, "Would you like me to seduce you?".

Of course we know how that scene unfolded.

When low priced PDP's try to seduce you, how will you react? 

Prescription for Psoriasis

If you have psoriasis, there is a new medication you may want to consider. But only if you have a fat bank account, or really good health insurance.

Many health insurance plans in Georgia have attractive premiums because they do not cover prescription drugs. Often I am told by prospective clients they don't need prescription drugs because they don't take any medications or they only use generics.

That's like saying you don't need fire protection on your home because you have never had a house fire.

Prescription drugs can be expensive.

VERY expensive.

And it is not just medications for cancer that are expensive. Sometimes you don't have to be terminal to need expensive medication.

Enbrel is sometimes used to control the symptoms of psoriasis. Each dose is expensive. If you have health insurance, a single dose will run about $1800. 

If you don't have health insurance it could be much higher.

Now we have Stelera.

If Enbrel isn't working, perhaps your doctor will suggest Stelera.

How much is Stelera?

$5,300 to $10,600 per dose . . . if you have health insurance.

So the next time you are looking for health insurance, make sure you opt for a plan that includes prescription drug coverage.

Affordable Health Insurance in Georgia is Available

At Georgia Insurance Shop we have all the major health insurance companies in Georgia. It does not matter if you are looking for individual health insurance or family insurance. We have HSA's and traditional copay health insurance plans. Affordable health insurance plans from Aetna, Blue Cross of Georgia, Cigna, Humana and others.

Prescription Drugs – Saving Money

Can you really save money with a prescription drug card? In most cases the answer is no. Even the "free" drug cards are a waste of money.

Many people who take prescription medication are looking for ways to save money. Seniors on a fixed income are finding that, in many cases, the Medicare Part D (PDP = Prescription Drug Plan) is little or no help.

Stand alone prescription drug plans with copay's charge monthly fees of up to $40. These plans are like the Wizard of Oz. "Pay no attention to the man behind the curtain". In most cases the copay is close to, or even higher than the price you would pay without the plan.

What kind of deal is that?

And the "free" drug plans are even worse.

Here is one drug plan that is heavily promoted to seniors on Medicare. The USA Drug Plan is deceptively attractive, at least until you peel away the layers of the onion and see what you really get.

If you are taking a popular cholesterol lower drug such as Zocor, how much will the drug cost using the USA plan? A 90 day supply of 20mg Zocor is $459 at your local Kroger when using the drug card. If you have a Costco nearby you can get Zocor for about the same per tablet price. (Note, you do not have to be a member of Costco or Sam's Club to take advantage of member pricing on prescription drugs).

But if you use a popular mail order pharmacy, such as Blue Sky, you can get Zocor for $91. Using Blue Sky will save you over $1200 per year on one medication.

We have been recommending Blue Sky to clients for years. This is not a paid endorsement. We get nothing other than the satisfaction of knowing those who follow our advice will achieve REAL SAVINGS.

You may be wondering why prescription drug plans such as the USA plan are popular. There is a lot of money to be made pushing these plans, especially to unsuspecting seniors on a fixed income. Drug plans that do not charge a monthly fee have built in compensation that pays the agent promoting the plan every time you fill a prescription. Each plan works differently, but most will compensate the agent as much as $2 every time you use the card plus up to $0.50 for every prescription.

If you use the card twice a month for a total of 6 medications the agent who sold you the "free" card could make $7. For certain, that is not a lot of money but for an agent with several hundred clients and numerous referrals this can be a real cash cow.

But this is not about how much the agent earns from peddling a drug card. This is about saving money, especially for seniors on a fixed income.

Affordable Medicare Supplement Plans for Georgia Seniors

If you are looking for ways to save money on prescription drugs and Georgia Med supp (Medigap) plans, we have the widest selection and the lowest rates. Compare Medigap plans from AARP, Blue Cross of Georgia and more.

What is an HDHP?

HDHP (high deductible health plan) is what it seems. No moving parts (in most cases). You pay the small medical bills, the policy pays the big ones. Pretty simple.

Some (but not all) HDHP's are eligible for coupling with an HSA. Your insurance agent can tell you which plans are HSA compliant and which are not.

The HDHP works like this. You choose a health insurance plan with a high deductible, usually $3500 or more, but it can go as high as $20,000. You act as your own health insurance company up to the deductible, the plan pays the rest.

Most plans pay 100% of covered charges above the deductible but some will pay a lesser amount such as 70 or 80%.

Some plans have a few office visit copay's or Rx copay's to give some sex appeal. They are usually a waste of money and are not HSA compatible.

Other plans are in fact limited benefit plans that do not cover brand name prescription drugs or may not cover any medication expenses at all. Others will not pay for outpatient doctor visits.

This is like buying auto insurance that covers everything except when you are at fault.

In looking for an HDHP you want comprehensive coverage that pays 100% after the deductible is satisfied and does not throw in a few copay's as window dressing.

Georgia Insurance Shop has plenty of HDHP's available from all the major health insurance companies. If you are looking for affordable health insurance in Georgia and have an interest in HDHP's and HSA's, we are your resource.

Seniors Get Coal in their Stocking

Seniors on Social Security and Medicare are about to find out there will be coal in their stocking this Christmas . . . for the second year in a row. Yahoo News is reporting that Washington will announce this week there will be no increase in Social Security checks in 2011. This is twice in a row the Social Security Administration has cut benefits to seniors.

This means 58 million seniors who rely on Social Security checks will have to get by on the same amount they received in 2009.

The cost-of-living adjustments, or COLAs, are automatically set each year by an inflation measure that was adopted by Congress back in the 1970s. Based on inflation so far this year, the trustees who oversee Social Security project there will be no COLA for 2011.

This comes on top of cuts in Medicare and Medicare Advantage plans that are due to kick in starting in 2011 as part of Obamacare.

This week's announcement about Social Security benefits raises more immediate concerns for older Americans whose savings and home values still haven't recovered from the financial collapse: Many haven't had a raise since January 2009, and they won't be getting one until at least January 2012.

Social Security was the primary source of income for 64 percent of retirees who got benefits in 2008, according to the Social Security Administration. A third relied on Social Security for at least 90 percent of their income.

While it is true that overall inflation has been kept in check for the most part over the last few years, some basic necessities in life continue to rise faster than the CPI.

Gasoline prices are down and food is mostly holding the line. The cost of housing is also relatively stable due to the mortgage crisis that is entering a fourth year of increasing foreclosure activity. Bankruptcy filings are still climbing and hitting new records each quarter but the overall cost of health care is rising unchecked in spite of campaign promises to bring down the cost of health care and health insurance.

Changes in the way Medicare Advantage plans are funded under Obamacrap mean there will be fewer choices next year. Roughly 1 in 4 Medicare beneficiaries opted for the popular Medicare Advantage plans over traditional Medicare and many of those have already been notified their plan will not be available next year due to cuts in funding.

Reduced funding means fewer doctors will be willing to treat patients on Medicare Advantage plans. Most seniors losing the MAP's will find it advantageous to return to traditional Medicare and purchase a Medigap plan to cover the out of pocket costs not paid for by Medicare.

This means a higher monthly out of pocket cost on top of no increase in their Social Security checks.

Popular prescription drug plans (PDP's) will also cease to exist next year under Obamacrap and premiums for PDP's will rise as a result in mandated increased prescription benefits.

So far, 2011 is not looking good for seniors on a fixed income.

The good news is we have access to many low cost, affordable Medigap plans for seniors in Georgia. Several of our Medigap plans have lower premiums than AARP or Blue Cross. This means Georgia seniors can potentially save hundreds or even a thousand dollars a year or more vs. their current Medigap plan.

You have problems, we have solutions. Ask about a competitive rates for Georgia Medigap plans.

Medicare Advantage Plans Go Poof!

Roughly 21,000 seniors will lose their Medicare Advantage Plans (Medicare Part C) in 2011. According to the Chicago Tribune:

A state agency says insurers have notified about 21,000 Iowans that they will no longer provide the Medicare Advantage plans in 2011. 

Under the plan, Iowa seniors get their health care insurance through a private company, not the government Medicare program. The plans provide prescription drug coverage as well as medical and hospital coverage.

Seniors in Georgia will be facing similar issues. Cut backs in funding under Obamacare plus restrictive rules CMS has applied to insurance companies offering Medicare Advantage and PDP's have resulted in many companies opting to withdraw from the market rather than deal with government bureaucracy.

People who lose their Medicare Advantage Plan have the option of returning to traditional Medicare and picking up a Medigap (Medicare supplement) plan to pay for things not covered by Medicare.

Georgia Insurance Shop has affordable Medigap plans for Georgia seniors of all ages.

Take Two and Call me in the Morning

"You will not believe the health insurance applications for young people still in high school. Many are on allergy or anxiety medications. (I understand) it is standard practice for health insurance companies to turn down applicants who are on 3 or more prescription medications. (Not true).

When I was anxious about something in school or my life my mother told me to go scrub the floor and then I would see how good life was.

Life presents trials and mountains to climb as well as disappointments. That is what life is all about . . . learning to deal with it.

There are too many people out there with REAL health problems and they need meds, but I think too many of us take a simplistic and easy way out."

(Quoted from a health insurance blog)