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Life Health > Health Insurance > Medicare Planning

5 tips to help clients select Medicare coverage

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With the Medicare enrollment period underway, now may be an excellent time to broach the subject of medical expenses with clients, especially those who could benefit from long-term care policies, according to advisor website

Advisors can help save their clients money on prescriptions thanks to the nonprofit Consumers Union, which, since the Part D drug program began in 2006, has tracked the total cost of five common prescriptions in five states. Medicare beneficiaries who shop around for the best plan could save as much as $2,200 on the cost of their prescriptions. In order to obtain the best deal, beneficiaries need to consider not just the premium but the entire cost of a plan.

The following checklist comes from Adrienne Muralidharan of Allsup Medicare Advisor:

1. Check deductibles and copayments as well as the premium when evaluating costs.

2. What drugs does the Part D plan cover? Clients must determine if a plan covers all their medications. They also need to learn whether the plan covers brand name or generic versions of their drug. In the event not all drugs are covered, the additional cost of the drugs not covered must be considered.

3. What pharmacies can your clients use? Medicare prescription drug plans have contracts with certain pharmacies. Even pharmacies within a network may result in higher copayments.

4 Does your client need “donut hole” coverage? In 2011, the gap in coverage starts when drug costs reach $2,840. Then, until costs reach $6,448, beneficiaries are responsible for 100 percent of costs. However, not everyone who expects to fall into the donut hole would benefit from purchasing gap coverage.

“Someone with very high-cost medications could move through the donut hole quickly to reach catastrophic coverage, where the plan will cover 95 percent of their costs,” Muralidharan says.

5. Do your clients have comprehensive information on the policies that interest them? Pharmacy or online services that aim to help beneficiaries select Part D coverage may not offer comprehensive or relevant information. Help your clients by steering them to the government website


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