Medicare Questions - my mother needs help picking plan?

My mother has come to me to help her pick a Medicare plan. I don't know ANYTHING about Medicare. I will probably spend most of the night on the internet looking up information about plans. In the meantime, if anyone has some advice for me on what plans are the best, Part A/B/C/D, etc., I would really appreciate it.

We have an appointment tomorrow to get her started in the process. If anyone knows the best questions I should ask them (at the office), please advise.

Thanks so much! I know some of you must have gone through this (either yourself or for a loved one).

: )

Your mother is very fortunate to have your help and concern! I sense true frustration in your post--and you are right, the folks in Washington don't exactly make it really easy to understand the nuances and facts about Medicare. Hopefully, you have already accessed the website Medicare.gov. This provides basic information that you will want to know.

Medicare questions can be confusing! Choosing between traditional Medicare and the new "Medicare HMO-type" plans is one of the first choices you and your mother will get to make. If you choose traditional Medicare--which I personally favor as an option, then you and your mother will get to choose to sign up for "supplemental" Medicare insurance and Medicare Part D--the part of Medicare that pays for certain prescription drugs. Getting the best supplemental coverage and/or a a Medicare Part D plan, for example, depends on several factors, including what kinds of prescription drugs your mother takes, what kind of plan she (and you ) are willing to accept, and whether the plan you want will pay for the specific prescription drugs you need. It is absolutely very helpful if you have a list of your mother's medications, frequency and dosages. You will also need the name of the pharmacy that your mother gets her medications from and the pharmacy's phone number. The two of you will need to know what Medicare Part D plans your mother's preferred pharmacy accepts

Unlike Medicare Part D plans, Medicare4 supplemental plans and options are standardized, however interpreting these benefits can still be very confusing!

If your mother and you are considering enrolling in a "managed care plan" --usually called "Medicare Advantage," you will for sure want to read the fine print. For example, if your mother likes to travel, will this plan cover her if she should become ill in another state or country? What are other advantages or disadvantages to enrolling in such a plan as to enrolling in "traditional Medicare?" If your mother likes her current physician, is this professional participating in the particular HMO plan? Will your mother be able to switch back to traditional Medicare if she does not like the health services she is receiving from the HMO group?

If you want to talk to "real people" who will listen carefully to your questions and who aren't "selling anything" I would highly recommend that you call your local Area Agency on Aging. Folks at the Area Agency on Aging can help you and your mother sort through Medicare options and choices. Area Agencies on Aging are one of the best kept secrets around for older Americans and their families who are seeking information on Medicare, Medicare supplemental policies, Medicare Part D and other kinds of consumer questions. There is one where you live, since this is a national network. The staff there will visit with you and guide you to information you need to answer your question. Since they talk with seniors every day--and answer lots of questions--they will know the "scoop" on Medicare and Medicare issues and plans available where you live. If you and your mother have already selected a couple options you are most interested in, they will be able to help you compare the pros and the cons of the plans you have identified as options and suggest other information to check out before you "sign on the dotted line."

You can call toll-free 1-800-677-1116 to find how to contact the Area Agency serving you. When you call your local Area Agency on Aging, ask for the staff who provide "Information and Assistance."

You and your mother should also know that Area Agencies on Aging have information and sponsor services available for older Americans and their caregivers. I know your focus is on Medicare enrollment, yet, connecting with your Area Agency on Aging will provide other helpful tools that you and your mother may find helpful in the future.

If you do contact your local Area Agency on Aging and like the help that they give you, let your local county officials and your folks in Congress know. Area Agencies on Aging don't have big budgets--their funding comes from the Older Americans Act--and funding for most parts of this Act has not increased significantly in about 25 years! Your voluntary financial contribution of any amount--which is not required to get the help you need to answer this question--would certainly be appreciated and would be used to help your older friends and neighbors.

(Another source of information about current issues related to Medicare you might want to check out is the website for the Medicare Rights Center.)

Hope this helps! Thanks for caring! Best wishes and good luck to you and your mother!

Medicare Part D is the part of Medicare that deals with prescription drugs. The most important thing to ask is which plan covers all or almost all of your mom's medication. Secondly, is there an annual deductible. Find the plan with the lowest deductible and covers all of mom's meds. Another thing to ask about would be, how much are her co-pays going to be for each of her medications (yes, they can vary from drug to drug). Those are the major points you want to ask about. Personally, I think our seniors got jipped by this whole Medicare Part D scam, but nothing can be done about it now, right. Good luck helping your mom find a plan that fits her needs.

I have been through pure unadulterated h--l with the Medicare situation. To begin with, I automatically had Part A when I reached a certain age; when I retired I took Part B and the cost was deducted from my Social Security check each month. There is no charge for Part A since a charge is taken out of your pay for that. The real headache is Part D (for prescription medication). That has to the most ridiculous thing that the Washington people has come up with. I e-mailed everyone from senators, congress, Social Security Admin., and President Bush inquiring mainly about why Social Security was considered income as most states will assist with medication expenses if your income is not too much. SOO, SINCE I AM ON SOCIAL SECURITY I HAVE TOO MUCH INCOME and have Blue Cross insurance through my last employer (it was part of the retirement package). To make matters even worse, the company that disperses medication for BC (Medco) has redone their co-pay prices and are basically the same as it would be under the Medicare Part D Plan. My co-pay alone the first of this month was $229.89. Believe me, I don't know what to tell you -- but it ain't gonna be easy.

By the way, I did find out that Congress sets the rules and guidelines for whatever the Social Security Administration does or can do.

I'm not sure about your question. There is only one Medicare health plan from the Social Security Administration. There are several health care coverage plans that can accompany Medicare and provide Rx coverage. A Medicare supplement plan is one that will be the primary insurer when costs are incurred. They are very expensive. Medicare is an 80/20 plan. A supplement will pick up the 20% that Medicare doesn't pay---in most states. Every state has different plans to offer. Medicare Part D is for Rx coverage. With some supplemental or advantage plans, a Rx plan is included.
However, you can just have the Medicare Part A & B and buy a separate Part D plan and it is cheaper. I went through all this last year and did a lot of research.
Make sure she looks for a Part D (Rx coverage) that has a drug formulary that has all her drugs on it. Not all of them do.
I chose a plan from AARP (Part D) and just have Medicare A & B and am happy with the choices.
Questions:
1) What is the difference in a Medicare supplemental plan and a Medicare Advantage plan?
2) Do they have a Rx drug coverage?
3) Compare coverage of all plans available and costs.
4) Why would I need an extra health plan if I have Medicare A&B?
5) Are all my prescribed drugs on the drug formulary of the Part D plan I'm interested in?
You can also go online to the SSA and pull up a comparison of different plans in your area. They are arranged in side by side tables that makes comparison easy.
GOOD LUCK!!