With his Medicare starting the next month, the television ad captured the man’s attention. The ad promised that the Medicare insurance would do a great job of covering medical expenses and, to top it off, it would charge no monthly premium.
Accustomed to using computers, the man went to the Medicare.gov website and enrolled in the insurance plan, whose coverage would join his Medicare in beginning the first of the following month.
Slick, except that the Medicare beneficiary subsequently learned that the insurance plan didn’t help pay drug costs at the pharmacy. Worse, he would have to wait months for annual open enrollment to change insurance plans.
The cynic might chalk up the man’s misfortune to deceptive advertising, but the ad accurately described what the plan covered. Not only that, but during enrollment the plan said it covered medical only, although one could arguably miss the disclosures. Unfortunately, the man’s mistake is easily made because the Medicare website mixes plans that cover both health and drugs and those that cover health only.
Fortunately for this beneficiary, his prescription drugs were inexpensive generics that he could afford during his temporary lack of drug coverage. If his doctor had prescribed an expensive drug, he could have investigated options at NeedyMeds.com or Arrayrxcard.com. He could also ask his pharmacist what if any drug-discount cards were accepted.
As a result of temporarily being without drug insurance, this Medicare beneficiary very possibly would be subject to a lifetime late-enrollment penalty; but that penalty would have been modest when applied for a year or less.
If you would like to make an appointment with a Senior Health Insurance Benefits Assistance (SHIBA) volunteer counselor, or to ask a question to be answered here, please see the end of this column.
My twin sister and I live together and will start Medicare soon. We’re interested in Medigap insurance, but have this question: Could we qualify for a “household discount,” or is that limited to married couples?
Many companies that sell Medicare supplement (Medigap) insurance policies offer a household discount on premiums, typically 10%. This discount is not limited to married couples. The insureds may instead be siblings, parent and child or any two people sharing a permanent residence. To qualify for the discount, they should be enrolling at the same time in the same Medigap plan type (Plan G, for example) with the same insurance company.
I’ve been assisting a woman who doesn’t drive and needs assistance getting to medical appointments. Do any Medicare Advantage plans pay for medical transportation?
Reviewing Medicare Advantage insurance plans on the Medicare.gov website, it appears that only three such plans will help with transportation for Medicare beneficiaries in Marion and Polk counties. These three plans have monthly premiums of zero, $99 and $173.
It would be important to call the company to identify details of the transportation coverage.
On the Medicare website, to see whether transportation (or another supplemental benefit) is available review the list under PLAN BENEFITS. If the plan has coverage for a benefit, the benefit will have a green check mark; if not, it will have a red X. Even easier, on the Medicare.gov website filter for Plan Benefits.
For medical transportation, you might also check for other options such as Cherriots Dial-a-Ride service and the Connections service in Polk County. Additional transportation options are available for people who have Medicaid.
Jim Sellers of Salem is a certified Medicare counselor with the Senior Health Insurance Benefits Assistance (SHIBA) program. To ask a question to be answered in this column, e-mail [email protected]. To schedule a free SHIBA phone, Zoom or in-person appointment with a volunteer Medicare counselor, call 800-722-4134.
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