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Medicare 101

Oct 01, 2016 08:30AM ● Published by Jason Huddle

Medicare 101

Medicare enrollment is confusing and unnerving for seniors. Fortunately, Cannon Pharmacy is helping people understand their options in picking the best plan for them.

Josh Young, a pharmacist at Cannon Pharmacy Concord, explains. “If you’re Medicare eligible and don’t have credible coverage, you have to pay a penalty for the time spent without it.”

Medicare Part A covers hospital expenses, Part B covers other medical expenses and Part D covers prescription drugs. Medicare typically pays 80% on parts A and B, leaving the payee responsible for the remaining 20% out-of-pocket. With Part D there are multiple companies a payee can choose from with different coverage options and expenses.

Fortunately, a payee can purchase extra coverage, called a Medicare supplement, that covers the 20% not covered by Medicare. Another option is a Medicare Advantage plan, also called Medicare Part C. These plans combine parts A, B and D into one plan, with monthly premiums as low as $0.

Young says it’s important to note that Medicare is not one-size-fits-all and spouses can have different plans. “Some plans can increase premiums by more than 300% or increase deductibles and co-pays,” he says. “Then again, some may not offer the same coverage they did before. Many times we’ve saved people up to $2,000 annually by tailoring the right amount of coverage for them by not enrolling for coverage they don’t need.”

Young says avoiding the donut hole is the #1 way in which a patient can save money with Medicare counseling. “We do this by utilizing therapeutic substitutions, screening for federal assistance programs, and manufacturer and federal grant monies that can further cut patient costs.”

While in the donut hole, patients are responsible for 45% of brand name medication costs and 59% of generic costs. “If we can keep the combined (patient and insurance) cost on prescriptions to less than $275 per month, we can keep them out of the donut hole. Our goal is to explore all plans available and pick the coverage that is exactly right, at the best cost.”

So where to begin? Young says that Cannon Pharmacy offers free Medicare counseling. “Call any Cannon Pharmacy and speak with a pharmacist about your Medicare coverage. We’ll be happy to help guide you through any Medicare and open enrollment needs you may have.” Medicare enrollment is October 15 through December 7.

Article by: Jason Huddle

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