Medicare Part D: What to know and how to save

While some find that the Medicare prescription drug program has its benefits, others believe that the program is flawed.

Since its implementation in 2006, Medicare Part D prescription drug coverage has held the attention of policy makers, doctors, pharmacists and senior citizens.

"Seniors have a lot of choice [with Medicare Part D]," said Devon Herrick, Ph.D., in praise of the plan. Herrick is a senior fellow at the National Center for Policy Analysis in Dallas. "They actually can pick a plan that really best meets their needs," he said.

Others, like U.S. Rep. Dennis Kucinich (D-Ohio), think that Medicare prescription drug coverage needs some improvements. This August, Kucinich introduced the Medicare Drugs for Seniors Act, (MEDS Act), which would, among other things, give seniors the option to purchase prescription drugs from an approved list of foreign countries.

"Unlike the current Medicare Part D program, the MEDS Act works to guarantee that all America's seniors are provided with the medication that they require," said a spokesman for U.S. Rep. Jesse Jackson, Jr. (D-Ill.). "With the ever growing cost of prescription medications, the MEDS Act works to ensure that no senior is forced to skip doses or go without because of the high cost of their prescriptions."

According to a spokesman from the federal Centers for Medicare  Medicaid Services (CMS), there are 44.2 million Medicare enrollees who are eligible for Medicare Part D. As of January 2008, only 25.4 million have signed up for the program. In Illinois, 12.2 million people are enrolled in Medicare while only 964,000 are enrolled in Medicare Part D.

As the time for Medicare Part D enrollment is quickly approaching, here are some things to think about when making decisions:

 Enrollment

Seniors who are 65 or older have from November 15 to December 31 to enroll in general Medicare - which covers hospital and medical insurance - and Medicare Part D.

While Medicare Part D is optional, seniors who do not sign up at age 65 will be penalized 1 percent of the "national base beneficiary premium" for the current year for each month they are not enrolled.

For example, the Medicare Part D national base beneficiary premium for fiscal 2008 is $27.93. One percent of this number is $.28, according to CMS. Upon enrolling, a senior would have to pay 28 cents for each month he or she does not enroll in Medicare Part D.

"If I turn 65 and I'm not actually on any drugs, I might go ahead and sign up and be part of the risk pool," Herrick said. "If I wait until I'm 75 and.I'm on 10 other drugs, it would be much more costly for the people enrolled as well as tax payers. So [the government] wants to create the incentive for you to be in the risk pool the entire time. In fact, a lot of people might be better off waiting."

Herrick's late grandfather actually never enrolled in Medicare Part D because he never took a prescription drug in his life up until he died at age 87. He just had no need for Medicare Part D coverage.

 Finding the right plan

According to CMS administrator Abby Block, Medicare.gov has an excellent online tool that allows senior citizens to type in the prescriptions they are currently taking and find the best plan to cover their drug costs. By using this Medicare Prescription Drug Plan Finder, you can compare premiums and co-payments of different plans, side-by-side.

"It will basically calculate for them a list, in descending order, of the plans that are the best choice for them," Block said. "So that's been in place for a couple years now, and every year we actually improve the information on it. "

Seniors can call 1-800-MEDICARE if they do not have Internet access and still want to use the tool. A customer service representative will walk a senior through the process of using the tool and then actually send them a printed-out version of the results through the mail, Block said.

Herrick recommends that once a year, seniors should reexamine their current Medicare Part D plan and see if changing plans would lower their costs.

 Ways to save money on prescription drugs

There are other ways to save on prescription drugs, Herrick said, regardless of what you currently pay for Medicare Part D.

One of the ways to save money on prescription drugs is by asking your doctor to write you a prescription for the generic version of the drug you need. According to Herrick's research, generic drugs can cost anywhere from 20 to 80 percent less than name brand drugs.

Luke Vander Bleek, owner of independent Fitzgerald Pharmacy in Morrison, Ill., and chairman of the board of the Illinois Pharmacists Association, said that choosing drugs that are in your Medicare Part D's formulary - or list of approved drugs - is more important than purchasing generic versions of drugs.

"Be involved in the prescribing process," Vander Bleek said. "Let your doctor know that you have a formulary plan for a drug, and that he or she finds the appropriate drug for your care." Vander Bleek adds that generic prescriptions are very readily available and benefit both pharmacies and customers.

Buying drugs in bulk can also help you save; so instead of purchasing only 30 pills at a time, ask your pharmacist if you can purchase 90 or 100 pills at once. Vander Bleek said this money-saving tip might be more appropriate for people paying directly out of pocket for prescription drugs.

Another way to save is to purchase pills that are double the dosage and split them in half. Sometimes a pharmacist will do it for you, Herrick said.

"A lot of companies are making their products difficult to split," Vander Bleek said, because drug companies realize they are losing potential profits from this trick. But it's still useful, if the pills can be easily divided.

So even though customers of Vander Bleek complain that Medicare Part D offers "too much choice," there are ways to navigate the sea of drug plans and find the right one that saves you the most money.