Tag Archives: prescription drug coverage

A Happy Ending from Your Decisions

Vantage Point: Life Is Not Like The Brady Bunch

Growing up watching The Brady Bunch, I loved how when there was a problem, like Jan getting a bad perm, Greg having his first fender bender, or Marcia getting braces, it was always resolved in a happy ending by the end of the episode.

I didn’t think to question how Mr. and Mrs. Brady could afford to raise 6 kids and pay for a maid and the mortgage on a tri-level house. I know now, from raising my own kids, that braces are really expensive, and so is adding teenagers to your car insurance. Real-life decisions don’t always end as positively as a Brandy Bunch episode.

In my work, I counsel people who made a choice that costs them later. For example, if you don’t pick up prescription drug coverage when you first become Medicare eligible and then realize you need to add it later, you’ll get charged a late enrollment penalty. Many times in these cases, members have sadly told me that they didn’t know or that no one had told them. They’ve truly taught me the importance of staying informed.

Recently, I had the chance to meet with Callie Klein from COUNTRY Financial, and we found that we share a mutual desire to learn about each other’s professional services.

We know Medicare can be confusing, so we do our best to help people make sense of their options. Retirement planning can also be confusing, but Callie helped me to understand how choices like life insurance and long-term care can affect your financial future. Callie pointed out that people are living longer, and some people can spend just as many years in retirement as they did on their career. That’s what makes it so important to plan ahead, so your resources match your longevity.

As we enter a new year, I am reminded how fast time goes and how important it is to give some thought to your future now. Set some long-term goals rather than just short-term resolutions.

If you haven’t already and need help, I encourage you to seek out a professional like Callie. She showed a genuine concern for her clients and a desire to guide them toward the decisions that will help them attain their future retirement goals. Professionals like her can help you at least become educated and stay informed.

Most importantly, though, I wish you happiness in 2016, and I hope that, like an episode of The Brady Bunch, your biggest problems are resolved quickly and with a happy ending.

Shannon Sims is a Medicare community liaison for Health Alliance, serving Chelan, Douglas, Grant and Okanogan counties in Washington. She has four sons and two grandsons. During her time off, she performs as part of a rodeo drill team on her horse, Skeeter.

Medicare Basics Without an App

Vantage Point: There’s Not an App for That – But We Can Help!

Personal fitness trackers—like the Fitbit® or Jawbone®—are popular devices to help you keep your New Year’s resolutions and stay fit all year long. The fitness tracker collects data and sends it to a phone app that tracks physical activity, calorie intake, and sleep quality. Wouldn’t it be cool if the device included an insurance tab to help people navigate their Medicare benefits, too?

Could you imagine how you’d feel slipping on the device if it said,
• “You have adequate coverage for your current health.”
• “Your doctor is in-network, and the out-of-pocket cost for your upcoming appointment is $10.”
• “Warning, you are nearing the prescription coverage gap.”

Until that technology comes along, Health Alliance Medicare can help explain Medicare basics. Most people paid for Medicare Part A through their payroll taxes while they were working, so they don’t pay a premium now. Part A covers inpatient hospital procedures, but not the doctor who does the procedure.

Medicare Part B covers the doctor and requires a monthly premium. Both A and B have deductibles (what you pay before your coverage kicks in) and coinsurance (a percentage of total cost that you pay). Figuring out coinsurance is tricky because it’s hard to plan what the overall doctor visit or hospital cost will be.

Medicare Part D is for prescription drug coverage. If you don’t choose Part D when you become eligible for Medicare, you could pay a penalty, called the Late Enrollment Penalty, if you add it later. If you pay a lot for your medicine, it’s important to read your monthly Explanation of Benefits to see if and when you’ll fall into the coverage gap.

Medicare Advantage plans, like Health Alliance Medicare, are called Part C and cover every benefit of Original Medicare and more, plus you can add prescription drug coverage. Medicare Advantage plans can be an easy transition for those turning 65 because they look a lot like employer insurance plans.

Until someone invents a Medicare app, consider Health Alliance Medicare your source for information. Helping people get started with the right information to avoid common and costly pitfalls later is the best part of our jobs.