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Paynesville Press - December 28, 2005

A Quick Guide for using www.medicare.gov

By Michael Jacobson

A rough plan for seniors seeking to sign up for Medicare Part D (prescription drug coverage) can be broken into three steps: gathering information, comparing plans, and signing up.

Before senior can compare any plans, they must calculate the drugs they need and monthly dosages. One way to do this is to read the labels of medicines taken regularly. Seek help from loved ones or friends if this proves difficult for you to do.

Seniors have several options for comparing plans. They can call Medicare at 1-800-MEDICARE (1-800-633-4227) or Senior Linkage at 1-800-333-2433 for help. They can see a certified insurance agent for help. Or they can search themselves online at www.medicare.gov.

Seniors can sign up by phone with help, through an agent, or online.

Searching Online
If you know your drug dosages and want to compare insurance plans under Medicare Part D, go to www.medicare.gov.

On the first page, click on Compare Medicare Prescription Drug Plans and then on the circled arrow next to "Find a Medicare Prescription Drug Plan" on the subsequent page.

On the next page, seniors can enter their specified information or choose a general search. Using the general search, they will next be asked for their zip code, current drug coverage, and whether they qualify for additional help. Because 56362 covers parts of three counties, they will next be asked which county they live in.

After choosing to search for Medicare drug plans, not Medicare Advantage plans, click on the button for Enter My Medications. Enter the name of each drug and then click the button Search For Drug.

There may be several variations of the drug, so pick the right one from the list and then choose Add Additional Drugs if you have more to enter or Continue with Selected Drugs if you have entered all your prescription drugs. Then you will have a chance to enter the correct dosages by choosing Change/Enter My Drug Dose & Quantity.

The next chart allows you to change the size of the pill you take - 5 mg, 10 mg, 20 mg, etc. - and the number you take per month. If you take one dose per day, that is 30 per month. If you take two per day, that is 60 per month, etc.

Again, when finished, click on Continue With Selected Drugs.

The next page should give you a chance to choose your pharmacy by clicking on Select My Preferred Pharmacy, and the next page warns you that this might affect your prices and makes you confirm that you want to Continue to Pharmacy Selection.

Then the program lists the Paynesville Community Hospital Pharmacy and Paynesville Corner Drug, the only registered pharmacies in the 56362 zip code. You can choose other pharmacies in various mile ranges. When you select, Continue With Selected Pharmacies, the program lists the available plans from the lowest estimated annual cost to the highest estimated annual cost. For every plan, you can choose to click Enroll at this point.

Examples
To further illustrate how this works, the Press used three fictitious patient examples - Ned VerSick, Mabel Healthy, and Al Waysill - and ran a mock list of drugs - provided by Todd Lemke, Pharm.D., into the Medicare search program.

Ned VerSick (pronounced "never sick") is very healthy and only takes atenolol (25 mg) once a day for high blood pressure (as well as aspirin that he buys over the counter).

For Ned VerSick, his lowest cost plan is estimated at $76 per year. His deductible is actually $250, but his monthly premium is only $1.87 with a monthly cost share of only $4.43.

Mabel Healthy (pronounced "maybe healthy") had a heart attack six years ago and has gone through cardiac rehab and watches her diet for salt and fatty foods. She takes atenolol (25 mg) for blood pressure and to protect her heart, furosemide (20 mg) to prevent fluid build-up in her legs, potassium (10 mEq) for potassium loss (from taking furosemide), lisinopril (10 mg) for her blood pressure, and zocor (10 mg) at bedtime for cholesterol. She also buys aspirin over the counter.

The two lowest plans for Mabel Healthy are only $52 apart but have very different payment structures. The first ($701 estimated annual cost) has no deductible but a monthly premium of $43.41 ($520.92 per year) and a monthly co-pay of $15 ($180 per year). The second ($752 estimated annual cost) has a $250 deductible with a monthly premium of $1.87 ($22.44 per year) and a monthly co-pay of $40 ($480 per year).

Mabel Health has 14 plan choices with estimated annual costs under $1,000. But it took the Press a couple hours to enter all her information.

Al Waysill (pronounced "always ill") has heart failure, atrial fibrilation, diabetes, high blood pressure, high cholesterol, glaucoma, and asthma and takes a host of medications: coreg (25 mg) twice a day for his heart and blood pressure; altace (5 mg) twice a day for his heart and blood pressure; spironolactone (25 mg) twice a day for his heart; furosemide (40 mg) twice a day for his heart; coumadin (5 mg) once a day for atrial fibrilation and to prevent heart failure; amaryl (4 mg) twice a day for diabetes; metformin (1,000 mg) twice a day for diabetes; zocor (80 mg) at bedtime for cholesterol; betoptic drops for glaucoma; xalatan drops for glaucoma; advair 500/50 inhalation twice a day for asthma; alburerol inhaler as needed for asthma; and singulair (10 mg) at bedtime for asthma.

To enter all these medications at www.medicare.gov took a couple hours as well (the website was running faster than with Mabel).

The plan with the lowest estimated yearly cost for Al Waysill is $3,928.



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