I am 70 years old and retired collecting SS and under...

7 answers | Last updated: Feb 16, 2011
Justcappy asked...

I am 70 years old and retired, collecting Social Security and under Medicare. I take no prescriptions. I am in excellent health and expect to remain that way. BCBS wants $35 + per month for Part D - Why should I pay this? Justcappy

Expert Answers

The Medicare Part D prescription drug plan you mention is about average in terms of monthly premium -- about $35 per month. For many people, the premium cost is offset by the savings they get on their regular prescription drugs. But if you do not take regular prescription drugs, why should you pay this $420 a year? The answer is, you shouldn't -- it's a waste of money. Nonetheless, you might still want to consider enrolling now in a different Medicare Part D plan if one with very low or no premium is available to you where you live. Here's why.

If you don't enroll when you're first eligible for Medicare (at age 65) but later do join a plan, you pay a penalty of 1 percent per month on the premiums for every month you've delayed. This higher premium cost applies to any plan you eventually enroll in, and the penalty is permanent. You don't regularly use any prescription drugs now, but it's possible that you might regularly need such drugs -- including some very expensive ones -- in the future. Since you've already delayed at least 60 months, if you were to enroll in a plan now, your premiums would be 60 percent higher. And if you continue to delay, that penalty amount could make the premiums much higher. If and when you do need drugs and you want to enroll in a Part D plan, the particular plans that cover your drugs may each have a high monthly premium, which would be considerably higher because of your long delay in enrolling. If you enroll in a plan -- any plan -- now, you will limit the penalty to 60 percent. So, if you can find a plan that has a very low premium ($5 a month or less) or none at all, you can sign up for it -- even if it doesn't have very good coverage -- because enrolling in any Part D plan will stop the growth of your permanent penalty, and you won't have to pay much if anything to do so. Then, if and when you do need drug coverage, you can switch to any plan that covers the drugs you need.

Community Answers

A fellow caregiver answered...

You mention nothing about supplemental coverage either. You may want to explore some low cost options there, if you can afford it. You may be healthy, as you define it. But even if your doctor says you are "healthy", there is always the unspoken "for a person your age". All it takes is one fall, one bout with an infection or flu, and you're health is on the bubble. Don't be cavalier about insurance, because even if you don't have much to lose if you were forced to file bankruptcy due to medical bills, you have plenty to lose if you were unable to get timely and appropriate care provided through supplemental coverage. I cringe when I think about how poorly my father would be faring with his cardiac and dementia issues if he did not have his supplemental coverage the last 20 years.

Lrossman answered...

A couple of additional points on Part D coverage. It's important to remember that Part D is insurance and like any other insurance you purchase it to protect yourself against financial risk - future or current. So while you might not need presecriptions today, one health event can put you in a position of spending a lot of your savings on prescription drugs. As suggested, a low cost plan gives you some coverage if you need it and stops the penalty increases for delaying purchasing coverage. If you meet certain income reuirements, you might be eligible for "special help" -- see medicare.gov.
You can't do anything about this right now because as a Medicare beneficiary you can only sign up for Part D plans between Nov. 15 - Dec. 31. You can look at plans now, but the new pricing won't be available until September-october 2010 for 2011 plans.

A couple places you might try to get a quote on a variety of companies is www.laihealth.com or www.planfinder.com or try the Part D comparision tool at www.medicare.gov.

Lindasd answered...

My mother was spending the average $35 a month premium. What is not mentioned is that you also have co pays on the drugs and a donut hole (gap) where there is no coverage (you pay it all at their rate plus still paying the premium). The gap period takes what the insurance company pays for the drugs and when that totals the maximum you start paying the full amount of what they pay for the drug (which is not the cheapest cost).

What I found was that I could get mom's drugs which are all but one generic at WalMart so much cheaper than through the Medicare PartD. The actual total cost of the premium, co pays, and gap cost her a horrible amount more than if I get the generics at WalMart and the brand name whereever I can find the cheapest.

Part D is very deceiving. The way the gap is calculated my mom ended up getting only 90 days drugs and then fell into the gap. Then was paying the premium the rest of the year with no benefits. How can the insurance charge her three times more than it can be bought at WalMart for a generic drug? It happens. She was better off before Part D was in place. It took me years to figure that out and almost broke her in the process.

I dropped the Medicare Part D and she is now actually saving money rather than going towards the poor house. As stated in the article, this assumes she will not need any expensive medication. However, expensive medication just moves you towards the gap faster so understand how these plan work very well before you think you are saving money.

Bonnie63 answered...

Like you my mom was healthy and frustrated about paying for insurance that she wasn't using then she had a heart attack.

She went from taking no drugs to now taking 6. The first month it cost me $207 for a 30 day supply. Luckily that was in December and I still had time to find a better plan for 2010.

Her plan is more money a month but the drugs only cost me $66 a month and she is working on getting some assistance with that.

Finding the cheapeast plan sounds good until you get hit with the reality of life.

Greendeere40 answered...

I fell into this situation, when Part D became active I was not quite the age for it. But my husband was, he was automatically put on a plan. At that time he was not taking any prescriptions. He cancelled the the plan and lo and behold didn't he get diagnosed with high blood pressure. Fortunate he was able to have his presciption filled at Walmart. Then about six months lately he was diagnosed with dabeties type 2. Again he was able to go to Walmart. He started have gastric problems with this medication and was put on a brand name and it cost a lot more. That fall he signed up for the RX plan through his health insurance, he was penalized because he had been without a plan for 10 months. This was do to fact that you can only sign up from Nov 15th through Dec 31st. Then it came my turn, I have never been prescribed a drug until I went in for emergency sugery last March, course my health plan paid most of the drugs they gave me. I have not taking and prescription or drugs since the sugery. I did sign up finally this past fall, I also was penalized for not having it sooner. I still think this wrong that we have pay for something we don't need at this point. But I realize that sometime in the future I might need to have this coverage. But my thought is this is so very unfair. I know there are people out there that don't have any type of coverage, but I feel we shouldn't have to pay for them.

Cmacp answered...

On the other hand, the maximum that Part D covers is $2850 before the Donut-Hole is reached. At that point you will pay all medications yourself out of pocket. Basically, if you need medications that retail at over $237 a month, you will wind up paying the monthly part D premium, plus co-pays, plus run out of coverage. Part D helps moderately. If your plan doesn't cover the drug you are on, your out of pocket will increase even before you reach the donut hole. The Part D needs a serious overhaul. It does not give Senior Citizens and the Disabled, the protection they need.