Some Tips To Find Information About Medicare, Other Products
Question: I am trying to figure out the Medicare options for my mother, can you direct me to resources to find information about Medicare and other insurance products?
Answer: For those individuals that are comfortable using the internet to search for solutions, there are many resources out there. I appreciate you helping your mother with this task.
I would encourage you to use www.medicare.gov. This is the most useful resource for anyone with Medicare. You can create an online username and password for your mother that will be useful each year as you evaluate her insurance options. This Medicare website enables you to evaluate insurance alternatives available, review Medicare Summary Notices (MSN) and even print out or order a new Medicare card. It also allows you to access a list of all the past insurance products you mother has had while enrolled into Medicare. In some situations you can even print out a temporary card for those current products you are enrolled in.
You may enter the current medications, and the pharmacies your mother prefers to use. This information is then processed into a useful list of coverage options for your prescription drugs. The calculation is based on the cost of medications, pharmacy contracts and plans available.
Once this data is entered using that login, the website saves this information so that you can update it as medications change over time or look up how a newly prescribed medication to see how it will impact the cost structures moving forward. You can also adjust your pharmacy choices to see if that could reduce your costs year to year. Each year, the Part D prescription drug plans adjust their pharmacy contracts therefore a preferred pharmacy this year, may not be a preferred pharmacy in 2024.
You also could use individual insurance company’s websites. If the www.medicare.gov website did not calculate this data for us, we would have to use each individual company’s website to calculate this cost evaluation. That would mean entering all this data into the individual websites (over and over) and that takes a lot of time. But those individual websites can offer us some insight into medication alternatives and also special information they like to highlight about their plan. If your mother has an inhaler and the current plan doesn’t cover it, you could use the insurance company’s website to see what alternative inhalers the insurance product does cover. Insurance company’s websites include their 2024 Formulary (List of Covered Drugs). This is an actual printed book, or a PDF that can be downloaded and view online to research particular medications you are interested in. The Evidence of Coverage would explain the deductible, the Tier structure of the medications (how much each Tier costs) and the gap coverage provided in the plan.
Another online resource is New York State Department of Financial Services. There is a section on the website devoted to those with Medicare who live in New York. The link I use most often is: https://www.dfs.ny.gov/consumers/health_insurance/supplement_plans_rates
This link connects you to the Medicare Supplement Plans offered in NY and the pricing structure offered by each plan. This allows you to put in your zip code and see the current pricing structures for all the Medicare Supplement Plans offered (DFS Portal). This website also includes contact information for all those companies, so you can call and discuss any concerns you have with a company service representative.
Another great website is www.medicarerights.org for The Medicare Rights Center. The Medicare Rights Center works to ensure access to affordable healthcare for those with Medicare through counseling and advocacy, education programs and public policy initiatives. This website is loaded with learning tools, resources and contact information that will be very helpful to you as you learn about Medicare.
Putting all these resources together may make managing your situation a little easier to evaluate insurance alternatives on behalf of your mother. There are many individuals with Medicare out there who are not comfortable using the internet, so your help is appreciated. There are also many individuals out there that are comfortable using the internet and hopefully this information will be useful to them as well.
Janell Sluga is a Geriatric Care Manager helping seniors in our community access services and insurance. To reach her, please email firstname.lastname@example.org.