The
question concerning prescription drug coverage for anyone reaching
age
65 is a little
compex and requires action, but isn't too terribly difficult to
understand.
Everyone
who has been covered by the American Airlines-United Healthcare insurance
and becoming that "magic" age, must then be covered by a separate "Medicare
D" drug coverage policy to receive any medicine cost benefits. UHC will
not continue any drug payments under the basic plan, except when the
insured has quite large annual "out-of-pocket" drug expenses, and
properly files for reimbursement for them. The policy then becomes quite valuable for paying the bills if falling victim to really
serious illness and Medicare benefits end.
The
monthly premium for the basic UHC health insurance drops considerably to make
up for the considerably different coverage, and the need for a
separate drug policy.
These
Medicare D insurance policies are different for each State. To find full
instructions on finding plans available to in your area, go to the
Medicare website at: www.medicare.gov.
The U.S.
Government cleverly designed this law to include penalties for anyone not
getting coverage when reaching Medicare-eligible age. If wanting benefits in
later years and not paying for a policy earlier, the premiums charged will be
considerably higher for the rest of the person's life. Not a good
idea.
If a
person uses few or no prescription drugs regularly, one should find a policy
at low monthly cost. It could be a good idea to choose one without a
'deductible', to avoid paying for an occasional medicine, but that's
individual choice. If you use several drugs regularly, then you need to check
each insurer's "Formulary" (drug list) to make sure they will supply your
particular ones. They do differ. Then, use the Medicare website to find which
one is the best value when entering your medications and comparing plans. It
works very well doing this...just takes some time. Change of company or
plan can be made annually in November-December if desired.
(When
applying, you tell them you do not have "creditable" drug
coverage.)
It is good
planning to do all this a few months before reaching 65, so your
insurance will be seamless. You can specify the effective date for
any new policies.
United
Healthcare should automatically change their policy coverage and
premiums when becoming 65, and also send information about your choices. If
you don't get a packet in the mail when nearing that age, do tell them you
need it. They can be sluggish.
I
always urge everyone who can afford the premiums to continue their
UHC basic policy in case of catastophic illness in later years. Though it pays
little during good health, there is no insurance which gives such excellent
coverage (a $1 Million Dollar lifetime 'cap') to prevent financial
disaster if needed, and cannot be re-joined once cancelled.
Now that I
outlined the steps for those who want to continue a personal-choice plan for
their medical care, there are other choices possible when becoming
Medicare-eligible. There are other types of plans available called
"Medicare Advantage Plans", which include "Preferred Provider
Organizations" (PPO), "Health Maintenance Organizations" (HMO), and
others.
These give
complete care with hospitals, doctors and necessary drugs but lessen your
choices of who you get to see and have a lot of rules and regulations,
but generally lower costs. They use your Medicare account to pay part of
their premiums, but will also require "co-pay" amounts when using their
services. If your budget is extremely limited, this could be a good choice,
despite loss of many choices of care. The companies offering this type of
medical insurance can also be found on the Medicare website. If this type
health plan is chosen do not apply for a Medicare D drug
policy.
A lot of
work for someone becoming a 'Senior Citizen'? You bet, but we all have to take
on the responsibility if expecting to enjoy those Golden Years in good
health.
I hope
this helps to understand the needs and choices necessary at this beginning of
your 'senior' life. My best wishes for not needing any
insurance in the years ahead!
The other
item below concerning a possible IAM benefit, will be
handled separately.
Bill Cottrell - TWA Seniors Club President
