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Medicare Part D can save money for low-income senior citizens
A Mahoning County woman living on $500 a month qualified for Medicare’s Part D low-income subsidy, or “extra help” program — and saved $4,000 a year on her prescription drug costs.
“That’s huge for her,” said Lisa Solley, chief of community relations, wellness and training for Area Agency on Aging 11, which conducted the Part D benefits check-up session this year, at which the woman learned the good news.
In addition, under “extra help,” recipients cannot fall victim to the so-called “doughnut hole,” a gap in coverage that can cost unsuspecting seniors thousands of dollars; and they can change their Part D drug plan anytime, not just during the annual re-enrollment period of Nov. 15 through Dec. 31.
“I want people to know about that program,” said Solley.
There are a lot of elderly, low-income people in the agency’s service area of Ashtabula, Columbiana, Mahoning and Trumbull counties who may be eligible.
“We will fill out the application for free — just call the agency.”
It’s not just low-income residents who can potentially benefit from help in choosing a Medicare Part D prescription drug plan, she said.
For example, she said General Motors and Delphi Packard employees who lost their health care benefits near the end of 2009 had to quickly choose a Part D plan. After a year on their plan they may not be satisfied with the coverage, or their health and prescription drug needs may have changed indicating a need for a different plan, she said.
Also, Solley said residents newly eligible for Medicare may need help sorting out Medicare rules and Part D plans.
First-time Medicare recipients must enroll in a Part D plan if they aren’t covered by a reputable private plan or through work or pension. If they fail to enroll by Dec. 31, they could face a penalty of 1 percent of their Part D premium for every month they are late, forever, said Jude Signoriello, a registered nurse and licensed social worker who is program director at the Girard Multi-Generational Center, 443 Trumbull Ave.
Seniors are very confused about Medicare Part D, said Signoriello, who counsels seniors on Medicare as part of her job.
One of the main things they need to realize is that “one size (plan) does not fit all,” she said.
They have to consider all their variables — medications, co-pay, deductible, cost, and that hospitals and doctors go on and off plans, she said.
“Mostly what seniors want to know is ‘what’s it going to cost me and do I have to change doctors,” said Signoriello, a 1967 graduate of Girard High School who has nursing and social work degrees from Youngstown State University.
Part D is not perfect, but it is a help. And for low-income people, it is a godsend, Signoriello said.
Most importantly, people need to know about the “extra help” program and come in every year for a benefits check, she said.
To save time and frustration, when people come in for counseling they need to bring information and documents, including Social Security card, Advantage card, list of medications including dosage, and income and assets information, Signoriello said.
One of the things that may not be clearly understood is gap coverage — the “doughnut hole,” Solley said.
Gap coverage is a period during the calendar year when recipients find themselves without prescription drug coverage in some plans.
In 2010, when total prescription drug costs, including what their plan has paid as well as out-of-pocket costs, exceeded $2,830 for people without gap coverage insurance, coverage stopped until total costs reached $6,440 when Medicare kicked back in.
If a recipient falls into the coverage gap he is responsible, in almost every instance, for 100 percent of the costs, which can be thousands of dollars. If they hit the doughnut hole early, that’s a red flag that they may not be in the right plan, Solley said.
She urged all Medicare Part D recipients to attend one of the agency’s free benefits check-up workshops or call their local senior center for help during the enrollment/re-enrollment period which ends Dec. 31.
AAA 11 Medicare check-ups are Dec. 8 from 10 a.m. to 2 p.m. at Senior Independence Home Health, 1110 Fifth Ave., in Youngstown; and on Dec. 14 from 9 a.m. to 3 p.m. at Area Agency on Aging 11, second floor of the Eastwood Mall, 5555 Youngstown-Warren Road, in Niles.
Also, they can visit medicare.gov on a computer and click on “picking a plan.” The program will search through the government-approved plans and give you a short list of the ones they might want to choose from, based on their medical needs, Solley said.