Here’s an Rx for your Medicare prescription plan
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Dear Mr. Berko:
I need to buy a Medicare prescription plan for my wife and me. The plan I bought last year was a huge mistake. I was sorely misled by the pushy salesman who recommended our policies. We are now using another salesman, a young man of 31, and he seems knowledgeable about the plan he is presenting. However, when we ask about other plans, he keeps saying that his agency has looked at every plan in Florida, and they have decided that the American Prescription Pathways plan is best for us. What can you tell us about American Prescription Pathways? My wife is concerned because this fellow only recommends American Prescription Pathways and won’t even discuss the more than 100 remaining Florida Medicare drug plans. He tells us that American Prescription Pathways pays for all 12 drugs we use, and that won’t change in the coming 12 months. Our current plan covered every drug we used when we bought the plan, but without notice it changed. Now, seven of the 12 drugs we use are no longer covered. My wife wants to visit with a Medicare representative to get an objective answer because she thinks this salesman has been trained to only sell American Prescription Pathways. Both of us would appreciate your input.
D.S., New Port Richey, Fla.
Dear D.S.:
I’m unable to provide you with the advice you need. I can’t tell you anything positive or negative about American Prescription Pathways. But I can tell you that it is an awesome profit-generating machine making bushels of bucks selling Medicare prescription plans to seniors.
These Medicare prescriptions plans are a fantastic financial boondoggle for the health-care industry. Most folks on Medicare don’t have even a molecule of an idea about which of the 145 different Medicare prescription plans offered in Florida is best suited for them. This bloated menagerie makes comparisons between plans impossible even for a supercomputer. And most of the quacky health insurance people who peddle these Tweedledum and Tweedledee plans are dumber than sand moles. So they tend to sell plans based upon the following:
1. Commission payout.
2. Free tickets to special sporting events.
3. Reimbursement for personal annual selling expenses.
4. Holiday gift packages.
5. Invitations with spouses to seminars in Hawaii or Las Vegas.
The agency employing your young man has trained him well. So I’m willing to give you an ironclad, personal guarantee that he knows bupkis about the 144 other Medicare prescription plans the legislators permit to be sold in Florida. The agency employing this lad tells him to sell either Plan A or Plan K or Plan S, and the common sales pitch is, “We always select the plan that covers more of the drugs you use than another plan.” Don’t even for a microsecond assume that the schlemiel giving you this advice knows what drugs are covered by the remaining 144 plans.
One would think that because you are taking 12 prescriptives and Plan K covers 12 of them while Plan A covers nine, the obvious choice for most folks would be Plan K. Wrong!
The right way to select a plan is to determine the percentage the plan will pay of the retail cost of all the drugs you use. For instance, if the retail cost of Lipitor is $60 at CVS, you need to know what percentage of that cost is paid by the plan. Is it 20 percent, 40 percent, 60 percent? An average coverage of 40 percent on the retail price of nine drugs is almost always better than an average of 20 percent on 12 drugs.
If this salesman is advising you properly, he should be able to tell you which of the 145 plans reimburses the highest percentage of out-of-pocket costs for all of the drugs you use. He should also be able to give you something in print to support his recommendation.
Meanwhile, don’t bother calling the Medicare Rights Center. I did, and I was overwhelmed by their underwhelming assistance. And the Center for Medicare Advocacy Inc., found online at www.medicareadvocacy.org, is also useless in helping you choose a prescription drug plan. So I sent you the phone number of a Colorado health insurance executive who, if you are nice, might help you make the right choice.
Please address your financial questions to Malcolm Berko, P.O. Box 1416, Boca Raton, Fla. 33429 or e-mail him at malber@comcast.net. © 2009 Creators Syndicate Inc.
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