Democrats don’t want to cut doctor fees by 21%, as required by law. Republicans don’t want these cuts either. But political partisanship has held up the necessary vote to prevent the cuts from going into effect. In order to avoid the cuts, which were supposed to take effect on June 1, Medicare has put off paying its bills to doctors. This delay was supposed to last just 10 days. Now they will delay paying bills for another week, so they won’t have to pay docs 21% less for services already provided to Medicare patients.

I’m on vacation, so I’m providing a link to an article from the AARP Bulletin that talks about this stalemate: “Medicare Doctors Face Pay Cut – Again”.

Seniors who have gone into the Part D donut hole will be getting a check from Social Security for $250, and scam artists are using this news to their advantage.  Apparently, crooks have been calling seniors telling them they need to provide personal information in order to get the $250 rebate check.  In fact, seniors and younger Medicare beneficiaries do not need to do anything to get their rebate check because Medicare has their prescription expense information. When a person hits the donut hole, a $250 rebate check will be generated and mailed to the address that Medicare has on record for that person.

A person enrolled in a Medicare Part D drug plan falls into the donut hole when what she has paid out-of-pocket for prescriptions and what her drug plan has paid for her prescriptions add up to $2,830.  Part D drug plans are offered by insurance companies and the companies send out monthly statements to people enrolled in their plans. These statements tell people how close they are to the donut hole each month.

When a person falls into the donut hole, she will then have to pay 100% of the cost of her prescriptions. People who take two or three brand name prescriptions are likely to go into the donut hole.  The more expensive the prescriptions are, the sooner the person will go into the donut hole.

The $250 rebate check is small consolation, but next year more relief is on the way.  In 2011, seniors who go into the donut hole will pay only 50% of the cost of their prescriptions.  The pharmaceutical companies  have “generously” offered to cut the cost of drugs by 50% for people who fall into the donut hole.  The Affordable Health Care Act that was passed this year requires drug companies to agree to this discount in order to participate in Part D.

Because so many scammers are targeting seniors, Medicare is spending millions of dollars in radio, television, and newspaper advertising to tell seniors not to give out personal information over the phone. If someone calls saying they are from Medicare or Social Security, the senior should not speak to them.  Medicare and Social Security do not call seniors.

CLICK HERE FOR A DETAILED EXPLANATION OF PART D AND THE DONUT HOLE.

The brand new Medicare Supplement Plan N is proving to be very popular with seniors who want lower premiums but comprehensive coverage to fill the gaps in Medicare. I was just talking with a representative of a well-known Medicare Supplement company that has been overwhelmed with 30,000 applications for Plan N coverage.  I can’t provide the name of this company because they think my writing about them constitutes advertising and they track what is written about them on-line and in the press.

The reason this company is overwhelmed with applications is because they are allowing seniors to apply for their new Plan N Medicare Supplement without having to answer any medical questions – no matter how old the person is.  While other Medicare Supplement companies are asking more medical questions of their applicants, this company has decided to make an exception for everyone applying for Plan N.

Plan N is a new Medicare Supplement that went into effect on June 1st.  This plan costs about 25% less than Plan F, which is a Medicare Supplement that fills all the gaps in Medicare.  Plan N costs less because it will require seniors to pay $20 co-pays when they see a doctor in the doctor’s office.  Seniors will also pay $50 if they go to the emergency room. Additionally, the Part B deductible ($155) is not covered by Plan N, and the plan does not cover excess charges (which very few doctors charge anyway).  Every other service (hospital stays, labs, physical therapy, chemotherapy, radiation treatment) is covered completely beyond the co-pays mentioned here.  Medicare pays its part of the bill and Plan N will pay the balance.

I asked this company representative how long they will continue their open application policy for Plan N.  I was told they have no plans to change it in the next few months.  Hopefully the policy will continue through the end of the year when Medicare Advantage enrollees will be able to get out of their plans, go back to Medicare, and get a Medicare Supplement.  Plan N might be the only option for people who might not pass the health questions required by most Medicare Supplement companies. Hopefully they will still have a chance to get Plan N with no questions asked by this company.

NOTE: When you turn 65, or when you first get Part B, you have a six month “guaranteed issue period” during which you can sign up for a Medicare Supplement without answering medical questions. This is very important for people with pre-existing conditions because they cannot  be refused a Medicare Supplement during their guaranteed issue period.

CLICK HERE FOR MORE INFORMATION ON YOUR MEDICARE CHOICES.