Why is Part D so Complicated?
by Denise Early on Mar. 29, 2011, under HealthYesterday I wrote about Jerry, who moved to Tucson and was able to drop his Colorado Medicare Advantage plan and enroll in a Medicare supplement without answering any medical questions. Because the move from Colorado to Arizona required Jerry to drop his Colorado Medicare Advantage plan, Jerry had “guaranteed issue” for a Medicare supplement.
The Medicare supplement choice was simple, but then Jerry had to sign up for a stand-alone Part D prescription drug plan. Jerry takes several prescriptions, so selecting a Part D plan requires doing some research to make sure all of his prescriptions are covered by the plan he chooses. So I went to Medicare.gov and clicked on “Health and Drug Plans”. Then I clicked on “Compare Health and Drug Plans”. I put in each of Jerry’s prescriptions, and the Medicare “Plan Finder” gave me a list of Part D plans that covered his drugs, starting with the plan that would cost him the least amount of money for monthly premiums and co-pays. The first plan on the list was the Humana-Walmart Part D plan for $14.80 per month.
I was going to have Jerry call up Humana to enroll over the phone, so I called him up and began to explain what he needed to do. Well….. this is where I remembered that Part D is rather confusing. You see, the plan that the Medicare Plan Finder gave as #1 for Jerry has a $310 deductible, so I began to explain this. Then I went on to explain co-pays for drugs on the Humana-Walmart plan, which can vary based on where he buys his drugs: at a Walmart store, by mail, or at a non-preferred pharmacy like Walgreens. Things got complicated and confusing pretty quickly, so I told Jerry I’d drop by his house and explain everything in person. (Note to Medicare insiders: I had gotten a scope of appointment form signed by Jerry before we met to talk about the Medicare supplement.)
To prepare for my meeting with Jerry, I went to the Humana website and put in his list of prescriptions. The Humana website, if you can figure out how to use it, provides a monthly breakdown of what a person will pay for their prescriptions and how much Humana will pay. The Humana Rx calculator provides lots of details, and I printed them out to help me explain the plan to Jerry.
So I went to Jerry’s house and showed Jerry the printouts, drew him diagrams, and explained the difference between the monthly premium and the co-pays for his drugs. And then there was the $310 deductible….. and we spent nearly an hour talking about this Part D plan. After going over the details several times, Jerry got the full picture, but he still asked me to write up a summary of everything he had signed up for and what his monthly costs would be.
Jerry wants to use use the Humana mail order service for his prescriptions, and this will save him a lot of money. I told Jerry to call me when he gets his package of information from Humana so I can help him set up the mail order. This is another confusing process, but once it’s set up it should be simple to use – I think.
Why is Part D so complicated?
During our meeting, I apologized several times to Jerry for how complicated Part D is, and I reassured him that it was not his fault that he was confused by it. In 2011 there are over 1,000 Part D plans offered throughout the country. Why? What value is provided by hundreds of insurance companies each offering several Part D plans? Has this saved Medicare money? Has this made drug coverage selection easy for seniors? Why not have one or two plans administered by Medicare (which could contract out the plans’ management to the private sector)?
I just can’t understand why Part D is so complicated.
