I wrote earlier today about the termination of the Any Any Any Medicare Advantage plan.  The 2,983 Medicare beneficiaries in Arizona who are losing their Advantage plan will have three options going forward:

1) Only Medicare – but beware

They will be moved to Original Medicare and will be automatically enrolled into a Part D plan. They can choose to stay with this coverage – but having only Medicare leaves them with some serious financial risks.  The 20% co-insurance for Part B services has no cap, meaning bills can go on and on.

Having to pay 20% of the cost of chemo and radiation therapy can quickly add up to $10,000 or more.  20% of a $10,000 emergency room bill is $2,000. (Note: Part B services include everything other than hospitalization, skilled nursing facility charges, home health care, and hospice).

2) Enroll in another Advantage plan

They will get a special election period (SEP) to enroll in another Medicare Advantage plan. They get one opportunity to enroll in another Advantage  plan up until May 31st, 2013.

3) Guaranteed issue for Medigap

They can apply for a Medicare supplement no matter what their health condition – and they will be accepted.  This is called “guaranteed issue”.

The letter they receive informing them of their Medicare Advantage plan termination will tell them about this option. A copy of the termination letter must be submitted with the Medicare supplement application.  (Note: “Medigap” is another term for “Medicare supplement” because these plans fill the gaps in Medicare.)

When a Medicare Advantage plan ceases operations, or is terminated, people enrolled in the plan have the right to buy Medigap plan A, B, C, F, K, or L that is sold by any insurance company in the state. (From the CMS publication: Choosing a Medigap Policy, page 22.)

Some Medigap details

**People with limited incomes (but over $950 per month) might consider a Medigap K or L because these plans have fairly low monthly premiums – though they do require co-insurance payments for just about every medical bill. Plan K has a $4,660 annual cap on a person’s out-of-pocket costs, and the plan L cap is $2,330.

When shopping for Medigap, be sure to compare prices from several companies. Paying more than $70 per month for Plan K, or $115 for Plan L is too much.

**Sorry to say, this Medigap guaranteed issue applies only to people on Medicare who are over 65.  Arizona does not require Medigap companies to enroll disabled Medicare beneficiaries who are under 65.

**People with monthly income below $950 probably qualify for Medicaid help with their co-insurance and do not need a Medigap plan.  There is a Medicare Advantage plan in Yuma County for people who are eligible for both Medicare and Medicaid. (AHCCCS is Arizona Medicaid.)

Medicare Advantage plans run by Universal Health Care, known in Arizona as the “Any Any Any” plan, are being shut down as of midnight Sunday, March 31st.  The insurance company that runs these Medicare Advantage plans has gone bankrupt and its Florida headquarters has been raided by the FBI.

People enrolled in the Any Any Any plan are just now receiving letters telling them their Medicare Advantage plan will end as of Monday, April 1st.  If they  take no action to enroll in another Advantage plan, they will be moved back to Original Medicare and will be automatically assigned a Part D drug plan. This will take effect on Monday, April 1st.

If people move quickly, they can enroll in another Medicare Advantage plan this weekend and their new plan will begin on April 1st.  With such last-minute notification, most people will end up having just Medicare and Part D through April.

People losing their Any Any Any plan will have a Special Election Period (SEP) up until May 31st to move into another Medicare Advantage plan.

The Any Any Any plan is a big deal  in Yuma with 1,129 enrollees.  This is almost double its closest competitor, Humana. Unfortunately, people in Yuma and rural areas in Arizona don’t have many Medicare Advantage choices. And the choices they do have come with monthly premiums that are much higher than the Any Any Any plan.

People who live in Pima and Maricopa counties have many zero-premium Medicare Advantage plans from which to choose. Medicare beneficiaries in Yuma don’t have this luxury.

People can get help figuring out what to do by calling Medicare (800-633-4227). Or, they can call the insurance agent who signed them up with the Any Any Any plan. I have a feeling there will be lots of insurance agents in Yuma offering assistance to people – but again, their choices are limited and more expensive that what they have had.

Any Any Any PFFS enrollment in Arizona counties from the latest CMS data:

Yuma: 1129
Maricopa: 747
Gila: 382
Coconino: 284
La Paz: 156
Greenlee: 82
Apache: 28
Graham: 18
Pima: 11

In Pima County, 11 people are enrolled in the Universal Hassle-Free PPO, according to an email I received from CMS.

The CMS Medicare Advantage enrollment data can be found at:

http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MCRAdvPartDEnrolData/Monthly-MA-Enrollment-by-State-County-Contract-Items/MA-Enrollment-by-SCC-2013-03.html

I’ve recently received several calls from clients who asked me about a discount drug card they got, unsolicited, through the mail. I don’t know if this is the same card being promoted through the Pima County Health Department.  That would be the  Coast2Coast Rx card which provides discounts on generic and brand drugs of “up to 75%”, according to press releases.

My clients have a Part D plan through their Medicare Advantage plan, or they have a stand-alone Part D plan because they have a Medicare supplement. They were wondering if they should use the discount card instead of their Part D plan, or if they could use it with their Part D plan.

Discount drug cards are for people who do not have health insurance that includes drug coverage – or people who have lousy health insurance that includes lousy drug coverage. There are lots of people in this category.

The prescription discount card is free. Here’s what the press release says about the card:

Coast2Coast Rx is a no-cost, comprehensive program for savings on thousands of prescriptions and additional health services. The Pima County Board of Supervisors recently approved the card for its health and financial benefits to their constituents:  it saves consumers money and provides them the opportunity to improve their health outcomes. And in the current economic climate, the free program serves as an important public service to residents and to participating counties—as it requires no administrative work by public personnel, it is a fiscally responsible way for the county to offer a resource to its constituents without overhead costs.

Should a person with a Part D plan use this discount drug card?

The answer is, “it depends”.  The discount card and a Part D plan cannot be used together. You can use one or the other, but not both. So if a person has an expensive drug, they will need to ask the pharmacy a few questions such as:

1) What is the cost to me if I use the Coast2Coast Rx card?   2) What is my co-pay if I use my Part D plan?

Choose to use the lower cost option.

An example: Zostavax, the Shingles vaccine

An example of an fairly expensive drug is the vaccine for Shingles. People over 65 are encouraged to get this vaccine because Shingles is a very painful illness.  I called Walgreens to ask what the cost would be for Zostavax.  Without insurance, a person would pay $219.99 for the Zostavax shot.  I do not know what the discount would be for this drug using the Coast2Coast discount card.

For folks who have a Part D plan, the cost for Zostavax will depend on the co-pay that comes with their plan. Most Part D plans call Zostavax a “non-preferred brand” drug.  Co-pays for this drug tier vary from $75 to $95, depending on the Part D Plan or Medicare Advantage plan a person is enrolled in.

If a person has a $90 co-pay for Zostavax on their Part D plan, that’s a 60% discount on the Walgreen price of $219.99. I’m guessing the Coast2Coast Rx card does not provide that much of a discount, so using a Part D plan would likely be the lowest-cost option.  But it’s always a good idea to check out all your options for saving money.