How to Choose the Best Medicare Part D Drug Plan

Choosing the best drug plan under Medicare Part D isn’t always easy. Some people just pick the plan with the lowest premium, but that Medicare Part D plan might not be the best value for you, depending on your needs.

Medicare Part D

The real cost of a Medicare Part D plan depends not only on the premium, but also on the availability of the drugs you need, your additional out-of-pocket costs, and how convenient it is to obtain your medications.

Here are the key factors to consider (besides the premium) when deciding on a Medicare Part D plan:

► The Formulary. A Medicare Part D plan’s “formulary” is the list of drugs it covers and will pay for.  Does the plan you’re considering include all the drugs you need, or anticipate needing? How much will they cost?

Keep in mind that a plan’s formulary can change from time to time, but typically, once you sign up for a plan for a year, the plan can’t drop your coverage of a drug you need until the end of the year.

If you switch to a Medicare Part D plan that doesn’t cover a drug you’re currently taking, the plan might cover it anyway during a brief “transition” period. You might ask about this period. A one-month transition is fairly common (and might be all you need), but some plans have shorter or longer periods.

Also, if you’re prescribed a medically necessary drug that’s not in your plan’s formulary, the plan might in some cases make an exception. You might inquire as to your plan’s process for granting such an exception.

► The Deductible. Is the deductible the legal maximum ($325 in 2013), or something less? Some Medicare Part D plans have no deductible at all.

► Covered Pharmacies. Will you be able to continue buying drugs at your customary pharmacy? Is that pharmacy a “preferred” provider, and if not, will you have to pay more to use it? If you’re living in a long-term care facility, is the facility’s pharmacy included in the Medicare Part D plan’s network?

► Expensive Drugs. It’s worth looking into whether a plan will try to “steer” you toward using lower-cost drugs. For example, will it require that you try a cheaper medication before it will cover a more expensive one prescribed by your doctor? Also, are there different co-payments for generic and brand-name drugs?

► Quantity Limits. Is there a limit on the number of prescriptions you can receive in a month? Is there a limit on the number of pills available in a single prescription?

► Mail-Order. Are you allowed (or required) to use mail-order for the Medicare Part D plan? Is there a price difference for mail-order purchases?

► The Plan Sponsor. Is the sponsor a known, reliable entity?

► Effect of State Programs. How do the plan’s benefits coordinate with any state pharmaceutical assistance programs you might use?

If you’re currently enrolled in a Medicare Part D drug plan, the window of opportunity to change plans runs from October 15 to December 7 (2013). If you’re newly eligible for Medicare, you can enroll in a prescription drug plan during the seven-month period that starts three months before the month you turn 65.

A review of your current Medicare Part D plan is part of a comprehensive elder law planning meeting. Have more questions about which Medicare Part D plan may be right right for you? Contact us today.

Telemarketing Fraud: Steps to Protect Elders

TELEMARKETING FRAUDElder abuse comes in many forms. An overwhelming majority of it is financial abuse. If you have an elder parent or family member who lives alone, he or she may be at risk of a new wave of telemarketing fraud targeting the elderly.

One recent case of telemarketing fraud billed elderly consumers for medical alert devices they never ordered. Telemarketers would claim they were calling in response to a request for information from the person or a family member and then try to sell them the device.  Even those who didn’t order were sent a bill along with the shipment. The company behind the telemarketing fraud would then use threats and intimidation to induce the victims to pay.

If you don’t think telemarketing fraud can happen to your loved one, consider this. According to a study by the AARP, seniors over age 50 are disproportionately at risk for becoming victims of telemarketing fraud.   The study found that the average age of victims was 69 and that women were twice as likely as men to become victims.

Telemarketing fraud is also becoming increasingly sophisticated. Fast-talking predators use high pressure sales techniques and psychological ploys to overcome a senior’s initial resistance. Some other common schemes involve low-cost, high-risk investments, fake charities, time-sensitive product deals, or prize winnings that seniors are told they have to pay taxes or a fee to collect.

When a senior becomes a victim of telemarketing fraud, it can be financially devastating. Because these crimes are hard to trace, it is very difficult for victims to get their money back. Sadly, many incidents of telemarketing fraud against the elderly simply go unreported. Elderly victims may be embarrassed, don’t know where to go to report the crime, or fear they will lose their independence if they do report it.

Here are some steps you can take to help protect your elderly parents or family members from becoming victims.

  1. Talk to your parents about types of telemarketing fraud and remind them never to pay up front for a product or service, or to give out personal information such as a credit card or social security number over the phone.
  1. Offer to help them manage their personal finances so you can monitor bank and credit card statements for any unusual activity.
  1. Have them sign up for national Do Not Call list (888-382-1222, to help cut down on telemarketing calls.
  1. Design a call script, such as “I don’t give out personal information over the phone,” to aid them in ending calls from pushy telemarketers.
  1. If your elderly parent has dementia, or is otherwise incapacitated, you may want to contact an elder law attorney to advise you on utilizing your parent’s durable power of attorney and/or obtaining a guardianship or conservatorship.

For more suggestions on how to identify and prevent elderly telemarketing scams, visit the Federal Trade Commission’s consumer education website.

The best protection against telemarketing fraud and elder abuse is to ensure that your loved ones are properly cared for and that their assets are protected. Proper estate planning can help give you and your loved ones piece of mind. Contact us to discuss various planning options today.

Photo Credit: Tim Dorr





Massachusetts Question 2: Assisted Suicide. What You Need to Know for Election Day

We’re not only voting for the next President and a Senator from Massachusetts in November, but on a battery of ballot questions. Ballot Question 2 is one of the more controversial. The so-called “Death with Dignity” or “Right to Die” legislation would allow an adult resident who is (1) capable of making and communicating health care decisions, (2) diagnosed with an incurable and irreversible disease that will cause death within six months, and (3) voluntarily, and in an informed manner, so decides to obtain a prescription for medication to end his or her life. You can read the proposed legislation here.

Oregon and Washington state already have similar legislation in place. In Oregon, most candidates are well educated cancer sufferers over the age of 65, who died at home and were enrolled in hospice care. This “typical candidate” is familiar to many of us working with elders. Maybe it is because so many of us know or have known someone like this that the “Right to Die” issue has strong voices on either side. [Read more…]

Whitney Houston’s Estate Plan: Good, But Not Great

Whitney Houston’s tragic death provides an example of how a trust that takes effect upon death can work as part of an estate plan. But Houston’s estate plan has some surprising aspects as well; there were pieces of her plan that could have, and likely should have, been better.

The late singer’s will leaves everything to her 19-year-old daughter, Bobbi Kristina, but Kristina can’t access her mother’s estimated $20 million fortune right away because it is in a trust. [Read more…]

Let Someone Know Your Medical Wishes For National Healthcare Decisions Day

National Healthcare Decisions Day is on April 16th, and it’s an important reminder for every adult to let someone know their most private wishes about medial treatments and possible end-of-life care. [Read more…]

Why Single People in Worcester County Should Consider Estate Planning

When we typically think of estate planning, we see grandma and grandpa putting together a Will and possibly setting up some trusts for the following generations. It’s all about providing for our offspring, right? [Read more…]

How Do I Bring Up the Topic of Estate Planning to My Parents?

In Worcester, just as everywhere else in the nation, there is a tendency for people to put off estate planning.  Elder law attorneys, like Kristina Vickstrom, recognize that there are multiple factors that lead people to procrastinate when it comes to the estate planning process. [Read more…]

I Take Care of My Mother. Can I Legally Get Paid for That?

As the number of family members providing care for aging parents increases, the solutions to find help with loss of income because of time off from employment for caregiving has become a major concern for many. The demands on both the time and energy needed to provide the needed care can make it impossible to maintain both a full time job with full time caregiving. [Read more…]

Grandparents Raising Grandchildren- Legal Options and Financial Support

With the decline of the traditional nuclear family, individuals over 50 are increasingly vested with responsibility for the caretaking of young children and adolescents. Financial problems are the primary cause of seniors having to assume more “traditional” child-rearing duties. Whether due to a divorce, military service, substance abuse, mental illness or other secondary issues, some adults may be unable or simply unwilling to be good parents themselves. [Read more…]

Marrying Later in Life: Do I Need a Prenup?

Welcome to the new singles scene. With the average life expectancy in the United States about 78 years old, people are living longer and healthier lives than ever before and more and more seniors are falling in love. However, what can be a thrilling and romantic time for an older couple can also be an anxious time for family members that have expectations regarding inheritance. It is worth noting that once married, a spouse will automatically inherit, at the very least, a portion of deceased partner’s estate, unless measures are taken to avoid this. [Read more…]