Older adults enrolled for prescription drug coverage under Medicare Part D but bewildered by its complexity will have a chance to clear up some of their confusion at a free health fair on Saturday.
Sponsored by the law and pharmacy schools of the University of Missouri-Kansas City, the fair takes place from 9 a.m. to noon at UMKC’s Pierson Auditorium at 50th and Holmes.
Medicare Part D drug plans are run by private insurance companies and typically require the payment of a monthly premium. The amount varies from plan to plan.
Some higher-premium plans offer more coverage and fewer out-of-pocket expenses; others offer less coverage at a lower premium. Most plans include some form of cost sharing by way of flat-rate copayments and coinsurance, which is a percentage of a drug’s cost.
Older adults who don’t join a Medicare Part D prescription drug plan or a Medicare Advantage plan with prescription drug coverage as soon as they become eligible face a late-enrollment penalty.
UMKC law professor and health care expert Ann Marie Marciarille, who helped organize the fair, says most people tend to focus on premiums and don’t understand that “you have to look at the whole thing to understand your out-of-pocket costs.”
“And the second thing is the formularies are different from program to program, so that’s where this ends up being very individualized,” she says, referring to the lists of covered medications. “Because then you have to think hard about, ‘O.K., what medications do I take now and am I likely to continue to take over the next 12-month interval,’ because there’ll be open enrollment in another year.”
Marciarille says there’s abundant evidence that when it comes to insurance selection in general, people get overcome by inertia.
“We just get tired,” she says. “We get tired of being asked to choose, assess and weigh all the time, and so people stay enrolled even when their health circumstances change, their pharmaceutical needs change, maybe even their financial circumstances change.”
The good news is that during the current open enrollment period, which lasts through Dec. 7, people can still change their plans and possibly save money.
“This is an opportunity to counsel people a little bit about what to take back, questions to take to their providers,” Marciarille says. “Like if you’re willing to take a generic (drug), you should probably consider being in such and such plan, because as long as you’re willing to take the generic, with all the other things you could save a significant amount of money.”
Fair attendees are asked to bring all their medications in its original packaging, placed in a plastic bag; their red, white and blue Medicare card; and any questions they have regarding Medicare and Medicare Part D.
Editor’s note: KCUR is licensed by UMKC.
Dan Margolies, editor of the Heartland Health Monitor team, is based at KCUR. You can reach him on Twitter @DanMargolies
