Recovering From a Medicare “Wrong Turn”

By Marc Manor

Much of what I do is problem solving.  Frequently, the problems relate to “wrong turns” through the streets of the Medicare “Metropolis”.  By wrong turns, I mean when someone that has been enrolled in Medicare Part A and Part B beyond their initial enrollment period finds themselves outside the traditional open or annual enrollment periods and wants to transition to or from Original Medicare.  Sometimes the constraints of the Medicare “system” prevent immediate relief. However, there are solutions in many cases depending on when and how the “wrong turns” occurred.

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Under the Medicare system, there are two basic paths: 1) Original Medicare and 2) Medicare Advantage (or Medicare Part C).  You can only be on one path or the other.  Typically, the path you choose occurs at the time you initially enroll fully into Medicare Parts A and B.  The choice initially of which path you take is very important so is necessary to give some basic information about these choices:

Tiers of Sadness...Tiers of Joy: Strategies for Medicare Prescription Drug Plans

By Marc Manor

The plight of those Medicare beneficiaries that take one or more high cost prescription drugs can be challenging; and as with anything in the Medicare Advantage or Prescription Drug Plan (PDP) world, the landscape can be foggy and difficult to sift through to find affordable solutions. Sometimes, it may be possible to save a few dollars if we take the time to research a few variables. Prescription drugs are categorized in “tiers” that relate to the coverage level according to the benefit schedule of each PDP. As a rule, the higher the tier, the more expensive the drugs will be for the consumer (and the plan). I say “as a rule,” because there are some exceptions to the rule if one digs deep enough and searches through several variables.

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Generic vs. Name Brand Drugs

Help For Medicare Beneficiaries With Special Needs

By Marc Manor

Many of our seniors and other Medicare beneficiaries are living on fixed incomes with very little wiggle room for unexpected medical expenses. Fortunately, there are a number of state and federal programs available that can bring much needed relief to those who need “extra help” with paying for medical expenses. One of the most prevalent sources of assistance for medical expenses is Medicaid.

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Those Medicare Beneficiaries who get their assistance via Medicaid are referred to as “Dual Eligible” because they qualify for both Medicare and Medicaid. There are a number of Medicare Part C (or Medicare Advantage) Plans that are specifically designed with Dual Eligible beneficiaries in mind. These types of plans are known as “Dual Special Needs Plans” or D-SNP. If you are getting Medicaid and qualify for Medicare, I highly recommend speaking to an agent about what plan choices are available in your area. The agent can assist you with sifting through the D-SNP options in your area to be sure any specific requirements you may have are met with the plan you choose.

Not sure if you qualify for Medicaid?