WellesleyWeston Magazine

FALL 2018

Launched in 2005, WellesleyWeston Magazine is a quarterly publication tailored to Wellesley and Weston residents and edited to enrich the experience of living in two of Massachusetts' most desirable communities.

Issue link: https://wellesleywestonmagazine.epubxp.com/i/1011917

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The most dramatic changes occur among drug plans. Medicare sub- sidizes prescription drugs, but it is not allowed to negotiate with the pharmaceutical manufacturers. Instead, private insurers individually bargain with the drug makers and with retailers such as CVS, Walgreen's, Walmart, and Costco. That means the so-called retail price of a drug can vary by hundreds of dollars, depending on the drug plan — and insur- ers offer more than 20 plans in Massachusetts. The insurance plans must cover at least two medications in each class of drugs covered by Medicare, so the drug that works best for you may be included in only a few plans. Medicare.gov has an on-line calculator to simplify the selection pro- cess. Try it yourself or, better yet, ask a SHINE counselor to help. Come to your appointment with a list of the drugs you take, including strength and dosage, and your Medicare card if you've received it. You can select which pharmacy you want to use — though you may save hundreds of dollars by changing chains. And, oddly enough, mail order isn't always cheaper. The plan finder computes the annual expense based on monthly pre- miums and copays. It will tell you which plan is cheapest by mail order or by retail pharmacy. Plans tend to have preferred pharmacies, with Walgreen's prices much higher than CVS's, or vice-versa. It's ridiculous. But that's why I wrote this article. Retired labor lawyer Al Glazerman and his wife, Phyllis, had been on the same Medicare drug plan for years before they met with Renee Rubin, a veteran SHINE counselor and neighbor in their Wellesley condo complex. "We didn't know what we were doing," Al realized after Rubin ran their drugs through the Medicare calculator. Now they are on two different plans and shop at different pharmacies for the best savings. Al's plan has a $26.80 monthly premium; Phyllis's premium is $12.60. But if he chose the same plan as Phyllis — even with the premium savings — his total annual costs would be $320 more be- cause of higher copays. Insuring Peace of Mind Since medical bills can run into hundreds of thousands of dollars, just being on Medicare alone still leaves you exposed if you become seri- ously ill. You can protect yourself by going one of two routes, depend- ing on the value you place on peace of mind. Medigap insurance picks up where Medicare leaves off. In Massachusetts, it comes in two basic forms. The most comprehensive coverage is through Supplement 1 plans; with a few exceptions, they pick up all the copays and deductibles for Parts A and B; Core plans, which cost about half as much, cover most copays, but no deductibles. Al has a Supplement 1 plan and underwent a hip replacement. "The bill must have been God-knows-what," he said. "I paid zero." As of now, seven insurance companies offer these Medigap plans. Even though they all basically do the same thing, the 2018 premiums for Supplement 1 plans range from $260 a month through Humana to 122 Baffled by Medicare? W e l l e s l e y W e s t o n M a g a z i n e | f a l l 2 0 1 8

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