Thursday, December 01, 2011

Medicare Part D

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My library presents Medicare Part D programs every week during open enrollment season.  One of our librarians presents a 15-20 minute Power Point that covers the basics of Part D, and then she and I work with the attendees one by one, entering their prescriptions into the online system . We print for them the details of the top three prescription drug plans for their individual needs.  It is a very well-attended, much-needed, and useful program. 

These programs have not only helped me answer reference questions about Medicare, and specifically Part D, but they have also opened my eyes to the state of health care in this country and also to the plight of senior citizens.  For one thing, many of the seniors who attend the program are pretty clueless about Medicare, and even about insurance in general.  I was shocked to find out how few people know what a premium and deductible are, and when you add the complications of things like drug tiers, Medicare's "coverage gap," and late enrollment fees, it quickly turns into a very frustrating experience.  Anything we can do at the library to help people understand the system is appreciated by them, and rewarding for us.

Others who attend these programs are representing their elderly parents who live in nursing homes or other assisted living arrangements.  They have to be pretty familiar with the prescriptions their family member takes, the doctors they see, and other personal information in order to choose the Part D plan that will best suit their needs.  There is a lot of pressure on these caregivers to make the right choices for their loved ones.

Medicare Part D has changed significantly in the three open enrollment seasons I have participated in.  The coverage gap (or "donut hole") has closed slightly, the open enrollment dates have changed, the maximum deductible has been raised, and the cheapest possible plan for those who take no drugs has also changed hands more than once.  The late enrollment penalty changes every year, there are more drugs manufactured, and more generics available.  It's something we have to re-learn each year.

We enter each person's prescriptions, one by one, and then print a comparison of the top three most cost effective plans that come up.  It's not so hard to enter the drugs and print the comparison chart.  It's more difficult to explain the chart to them.  They have to look at their estimated annual costs, including premium, deductible, and co-pays.  They have to decide which plan will help them best deal with the coverage gap if they are unlucky enough to fall into it.  They have to decide if they'd rather pay a higher premium and have no deductible or pay more up front with a deductible and then have lower payments through the rest of the year.  They  have to look at the cost of each individual drug in the different plan options and talk to their doctor about the drugs they are prescribed vs. what is in each plan's formulary.  We give them the tools and information to make an informed decision.  They leave our programs armed with a print-out that includes phone numbers for each plan, as well as a lesson on what they should consider when deciding which plan to go with.

Most importantly, they leave with the understanding that they'll have to do it all over again next year.  These plans change every single year, and you have to run your prescriptions through the online program each open enrollment season to find out if they should switch plans.  Maybe their prescriptions have changed, their financial situation, or the plan they've been on all year.

The Medicare & You booklet is the best place to start if you're thinking about offering a program like this at your library.  I highly recommend it!  We do not give any medical advice, we do not actually enroll people in a plan, and we do not made a specific plan recommendation.  We give piece peace (oops!) of mind and arm people with information they wouldn't have had otherwise.  It's nice to get people in the same room who are dealing with the same frustrations and who have the same questions.  It's almost like a support group where they can see that they are not alone.  There are millions of Americans dealing with Medicare Part D every year, and anything we can do to help is always so appreciated by them.  It is definitely a feel-good program for us, knowing we gave out crucial information to people who have to make a careful decision.


  1. Ha ha ha!! Thank you, anonymous. I need to blog in the morning, not at night when my brain is fried. Now fixed.

  2. (...although in some cases, people could use a "piece" of mind. I'm shocked at the ignorance people display sometimes. How do they get by??)