The new health care law that was signed last year has made some provisions starting in 2011 the attempts to shrink the gap of the out of pocket expense for drugs under the Medicare part D section. It will save some people a considerable amount of money they had to spend last year but it is still complicated. Does it really save us out of pocket expenses? We need to understand how it works!
How will this lower my drug costs?
This reduction will take place after you have reached a certain level: $2,840 for the year 2011. This is not the amount you have spent on drugs but the total cost of the drugs. This includes what you spend as well as what Medicare pays for. Once you have arrived at this level you are considered to be in the “doughnut-hole”. Last your once you met this level you had to pay 100% of the costs for drugs up to $4,550!
This year you might spend less in the doughnut-hole. This is where it gets tricky. You will now get a 50% discount but only on Brand name and biologic drugs. This includes insulin and vaccines. This is for Brand Name Drugs only. There is a discount on generic drugs but only 7%. Also Part D covered supplies used to administer insulin will have a 7% discount as well.
Something to note however is that the discounts on generic drugs do NOT count towards the doughnut-hole limit.
Who qualifies for these discounts?
Everyone who gets into the doughnut hole and is:
- enrolled in a Medicare stand alone Part D drug plan or
- enrolled in a Medicare Advantage health plan that provides drug coverage or
- enrolled in any Part D plan sponsored by a current or former employer or union
Anyone with limited income and already receive help from the government-subsidized Extra Help program do not qualify.
What do I need to do in order to get the discounts?
There is nothing to do. No paperwork to fill out. The discounts will automatically be applied when you fill your prescriptions either at the pharmacy or mail order. Currently 99% of the drug manufacturers are participating in this program. If a drug manufacturer is not participating you won’t have any coverage for that particular drug.
Other Situations
There are other situations you might be in including but not limited to:
- You have a drug that your plan agreed to pay for but that it doesn’t normally cover. You will still get the gap discount.
- You are enrolled in a state pharmacy assistance program. You will still get the gap discount.
- You receive help from a drug manufacturer. Check with the drug manufacturer for information.
Catastrophic Drug Coverage
After you have gone through the gap you will reach what is called Catastrophic Coverage. This is where the plan will pay for the majority of the costs for your prescriptions.
Senior Care Concierge is empowering Seniors and Their Families through Information and Education.
Posted in Medicare by .
Feb 11
13
Why do We Need a Will?
The Importance of a Will
Wills are important for a variety of reasons, the greatest of which is to ensure that YOU decide how your estate is distributed to and among your loved ones. However, here are four more benefits to having a Will:
1. To appoint a Guardian for your minor children
2. To appoint a Trustee to manage assets and property that might pass to your children, regardless of their age
3. Appoint a Personal Representative of YOUR choice
4. Avoid the State from distributing your Assets according to statute
Choose a Guardian for your Children
If you have minor or dependent children, it is critical to select a Guardian who you believe is fit and able to care for your children in their time of need. A Will is the most reliable way to select a Guardian to care for your child in the event of your death. If both parents die without appointing a guardian in a Will, the Court will choose the person who will care for your children.
Appointing a Trustee to Manage Assets
Most parents, when asked, elect to establish Trusts in their Wills to benefit their children, which are administered by a Trustee. The assets are managed and distributed by the Trustee to the children in accordance to the wishes of the parents, as set forth in the Trust. The Trust then terminates at a point in time when the parent feels their child would be able to manage their own affairs.
If parents die leaving assets and/or property to a minor child or children, without the establishment of a Trust, then the Court will step in and decide who should administer the property on behalf of the child or children. Once the child reaches the age of majority, the child will receive full control over the assets and or property.
A Will is an excellent mechanism by which to create a Trust for the benefit of a child or children. Moreover, a Will is where a parent appoints a Trustee and describes the disposition of the Trust.
Choosing a Personal Representative (Executor)
A personal representative ensures that your wishes, as contained in your Will, are carried out after your death. The Personal Representative collects and inventories all of the property and is responsible for making distributions in accordance with the Will.
Most people choose a spouse, sibling or other close family member or trusted friend to act as Personal Representative.
Without a Will naming a Personal Representative, a Court will appoint an administrator to oversee the distribution of your property. Consequently, your Estate may be administered by a stranger who knows nothing of your wishes or intentions.
Avoid Intestacy
If you die without a Will, then the Court deems that you have died Intestate and imposes State created rules that govern the distribution of your estate. .
Generally, the spouse and children of the deceased are the first to share in the Estate. In Washington State, spouses receive items considered as community property and children receive portions of separate property. Oftentimes, these distributions are contrary to the wishes of the deceased and create strife between families. Also, without a Will, it is impossible to give gifts or property to close friends, in-laws, charities or other organizations. Worse yet, if there are no living blood relatives, the state confiscates all the property and it accrues to the benefit of the state.
The best way to avoid the state’s intrusion into your personal affairs is to establish a valid Will.
Senior Care Concierge empowers Seniors and their Families through Information and Education.
Posted in Legal by .
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