Monday, May 30, 2016

2016 || Part D Donut Hole

 | Tue, Apr 26, 2016 @ 09:00 AM

The Medicare Part D Donut Hole: Going…Going…Not Quite Gone

Posted by Medicare Made Clear


The prescription drug donut hole is a gap in Medicare Part D’s prescription drug coverage.
Once you and your Medicare Part D plan have spent a certain amount on covered prescription drugs during a calendar year ($3,310 in 2016), you reach the coverage gap. You are now in the Part D donut hole.
You pay a larger percentage of your prescription drug costs while you’re in the donut hole until another dollar limit ($7,062.50 in 2016) is reached. Then Medicare Part D coverage kicks in again.

Closing the Part D Donut Hole

The good news is the donut hole isn’t as big as it used to be. When Medicare Part D launched in 2006, Medicare beneficiaries had to pay 100% of their prescription drug costs during this gap in coverage. With the passage of the Affordable Care Act, that percentage started to drop.
In 2016, you pay 45% of the cost of brand-name prescription drugs and 58% for generics while in the donut hole. These percentages are scheduled to decrease every year, bottoming out at 25% for both brand-name and generic drugs in 2020.
This will effectively close the donut hole, putting costs on par with what you pay between the time you meet your deductible (if you have one) and when you hit your out-of-pocket spending limit.

Getting Into and Out Of the Donut Hole

It’s important to note that it’s not just your share of your prescription drug costs that get you into and out of the donut hole. The amount your plan pays also counts towards the first milestone that puts you into the donut hole.
Drug companies may help pay your way, too. They provide a 50% discount on brand-name drugs purchased while in the donut hole.
The drug company discount counts toward the second dollar limit, the one that marks the end of your passage through the coverage gap. For generic drugs, only the amount you pay out-of-pocket applies to your spending limit.


This will all get simpler in 2020 when the donut hole closes. Until then, following these tips may help you climb out of it more quickly – or keep you from falling into it in the first place:
  • Stick with your plan’s formulary whenever possible. Only medications on the formulary, or for which you get an approved exception from the plan, count toward your spending limit.
  • Make sure to get your drugs from a network pharmacy. Prescriptions you fill outside your network pharmacy don’t apply to your spending limit.
  • Opt for generics if your doctor thinks they’re appropriate. The lower costs for generics may be enough to keep you from slipping into the donut hole.

Tuesday, May 24, 2016

Medicare Made Clear

10 Key Medicare Facts

Your Medicare journey may be smoother when you understand the rules of the road.

Medicare is a complex subject. Watch this video to get the main ideas behind it. Then you can dig deeper into what’s most important to you

10 Key Medicare Facts Summary

  1. There are two main ways to get Medicare.

    • Original Medicare (Parts A and B) which is provided by the federal government
    • A Medicare Advantage plan (Part C) offered by a private insurance company
  2. With Original Medicare, you may pay a share of the cost.

    • You contributed to Medicare by paying taxes. That’s why you’re eligible for Medicare when you turn 65.
    • Original Medicare may not pay for everything. You may pay a share of the cost in monthly premiums and copays.
  3. Medicare supplement insurance helps with some out-of-pocket costs.

    • Medicare supplement insurance plans help with some of the expenses Medicare Parts A and B don't pay.
    • Medicare supplement insurance plans are offered by private insurance companies
  4. Prescription drug coverage may help limit drug costs.

    • Original Medicare does not include prescription drug coverage. However as a Medicare member you can get Medicare Part D prescription drug coverage.
    • Prescription drug plans, also known as PDP, and Medicare Advantage plans are offered by private insurance companies.
    • You can enroll in a stand-alone Part D plan to go with your Original Medicare coverage.
    • You can enroll in a Medicare Advantage plan that includes prescription drug coverage.
  5. Coverage choices vary by plan type and state.

    • Original Medicare (Parts A and B) is the same across the United States.
    • Medicare Advantage (Part C) and prescription drug (Part D) plans are offered by private insurance companies and may be available only in certain counties, states or regions.
    • Medicare supplement plans travel with you nationwide. The plans are standardized, but the availability may vary by state.
  6. Your initial enrollment in Medicare is time sensitive.

    • The Initial Enrollment Period (IEP) is your first chance to enroll in Medicare. It’s the three months before your 65th birthday month, the month of your birthday, and the three months after your birthday month.
    • If you are eligible for Medicare due to disability, your IEP is based on your disability date.
    • Late enrollment penalties may be incurred for missing certain enrollment periods for Part B and prescription drug coverage.
  7. Your health care needs may change over time.

    • After you choose your Medicare coverage, you can make changes once a year during Medicare Open Enrollment, October 15 through December 7.
    • You may change your coverage at certain other times if you qualify for a Special Enrollment Period.
    • Review your coverage each year to see if it still fits your needs.
    • These enrollment period restrictions do not apply to Medicare supplement insurance.
  8. Special Enrollment Period (SEP).

    • In some cases you may be able to enroll in or switch plans at times besides your IEP or Medicare Open Enrollment.
    • You may qualify for an SEP if you retire and leave a health care plan sponsored by your employer or union.
    • You can usually use an SEP to change your coverage if you move out of your current plan’s service area.
  9. Medicare can work with other health insurance.

    • Group or retiree health insurance sponsored by an employer or union can work with Medicare.
    • Your plan administrator can help you figure out how Medicare could work with your current coverage.
    • Medicare supplement plans work with Original Medicare, but not with Medicare Advantage plans.
  10. Help is available.

    • Medicare can be complicated, but help is available.
    • You may qualify for financial help.

Friday, May 6, 2016

2016 Best List Of Senior Discounts

The Best List of Senior Discounts on the web.  Feel free to share it with friends and family!

© The Senior List, 2016. If you plan on recommending any of our discount lists, please do so with appropriate attribution to The Senior List® and a link back to our website. Thanks!  If you’re looking for a printable version of our list you’ll find it in our community library (members only area) located —> HERE.

2016 list of senior discounts
*Please note: Many of the discounts you’ll see below are offered by franchise owners in local markets.  This means that discounts will vary from location to location.
We had an incredible response to our 2015 senior discount lists published last year.  Many of the service providers on our 2016 senior discounts list have been verified and those that have with be noted with a “verified” flag.  We reached out to all the businesses on our list, but some were unresponsive.  As usual, we’ll  rely on our community (you) to provide updates as you uncover them.  Use the comments section to help verify discount policies and/or note the specific senior discounts in your local area.Senior Discounts from The Senior ListBe the first to hear about new Discount Lists by joining us on Facebook.  We’re building an online community where people can engage with each other, provide advice, discuss products, and more.
Please understand that discount policies do change.  They change at the national level, and they change at the local level.  Sometimes these changes are published, and sometimes they’re not.  Our best advice for discount shoppers is to ask ahead of time so there are no surprises.

2016 Best List Of Senior Discounts

This master list of senior discounts is meant to be a guide, and with your help we’ll keep it updated throughout the year.  If you’re looking for short versions or printable versions of the individual categories, just navigate to the category “header”, and it will link you to that specific discount list.  You can also click the printer icon below for a printable list.

Senior Discounts at Grocery Stores

Albertsons: 10% off first Wednesday of each month ( 55 +)
American Discount Stores: 10% off every Monday (50 +)
Compare Foods Supermarket: 10% off every Wednesday (60+)
DeCicco Family Markets: 5% off every Wednesday (60+) verified
Fred Meyer senior discount: 10% first Tuesday of each month (55+) verified
Fry’s Food Stores: 10% off on the first Wednesday of every month (55 +) verified
Get free printable coupons now from
Great Valu Food Store: 5% off every Tuesday (60+)

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Older adults on social media
Gristedes Supermarket: 10% off every Tuesday (60+)
Harris Teeter: 5% off every Thursday (60+) verified
Hy-Vee: Says “Yes” (but discount policy varies by locale) verified
Kroger: 10% off (date varies by location) verified
Morton Williams Supermarket: 5% off every Tuesday (60+)
New Seasons: 10% off every Wednesday most items (65+), 10% off every Tuesday for militaryverified
Publix: 5% off every Wednesday ONLY in Tennessee, North Carolina and the northern portions of Alabama, South Carolina and Georgia (60 +) verified
Rogers Marketplace: 5% off every Thursday (60+)
Uncle Guiseppe’s Marketplace: 5% off (62+ on Wednesdays)

Senior Discounts On Prescriptions

Senior Discounts on Prescription Drugs
AARP:  With the AARP Prescription Discount Card (provided by Catamaran an OptumRx company), AARP members and their families can access an average savings of 38% off prescription drugs (regardless of age or health status).  Must be a member of AARP to access benefits.  AARP boasts acceptance by 64,000 pharmacies nationwide. verified
Rite Aid:  Sign up for the Rite Aid Rx Savings Program.  Save 15% or more on thousands of brand name and generic prescription drugs by signing up for the Rite Aid Rx Savings Program. When you sign up, you’ll receive Rx Savings Card that gives you access to special discounts at Rite Aid pharmacy. verified
Costco Member Prescription Program:  The Costco Member Prescription Program is a prescription savings program for you and your family. It allows Members who have no prescription drug insurance or whose insurance does not cover all of their prescription medications. Save 2% – 40% at time of sale. verified
CVS Pharmacy:  Enroll in the CVS ExtraCare Savings and Rewards program.  You’ll receive “ExtraSavings” through personalized coupons delivered on receipts, and online via theExtraCare Coupon Center. ExtraBucks Rewards are earned by shopping and filling prescriptions.  You can earn up to 2% back in ExtraBucks Rewards from your everyday purchases.  Also, if you fill 10 prescriptions, your can earn $5 ExtraBucks Rewards through the ExtraCare Pharmacy & Health Rewards program.  verified
Kmart:  The Prescription Savings Club at Kmart (Pharmacy Savings Plus) is annually $15 per household or $10 per person.  You and the family are then covered  for certain generic drugs (starting at $5 for a 30-day supply and starting at $10 for a 90-day supply). The Drug Price lookup tool is an easy way to see if and how much you can save.   You can even get discounts on pet medications with a prescription from your vet. verified
Target: Target pharmacies are being rebranded to CVS Pharmacy brand.  This change is underway now.  Your Target (CVS) Pharmacy will already have your prescription records on file. You’ll be able to access your records and refill your prescriptions at or by visiting CVS Pharmacy inside Target stores.  Target says “As of December 16, 2015, Target Pharmacy guests have automatically moved to CVS Health’s network. Guests are encouraged to call their health-plan provider with any questions. For general pharmacy questions, you can contact your local pharmacy or CVS Customer Relations: 1-800-SHOP-CVS (1-800-746-7287).  The Target Prescription Savings Plan is no longer being offered.  It will be replaced with the CVS pharmacy and CVS rewards plan (which you can review above). verified
Walgreens Prescription Savings Club:  Membership fee required ($20 individual or $35 family per year). Walgreens Prescription Savings Club members get special discounts off the cash price of thousands of brand-name and generic medications as well as other benefits when they use their Prescription Savings Club Card. Additionally, if you don’t save at least the cost of your membership fee in one year, Walgreens will give you the difference. verified
Walmart Pharmacy Services: Walmart pharmacies offer low-cost generic prescription medications that can save you money. Walmart carries both generics (where they boast $4 refills) and branded drugs.  Check out the Walmart drug list to see if you can save on your medications. verified Start saving money today with’s prescription discount card for credit union members age 50 plus. However, it is also open to the general public. The program is for families, children and grand children who have no prescription drug insurance or whose insurance does not cover all their medications.
By using their prescription discount card, a person can save up to 50% on FDA approved drugs. In addition to 18,000 independent pharmacies, large chains including Walgreens, Kmart, Target, CVS, Rite Aid, Publix, Winn-Dixie and Safeway also participate in the does not charge any membership dues or fees. You can print off a prescription card and use it immediately. You can request a durable card by mail. A nice feature of the program is that you can look up your medication price based on your zip code. You can also compare prices at other pharmacies. verified

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Thursday, May 5, 2016

Unexpected Costs of Medicare

Pills and a stethoscope on top of dollar bills with Best Medicare Plans.

The Unexpected Costs of Medicare

With a little planning, seniors on Medicare can minimize their out-of-pocket expenses.

Pills and a stethoscope on top of dollar bills with Best Medicare Plans.
Seniors can save hundreds – or even thousands – on Medicare costs through careful planning.
By + More

​Created in 1965, Medicare was intended to answer growing reports of impoverished seniors languishing or dying because they lacked health insurance. Since then, Medicare has acquired a reputation as the ultimate government entitlement, a system of low-cost, taxpayer subsidized health care provided at the stage in life when retirees need it most.
But the broad-reaching health care insurance system comes with costs that many seniors – including those already using the plan – don't see until the bills show up. Those out-of-pocket expenses, according to experts, can range from hundreds of dollars in monthly premiums and office visit copays to six-figure bills for surgery and hospitalization for things like joint-replacement operations, a procedure common among older Americans.
Those costs, which add up quickly, can stress or even break a household budget, particularly for retirees getting by on fixed incomes. Even declining to sign up for Medicare when you first become eligible, experts say, can cause a lot of pain in the wallet later on.
"A lot of people looked at Medicare as this Promised Land – 'Everything is covered, until the end of time,'" says Nicole Duritz​, vice president of health education and outreach for AARP, a nonprofit advocacy group. "I don't think people have a great understanding of how the system works. They're surprised at how much they'll have to contribute."
Compared to individual or group health insurance plans, "Medicare is unique in that it has no out-of-pocket spending limits," says Nancy Metcalfe​, a health policy analyst at Consumer Reports.
That's because Medicare plans are typically private health insurance policies that are government-subsidized. Nothing is completely covered, and no expense is 100 percent paid for. Though the subsidies paid to the insurance companies help keep costs low for seniors, the plans vary and usually require beneficiaries to pay some premiums.
There's good news, however: Metcalfe and others say a little planning, homework and realism can go a long way toward helping Medicare consumers keep more of their hard-earned money in their pockets.
That means seeing past the monthly premium payment to take a hard look at what may be some uncomfortable things – including a realistic assessment of your finances, anticipating how healthy you'll be during your sunset years and choosing what services you might need in a worst-case scenario.
Updated on Oct. 15, 2014: This article was originally published on Oct. 18, 2013 and has been updated to reflect new costs.

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