Factors To Consider When Selecting a Plan
(Part 2 of 2)

MEDICARE TOPICS
Part 1 of 3 Why Ordering From Canada Still Makes Sense	Part 2 of 3 Factors To Consider When Selecting A Plan	Part 3 of 3   Comparison of Medicare and Meds Thru Canada

Medicare Part D is the new U.S. Federal Government program that will provide some price savings on medicines for selected American Citizens. The government has set out guidelines for companies who offer Medicare Part D plans, in an effort to encourage competition among those providers, and hopefully, to allow better coverage (and therefore drug availability) for Americans.

With this goal in mind, the Federal Government has authorized a number of PDP Providers ("Prescription Drug Plan" Providers). These companies have each created their own coverage plan (or plans) to entice people to sign up for those plans. These plans are extremely complex, and need to be investigated individually by everyone who wishes to get prescription coverage.

Factors to consider when choosing a Medicare Part D Prescription Plan (Table 2)
Your Zipcode	Depending on where you live, there are different Providers with different plans. Some providers offer plans in more than one geographic region. The Government has created 34 Medicare Regions across all 50 States. This is the first step: find the providers in your region, and get information about all of the plans that they offer, so you can compare them with all of the following factors.
Your Income	Some plans take your income into consideration. If your personal or household income is below a specified yearly amount, you may or may not be eligible for certain additional assistance with your plan.
Your Age	Medicare Part D is aimed at Seniors. However, there are others who qualify, such as those with End Stage Renal Disease (ESRD). Check the plans and requirements that are available to you. (See Medical Conditions, below)
Your Marital Status	Certain plans offer discounts if spouses, or entire families enroll together. This might be more useful if there were only a few plans, but, in fact, this adds another layer of complexity, and therefore makes more work for you in considering which plans will work best for everyone in the family. If you are considering one of those plans, you will need to consider all of these factors as they apply to ALL people you wish to enroll. That is, you will have to consider what medications EVERYONE is taking, their incomes, their ages, their medical conditions, their medications, etc.
Your Medical Conditions	Medicare Part D is aimed at Seniors. However, there are others who qualify, due to specific illnesses such as people with End Stage Renal Disease (ESRD). Check the plans and requirements that are available to you. (See Age, above)
Your Existing Coverage	Medicare Part D is automatically available to people with existing Medicare coverage. It is intended to ensure that if you already have Part A (Hospital Coverage) and Part B (Medical Services like doctor visits), you can get Part D coverage. However, this is just one of the requirements. If you already have prescription coverage through Part A or Part B or some other coverage, you will automatically be assigned a Part D plan if you don't select one before the deadline of May 15, 2006.
Your Medications	Most plan providers have a "formulary", or list of drugs that they will cover. Drugs not on your plan may not be covered at all, or may incur additional surcharges. You should try and find a plan that covers the drugs that you take right now. Ideally, you would try and find a plan that will cover any drugs that you may need in the future, but trying to guess at your future medications is a hard thing for a non-medical person.
Initial Membership Cost	Most plans charge a yearly membership fee. This is meant to cover the cost of registration and bookkeeping that will have to be done by the plan administrators to track the members of their plans. Some plans, however, have NO YEARLY FEE, but will charge higher monthly premiums. Be sure you know what your basic costs are going to be, even if you do not order ANY medicine during the entire year! (See Monthly Premiums, below)
Monthly Premiums	Prescription Plans may charge monthly premiums as a way to help them offset the costs of your medications. There are some plans that have no monthly premiums, but there could be higher membership costs, or higher co-pay costs. Be sure you know what your basic costs are going to be, even if you do not order ANY medicine during the entire year! (See Co-Pay Amounts, below)
Co-Pay Amounts	On top of initial membership fees, and monthly premiums, plans could have you pay a "co-pay amount per prescription" when you actually purchase medications. Co-Pay amounts can be specified in dollars or percentages. For example, some PDPs offer a 25% co-pay, which means that you will pay 50% (half) of the retail price of that drug. Some plans offer a set co-pay amount, like $5.00 per prescription that you purchase. Some plans offer different co-pay amounts for different drugs, or classes of drugs. A good example of this is a plan that has a co-pay amount of $3.00 for generic medicines, but $5.00 for brand name medicines. These co-pay amounts are directly related to the drugs that you order, and whether or not they appear on the formulary for the plan that you have selected. The co-pay amounts will be higher if the initial membership and monthly premiums are lower. This could be a good strategy if you only take a few medicines, because your costs are more closely tied to the actual drugs that you order, rather than yearly or monthly payments that are due whether you order medicine or not. Again, be sure you understand what you are actually paying, and how much your total will be at the end of the year.
Processing Fee	Some plans may charge you an ordering fee (processing fee), to cover their overhead in providing coverage to you. If you order your prescriptions monthly, you will have to pay 12 of these fees during the year. If you can order more medicine less often, you can avoid some of these processing fees. A good strategy is to order 3 months at a time, and limit these processing fees to 4 per year.
Additional Coverage	Plans providers offer Part A and Part B coverage with their Part D coverage. You should decide if you want to use their Part A and Part B, or if you are happy with your current Part A and Part B provider. Certain providers may insist that if you want Part A and/or Part B, then you must get all Medicare coverage from them, and not "pick and choose" the best providers for each part of Medicare. This is especially important if you do nothing, and have a Part D provider selected for you. If your current provider offers Part D, you may be OK. If your current provider doesn't offer Part D, the automatic selection process for you may disqualify you for your EXISTING Part A and Part B coverage.
Restrictions on Service Providers	Many plans have a "network of service providers", and you must use those providers, or pay an additional surcharge. Those plans may specify doctors that you must use. Some specify which pharmacies that you must use. Some might not allow you to use any pharmacies outside of "their network", even if you are willing to pay a surcharge. Make sure you understand which doctors and pharmacies you can use, and if you are happy with their choice of service providers.

MEDICARE TOPICS
Part 1 of 3 Why Ordering From Canada Still Makes Sense	Part 2 of 3 Factors To Consider When Selecting A Plan	Part 3 of 3   Comparison of Medicare and Meds Thru Canada

For more information on how Medicare Part D affects you, or how you can get the most out of Medicare and still save money by ordering certain medications from Canada, please call us directly at 800-584-5598 (573-256-5036), and ask for our Medicare Specialist.