We Found $6,636 - and Returned it to Our Client

Client Story 1

Sam and Gina had supplemental insurance plans, which included prescription drug coverage and cost $996 per quarter per person. In June 2006 they had signed up for the Medicare Part D Plan, which was the correct course of action. The problem is that the secondary insurance company was never informed. Sam and Gina continued with their secondary insurance provider's expensive plan instead of switching to the plan without drug coverage, which cost $759 a quarter.They were each paying $237 per quarter more than they needed, plus a monthly premium for the Medicare D plan, deducted from their Social Security.

Rebecca Eddy discovered this overpayment when the annual letters arrived from the supplemental plan stating that Sam and Gina did not have credible drug coverage. Since this did not make sense, Rebecca called both the supplemental insurance company and the Medicare D company to clarify the situation and get instructions on how to remedy the problem.

We received proof of the start date of the Medicare D plan for both Sam and Gina. We then wrote letters to the supplemental insurance provider for each stating that they wanted a refund of the overpayment going back to June 2006 and that going forward they wanted the non-prescription coverage supplemental plan. These documents were faxed to the supplemental plan and after several follow-up phone calls, it was arranged that Sam and Gina would receive their refunds.

The total refund was $3,318 for each or $6,636 for the couple. In addition, savings for each of $237 quarterly going forward resulted in a total future savings of $1,896 per year for the couple.

Client Story 2

Joe and Laura were on a joint health insurance plan through Joe's pension, which had a medical prescription cap of $5,000 per family. They exceeded this cap every year. Consequently, they were paying a third of their drug cost in full. With Gideon's help, Laura signed up for a Part D plan. Now she will be paying essentially the same premium as she was under her husband's plan. One week after signing up for Part D she was diagnosed with breast cancer. This could have potentially increased her out-of-pocket medication cost substantially. Fortunately, this year, as a result of being on Part D, not only will she be covered for 95% of her costs above $4,850, but her husband will be able to use the $5,000 cap in his private insurance for himself alone, thereby covering his current needs in full. In either case, the family will be saving an as yet undetermined amount of money, with very few limits.

The Medicare Part D Plan is excellent insurance against the increasing expense of medications as we grow older. There may or may not be initial cost savings, but in the long run, considerably more money should be saved than under private policies.

January 2010 - FEATURE
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