About AARP Medicare Supplement and Drug Plan

The AARP Medicare Supplement and Drug Plan is an HMO that provides for health care as well as prescription drugs. It is available as an alternative to traditional Medicare coverage and in some cases may offer more coverage for conditions than just Medicare. However, some beneficiaries in other Advantage plans who switched from Medicare had problems with their plans and were even forced to choose other plans when the Advantage provider stopped covering Medicare patients.

Significance

• Medicare Advantage Plans are intended to provide both drug coverage and health care for seniors at what was hoped to be a reduced cost. There is continuing debate about their success, particularly in the area of keeping down prescription costs. A Congressional study found that in the first seven weeks of the Medicare Part D drug program, prescription drug plans raised drug prices. However, the plan did extend drug coverage to many seniors who lacked this insurance.

Types

• The plans sponsored by AARP and provided by Secure Horizons are available in four levels, named AARP MedicareComplete Plan 1, MedicareComplete 2, MedicareComplete 3 and MedicareComplete Essential. Monthly premiums range from $99.00 for Plan 1, $125.00 for Plan 2, $0.00 for Plan 3, and $85 for Essentials. All but Essentials include drug coverage besides health care. Office visit co-pays go from $0.00 to $30.00 depending on the plan and whether to a primary care doctor or specialist. These are Health Maintenance Organization (HMO) plans.

Effects

• The effects of changes in the ways health care and drugs are provided to seniors, in both the AARP plan and hundreds of similar plans have not had the desired effect on medical costs. Unlike Medicare itself, drug coverage is only available through private insurance plans, either alone or combined with health care plans (Medicare Advantage). There is therefore no negotiation of prices as there was with traditional Medicare coverage. The sheer complexity of all of the plans offered, each using different formularies (lists of covered drugs), which may or may not include drugs that some patients need, increases enormously the difficulty of making informed health care decisions.

Benefits

• The AARP Medicare Supplement and Drug plan is available at several levels. Unlike the Medicare Part D Drug plans, Medicare supplementary plans that include drug coverage are called Medicare Advantage plans. In this type of coverage, the patient gets both health care and drugs through a central provider. In the MedicareComplete plan, patients have a co-payment of $5.00 for a 30-day supply of preferred generic drugs at retail pharmacies. Preferred brand name drugs have a co-pay of $29.00. Non-preferred drugs are $60.00 and for specialty drugs patients pay 33 percent of the retail cost. Ninety day drug supplies are available through mail order at a cost savings.

Considerations

• Medicare collects customer service reports on all Medicare regulated plans. The AARP MedicareComplete plan got high ratings (four or five out of five stars) in the areas of customer service, telephone call disconnects, complaints about leaving the plan, access to primary care visits and specific disease care among other areas. They got much lower ratings (one or two stars out of five) in areas such as members staying with the plans from one year to the next, drug plan prices on the website being similar to actual prices paid at pharmacies, and answering calls in a timely fashion. In the latter case, only 48% of calls were answered in a timely fashion.