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<< Previous   of   Next >>   ADVERTISEMENT   CONTACT THE HERALD Melanie Munk, Features Editor munk@heraldnet.com   Published: Sunday, November 9, 2008 Several Medicare plans begin enrollment By Linda Bryant Smith Herald Columnist Just when we're finally past endless political rhetoric and nasty campaign ads, comes a new campaign aimed at the Medicare generation. Yes, my friends, we're only days away from the formal open enrollment period for Medicare Part D prescription drug insurance, Medicare supplement plans and Medicare Advantage plans. One piece of good news: No increase in what Medicare deducts for Plan B from your Social Security check ($96.40) unless your income was more than $85,000 as an individual or $170,000 as a couple. This lack of increase is the result of a bookkeeping mistake at Medicare. The Part B reserve gained $9.3 billion earlier this year after officials discovered money was inadvertently being drawn from Medicare B to cover hospice benefits. Part D, the prescription drug plan, was also the subject of a government miscalculation. In 2006 when the plan took effect, experts in the Congressional Budget Office predicted the prescription drug plan would cost taxpayers as much as $74 billion annually by 2008. They were wrong. Costs dropped in 2007 and again this year to $44 billion. These savings were driven by the widespread use of generic drugs and the fact that Part D has 2 million fewer participants than originally projected. However, premiums for many supplements, Medicare Advantage Plans and Prescription drug plans are going up. So read the information you receive carefully and ask lots of questions before making a decision. This is especially true for Part D. The top 10 plans in the country have raised their premiums anywhere from 8 percent to 64 percent, according to consumer watch groups. For example, United Health Group's AARP preferred plan used by 2.7 million folks has a 15.5 percent increase to $38.40, but it still has no deductible. Humana, another large provider, has increased its PDP Enhanced plan premium by 64 percent to $36.50 with a $295 deductible. If you have a computer or access to one, you can go to www.medicare.gov and see a list of all the part D plans in Snohomish County and their premiums. There are 48 prescription drug plans offered in this county. Premiums range from $21.60 to $120. There are only seven plans available for low income Medicaid/Medicare patients. Call the SHIBA help-line for assistance in finding the Medicaid-qualified Part D plan that will best suit your needs. Generally, the lower the premium the higher the deductible. The maximum deductible companies can charge you in 2009 is $295. Some of the pricier ones include coverage of generic drugs through the infamous donut hole. Many companies have also increased their co-pays. On the other hand, some will supply your generic drugs free if you order a 90-day supply from their preferred mail-order pharmacy. More critical than the cost, however, is whether or not the drugs you take are covered in the plan's formulary and what level they are in the formulary, one being the lowest and three the highest costs. Before signing up for any plan, make sure the drugs you require are listed in the plan's formulary and know what the co-pay is. Be aware that an insurance company can choose at any time to remove a drug from its formulary. They're supposed to give clients a 60-day notice if it is a drug your are currently taking. For those seniors with serious medical conditions requiring level-three brand name medications, no plan in 2009 will cover these meds during the doughnut hole. You hit this hole when you and your drug plan have paid out $2,700 in the current year. When you reach the "hole" your out-of-pocket costs must reach $3,454 before you qualify for catastrophic coverage, where costs drop to about 5 percent. You may be able to get help with drug costs when you're in the doughnut hole through manufacturer's prescription assistance programs. Ask your physician about these programs or call the SHIBA hotline for more information If you take generic drugs, you can pay cash at pharmacies in stores such as Wal-Mart, Costco, Safeway, that offer $4 refills ($10 for 90 days) on generic drug prescriptions. That means the amount will not be counted toward the doughnut hole. Sometimes, that may be enough to keep you from hitting the "hole" before the end of the year. I decided to do this after checking a statement from Medicare that showed one of my generic drugs was billed at $18 for a 30-day prescription plus another $6 that was my co-pay. I could (and now do) buy it without insurance for $4 ($10 for 90 days) at Wal-Mart or Costco. None of this is easy to sort through. I used to dread income tax time, but that's nothing compared to plowing through this morass of Medicare paperwork to find plans that work for my needs. It's a real pain in the patoot. If you have a Medicare Advantage plan you'll probably find that premiums and co-pays have gone up and some benefits are not returning in 2009. Not all medical clinics and hospitals accept any or all of these plans. Again, you need to review the coverage item by item, check with your doctor and the hospital you prefer to ensure they are still accepting this type of coverage. The helpful folks on the Senior Information and Assistance line as well as the SHIBA (Senior Health Insurance Benefits Assistance) advisers are available by telephone to answer many of your questions. (See info box). In addition, a series of informational meetings are scheduled at senior centers throughout the county. Check with your nearest center for a meeting near you. Or, call Senior Services of Snohomish County. They have enrollment assistance events schedule throughout November and December. You need to call ahead at 425-513-1900 for an appointment. You have until the end of December to make an informed decision to meet your insurance needs in the coming year. Don't plan on any speedy bailouts for ordinary folks struggling to pay for health care. Grandiose plans offered up before Tuesday's election still have to slog past pork barrels on a rough road meandering through Congress. Linda Bryant Smith writes about life as a senior citizen and the issues that concern, annoy and often irritate the heck out of her now that she lives in a world where nothing is ever truly fixed but her income. You can e-mail her at ljbryantsmith@yahoo.com. Learn more For information on Medicare Part D: n 425-290-1276 (SHIBA help line in Snohomish County) n www.Medicare.gov online. Go to category "plans in your area" To locate an informational meeting near you: Senior Information and Assistance, (Snohomish County) 425-513-1900 or 800-422-2024 READER COMMENTS Be the first to comment. You must be a registered user and verify your e-mail address to post comments to blogs or articles on HeraldNet. To register, click here. To read other terms and conditions, click here. Log out

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