Seniors’ drug plans to change

Published 9:00 pm Monday, October 23, 2006

If you’re signing up for a Medicare prescription drug plan for the first time or want to make a change in a current plan, get ready to do some homework.

In Washington, there are 57 prescription insurance plans to choose from, with fees ranging from $15 to $78 a month. This year, the most expensive plan was $65 a month.

There are differences in deductibles, co-pays and coverage to consider, too.

Signups begin Nov. 15 and continue until Dec. 31. The benefits begin on Jan. 1.

Medicare will soon mail a booklet to newly eligible seniors and those with disabilities who qualify for the plan.

And Senior Services of Snohomish County has announced a series of information sessions to provide answers to questions and help people sign up.

Some of the changes next year in the prescription drug program include an increase in the deductible, which will be $265, up from $250 this year.

Enrollees will hit the initial limit of prescription drug coverage, sometimes called “the doughnut hole” when their total prescription costs hit $2,400, up from $2,250 this year, said James Pham, a coordinator with Snohomish County’s Senior Information and Assistance.

Once the initial limit is hit, catastrophic coverage doesn’t kick in until a total of $5,451 is spent on prescriptions, meaning seniors would have to cover $3,051 of their own costs during the “doughnut hole” period.

Pham said that some plans do pay for prescriptions in this coverage gap, but only will cover the costs of generic drugs. Of the 17 drug plans offered in Washington that pay for prescriptions once people hit the initial coverage gap, only two are offering generic and preferred medications next year, he said.

A lot of people with high medication needs ended up in the coverage gap this year, with no help paying for their prescriptions, Pham said. “I think those people will need to reevaluate” which plan they use next year,” he said.

Because of the number of plans that will change prices or coverage, Pham said he expects a lot of people currently signed up with one plan to change to another.

Individuals or couples who meet low-income guidelines can get help paying for their monthly premiums for the prescription insurance, said Bob Quirk, who works for Senior Services of Snohomish County.

Couples can make up to $19,800 a year and still qualify for help paying for their monthly premiums for prescription drug coverage.

Individuals making no more than $9,800 a year or couples making no more then $13,200 a year will not have to pay anything for the monthly premium. However, they will have a $1 co-pay for generic drugs and $3 for each brand name prescription.

Help session

Heres a list of upcoming help sessions, sponsored by Senior Services of Snohomish County and the Statewide Health Insurance Benefits Advisers, for people to sign up for a Medicare prescription drug plan or make changes to their current plan. Anyone coming to these sessions should have a list of their medications and their Medicare card.

Call for an appointment.

Nov. 16: 12:30 to 3:30 p.m., South County Senior Center, 220 Railroad Ave., Edmonds, 425-774-5555

Nov. 21: 8 a.m. to 10 a.m., Snohomish Library, 311 Maple Ave., Snohomish, 360-568-0934

Nov. 27: 10 a.m. to 2 p.m., Senior Services of Snohomish County, Building A, Suite E, 8221 44th Ave. W, Mukilteo, 425-513-1900

Nov. 28: 8 a.m. until noon, Camano Senior and Community Center, 606 Arrowhead Road, Camano Island, 360-387-0222

Dec. 1: 10 a.m. until 2 p.m., Senior Services of Snohomish County, Building A, Suite E, 8221 44th Ave. W, Mukilteo, 425-513-1900

Dec. 4:10 a.m. to 2 p.m., Senior Services of Snohomish County, Building A, Suite E, 8221 44th Ave. W, Mukilteo, 425-513-1900

Dec. 5: 12:30 p.m. to 3:30 p.m., South County Senior Center, 220 Railroad Ave., Edmonds, 425-774-5555

Dec. 7: 8 a.m. to 10 a.m., Snohomish Library, 311 Maple Ave., Snohomish, 360 568-0934

Dec. 8, Dec. 11 and Dec. 15: 10 a.m. to 2 p.m., Senior Services of Snohomish County, Building A, Suite E, 8221 44th Ave. W., Mukilteo, 425-513-1900

To learn more

These sessions have been scheduled to give people background information and an update on the Medicare prescription drug plan:

Oct. 27: 1 to 2 p.m. Camano Island Senior Center, 606 Arrowhead Road, Camano Island.

Nov. 3: 10 to 11 a.m. East County Senior Center, 824 Village Way, Monroe.

Nov. 6: 10 to 11 a.m.. East County Senior Center- 824 Village Way, Monroe

Nov. 14: 1:30 to 2:30 p.m. Ken Baxter Senior Center, 514 Delta Ave., Marysville

Nov. 21: 1:30 to 2:30 p.m. Ken Baxter Senior Center, 514 Delta Ave. Marysville

Source: Senior Services of Snohomish County