Medicare Part D Open Enrollment Began November 15

Joyce Remy

If you signed up last year, should you stay with your plan? If you are not satisfied with your plan, how do you select a new one?

Each year, all people with Medicare have a chance to sign up for the Medicare Part D Prescription Drug Benefit. This year’s Open Enrollment Period is November 15 – December 31. In this second year of the new program, many seniors and their caregivers report uncertainty about what steps to take in selecting a plan—and what, if anything, to do if they already signed up for a plan last year.

If you are already enrolled in a plan, and you are satisfied with its coverage, you don’t need to take any action at this time. If you sign up for the first time during this period, or if you switch plans, coverage will begin on January 1, 2007. 

The most complicated part of the decision making process is the many plans that are available—at least 50 in most states. So if you went through the process last year, you might be tempted to stick with your current plan rather than investigating your options again. But this could be a mistake because…

…there are many new plans on the market

…your current plan may be changing its coverage for 2007

…your own needs may have changed since the last enrollment period

Not sure if staying with your current plan is the right decision? The first step is to figure out if your plan is best meeting your needs. By now, you should have received an “Annual Notice of Change” letter from your current plan. Once you have reviewed this information, ask yourself these important questions:

1.) Will your premium and costs change in 2007?

As you look at available plans, consider the premium (the monthly fee you pay to get coverage); the deductible (the yearly amount you pay before the drug plan begins to pay); copays or coinsurance (the portion of each prescription for which you must pay out of pocket); and the coverage limits (many plans have gaps in coverage that require you to pay for all drug costs at certain times).

2.) Does your plan have the coverage you will need in 2007?

Each drug plan has its own formulary (list of generic and name-brand drugs it covers). Be certain that your plan will still cover the medications you currently take. If your plan doesn’t cover your specific drug, ask your healthcare provider if a drug the plan does cover could be substituted.

3.) Are you satisfied with the convenience and customer service of your plan?

Are the pharmacies in your plan the ones you want to use? Does the plan allow mail order if you want that option?  Last year, how responsive was the company if you had questions or problems?
 
Help is available as you make the decision

Whether you are enrolling for the first time, or trying to decide whether the plan you signed up for last year is still the best for your needs, resources are available to help in the decision making process.

Senior Services of Seattle King County

Senior Information and Assistance website
Telephone: (206) 448-3110
1-888-435-3377 (WA only)
(206) 448-5025 (TTY)
E-Mail: Info@seniorservices.org

Statewide Health Insurance Benefits Advisors (SHIBA) HelpLine

A statewide network of trained volunteers who help people of all ages with questions about health insurance, health care access, and prescription access. Visit the SHIBA website to find out the number for the unit closest to you, or call 1-800-562-6900. 

Centers for Medicare and Medicaid Services (www.medicare.gov)

1-800-MEDICARE
TTY 1-877-486-2048
Select “Compare Medicare Prescription Drug Plans” for the Medicare Prescription Drug Plan Finder, which includes a state-by-state list of plans. And if you haven’t yet received a copy of Medicare and You 2007, you can view it online. 

Eldercare Locator

The Eldercare Locator now has information on getting personal help in locating a drug plan in your community.  

Social Security Administration

Do you need help paying for your prescription drug coverage? Those who qualify can receive financial help in paying for premiums and deductible. To find out more about the “Extra Help” program, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) or visit the "Extra Help" section of the Social Security website.

My Medicare Matters.org

From the National Council on the Aging, www.mymedicarematters.org offers a tutorial you can use while researching your Medicare Prescription Drug benefit options.

AARP

The Medicare section of the AARP website includes much information, ongoing coverage and tools for selecting a prescription drug plan.

© 2006 Caresource Healthcare Communications