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Senior Citizens Urged to Review Medicare Drug Plan Options as Window for Change Opens Thursday

Medicare Rights Center offering free tools, advice to help seniors make choices

	Tips on Drug Plan Choice
	Things to Consider Before Enrolling in a Medicare Private Drug Plan (Part D) or Changing Plans Time to make changes - Starts Nov. 15 and ends Dec. 31, 2007 See list below in story.

Nov. 14, 2007 – The window opens tomorrow – Thursday, Nov. 15 – for senior citizens to make changes in their Medicare programs. The most vital change, for many, may be their drug coverage in Medicare Part D. Anyone who gets drug coverage through a Medicare private drug plan should review all of their drug plan choices for 2008 - even if they are satisfied with their current plan - because most drug plans will change their costs and benefits, according to the Medicare Rights Center.

	Related Stories
	Senior Citizens Get More Encouragement to Reconsider Medicare Drug Options Time to make changes in Medicare begins Thursday, open until end of year - There are helpful links in this story. Nov. 13, 2007 Medicare's Open Enrollment Period Opens Thursday with More Confusion Than Ever Nov. 12, 2007 Medicare Part D Enrollment Season Offers Seniors Higher Costs, Confusion Families USA analysis says no ‘Doughnut Hole’ protection available Nov. 9, 2007 Medicare Drug Plan Choices for 2008 Available Online October 11 Medicare says it has enhanced tools to help make better drug plan choices Oct. 10, 2007 Senior Citizens Should Check Which Medicare Drug Plans Hike Prices After You Enroll Seniors can’t rely on drug prices companies list at beginning of year: Consumers Union wants changes Oct. 2, 2007 Medicare Part D Pushed Drug Prescriptions Up 158 Million, Gov Cost by $32 Billion Oldest, poorest spending a much greater share of their own income on premiums and health services than others Nov. 1, 2007 Medicare Consumer Groups, Legislators Call for Medicare-Operated Drug Plan Advocates release report citing cost, instability, coverage gaps, fraud in Part D Oct. 25, 2007 Read the latest news > Medicare > Medicare Drug Program > Senior Politics > Today's Headline News

People with Medicare have the right to change their Medicare private drug plans, or enroll in one for the first time, from November 15 through December 31. It is important for people to review their Medicare private drug plan choices now and choose the plan that best suits their needs, because after January 1, most people will be locked into the plan they chose for the rest of the year.

"Medicare private drug plans are a moving target for Americans with Medicare," said Robert M. Hayes, president of the Medicare Rights Center, a national consumer group.

"A plan that worked well for someone this year may be more expensive, cover different medications and have different restrictions on their covered drugs in 2008. No one should assume that their drug coverage will remain the same if they stay in their current plan."

Medicare drug coverage is available only through private insurance companies. People who have Original Medicare can purchase a "stand-alone" plan (drug coverage only). Most people who get their Medicare benefits through a Medicare private health plan-such as an HMO or PPO-must get their drug coverage as part of the health plan's benefit package.

Annual deductibles, copayments, covered drugs (formulary) and participating pharmacies vary from plan to plan. In 2008 the annual deductible can never be more than $275. People who are currently enrolled in a Medicare private drug plan should have received a letter from their plan that informs them of changes for 2008. They should call their plan if they have not received a letter.

Doughnut Hole important consideration

Medicare private drug plans have a gap in coverage known as the "doughnut hole," during which people must pay the full cost of their prescriptions. In 2008, the gap for many plans begins when total drug costs (what the consumer pays plus what the plan pays) reach $2,510.

The coverage gap ends and catastrophic coverage begins after the consumer has spent $4,050 out of pocket. People with catastrophic coverage will then pay 5 percent of the cost of each drug or a copayment of $2.25 for covered generics and $5.60 for covered brand-name drugs, whichever is greater. There are plans in most states that offer some coverage through the gap, but they generally have higher monthly premiums and most cover only generic drugs in the gap.

People with low incomes (monthly income of $1,276 for singles, $1,711 for couples) and few assets (below $11,710 for singles, $23,410 for couples) may be eligible for Extra Help, a federal program that helps pay for some or most of the costs of Medicare prescription drug coverage.

People whose income or assets are above the limit may still qualify, because certain types of income and assets may not be counted. Applications for Extra Help are available through the Social Security Administration. You can also apply online at www.ssa.gov.

People who have Medicaid, Supplemental Security Income (SSI) or a Medicare Savings Program (MSP) automatically qualify for Extra Help, and do not have to apply.

To compare plans, consumers can use the Medicare Prescription Drug Plan Finder tool at www.medicare.gov or call 800-MEDICARE to review all of their options and get details about the plans. Before signing up with a drug plan, people should call the plan and confirm all details.

Enrolling in a Medicare private drug plan is voluntary for most people, but people with both Medicaid and Medicare, and those enrolled in some state pharmaceutical assistance programs, must have one.

Whether you should enroll depends on your current drug coverage, your prescription costs and your drug needs. If you have drug coverage that is considered as good as Medicare's ("creditable") - for example, from an employer - you can keep it and enroll in the drug benefit later without penalty, as long as you are not without creditable coverage for more than 63 days when you take part D.

Things to Consider Before Enrolling in a Medicare Private Drug Plan (Part D) Time to make changes - Starts Nov. 15 and ends Dec. 31, 2007 Insurance companies are currently marketing their Medicare private drug plans and consumers may be overwhelmed and confused by the vast array of information they are receiving. Before signing up for any Medicare private drug plan, you should:   ● Make a list of the medicines you take, the dosages and how much you currently pay.   ● Make note of pharmacies you use regularly. Then use the Medicare Drug Plan Finder tool at www.medicare.gov or call 800-MEDICARE to review all options and get details about the plans. Some things to consider are:   ● Does the plan cover all the medications I am taking?   ● Does the plan require that I get special permission before it will cover the medication I need (such as prior authorization or step therapy)?   ● How much will I pay at the pharmacy (copayments or coinsurance) for each drug? (Certain drugs may cost a lot even if they are covered .)   ● How much will I pay in monthly premiums and annual deductible?   ● Will I have to pay the full cost of my drugs at some point after the deductible (coverage gap)?   ● Can I fill my prescriptions at the pharmacies I use regularly?   ● Can I fill my prescriptions when I travel?   ● What happens if I go to pharmacies that are not in the network?   ● Can I get prescriptions by mail order?   ● If you have health or drug coverage from another source, such as from an employer or retiree plan, ask if the Medicare drug plan will work with it. (Some health and drug plans do not work with Medicare drug coverage or work only with certain types.) Call the plan to confirm the details before signing up. For more consumer-friendly guidance on choosing a drug plan, go to Medicare Interactive Counselor at www.medicarerights.org/help.html. Source: Medicare Rights Center

If you do not have creditable drug coverage, and do not enroll in the Medicare drug benefit when you are first eligible, you may have to pay a premium penalty when you do enroll.

The Medicare Rights Center offers the following resources, at no charge, to help people choose a drug plan that best meets their needs:

  ￭ Medicare Interactive Counselor: www.medicarerights.org/help.html
MRC's free, online educational tool provides consumer-friendly information about Medicare benefits, rights and options, including:
   ￮  explanations of the different types of Medicare private drug plans
   ￮  explanation of how to compare your Medicare private drug plan options
   ￮  questions to ask before joining a Medicare private drug plan
   ￮  tips on how to avoid marketing fraud
   ￮  state-specific health care information

  ￭ Telephone Counseling
Consumers who prefer to speak with a counselor can call the Medicare Rights Center's toll-free hotline at 1-800-333-4114. Counselors are available Monday through Friday, 9AM - 6PM (Eastern Time).

  ￭ Medicare Basics

Easy to understand explanations of how Medicare works. Click Here

Medicare Rights Center (MRC) is the largest independent source of health care information and assistance in the United States for people with Medicare. Founded in 1989, MRC helps older adults and people with disabilities get good, affordable health care. Founded in 1989, MRC helps older adults and people with disabilities get high-quality, affordable health care.

 

 

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