SENIOR JOURNAL.COM - Senior Citizens Information and News

Front Page    Search     Contact Us     Advertise in Senior Journal

E-mail this page to a friend!

Seniors Who Don't Take Drugs Can Wait Until May 15 to Join Medicare Plan

Find a plan that will cost the least for not using it before enrollment ends

By Tucker Sutherland, editor

Dec. 27, 2005 – Senior citizens who do not take any prescription drugs may want to wait until 2006 to join a Medicare prescription drug plan. You are penalized for the rest of your life for not joining during this initial enrollment period, but this does not end until May 15, 2006, although the plans begin coverage on Sunday, Jan. 1, 2006. The strategy is to also find the plan that will cost you the least for not using it.

Seniors do not have to join a drug plan at all, but here is what Medicare says will happen if you do not –

"If you don’t join a plan by May 15, 2006, and you don’t currently have a drug plan that, on average, covers at least as much as standard Medicare prescription drug coverage, you will have to wait until November 15, 2006 to join. When you do join, your premium cost will go up at least 1% per month for every month that you wait to join. Like other insurance, you will have to pay this penalty as long as you have Medicare prescription drug coverage.

"If you join after May 15, 2006, the next open enrollment period is November 15, 2006 to December 31, 2006. However, coverage for people who enroll during this period will not take effect until January 1, 2007."

So, if a senior does not need prescription drug coverage now, there seems to be no point in joining before May 15.

Many seniors think they must join by Dec. 31 of this year, since they know the program begins coverage on Jan. 1. That is not the case. Everyone has until May 15, 2006 to join and avoid the penalty.

But, if you do join in the early months of 2006, your coverage will begin on the first of the following month. For example, if you wait until February to join, your coverage will begin on March 1.

Those who do not take any prescription drugs can save months of premiums by waiting until May. This also gives extra time to be sure you select a plan that meets your needs. In other words, to find a plan that will cost the least for not using it.

There are two good ways to find the right plan.

First, we recommend using the Medicare provided program for finding a plan. Click here to our step-by-step guide to using the Medicare plan finder. After you provide the information that you take no prescription drugs, it will automatically show you the plans in your area that will cost you the least.

Another quick way to do this search is to use the prescription drug plan state charts provided online by the Health Assistance Partnership.

You can click here to go to their page listing all the states. Click on your state and it provides details on all the plans available in your state. The list is in Excel format, which allows you to sort the plans by "premium" to find the one with the lowest monthly premium.

In checking one state – Texas – we found a Human plan was the cheapest, with a monthly premium of $10.63 per month. On the high end is Marquette National with a monthly premium of $68.41.

With lower monthly premiums, the users usually must pay high copays and may have higher minimums than the more expensive plans. If you do not take any drugs, however, there is no reason to care about lower copays and lower minimums.

These charts are provided by the Health Assistance Partnership, a project of Families USA, and which is funded by the Robert Wood Johnson Foundation.

Medicare also provides an interactive page for finding plans by state - click here. It provides the information for Medicare Advantage Plans and stand along plans in separate pdf documents.

The other important consideration is what happens if your needs change – you need to start taking prescription drugs. In this case you have the opportunity to change plans every year during the annual enrollment period that will begin on Nov. 15 of each year.

Another option that should be considered is a Medicare Advantage Plan. These HMO/PPO plans include health care and the drug plan in one premium. Generally, these are the least expensive way for senior citizens to receive health care, as well as drugs, but enrollees sacrifice some options about their health care – for example, you may only use doctors or hospitals participating in the plan you join.

Again, looking at the Texas plans, the lowest stand along drug plan is the Humana plan for $10.63 per month. But, Humana has a PPO plan that includes drug coverage for only $45.00 per month.

Regardless of your situation, as President Bush said, making a choice is a "daunting task."

Click here to Search SeniorJournal.com for more on this subject

Click to More Senior News on the Front Page

Copyright: SeniorJournal.com