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Opinion - Medicare Drug Program
Every Senior Citizen Should Reevaluate Their Drug
Plan Choice
By Tucker Sutherland, editor
November 16, 2006 – The enrollment period for the
Medicare drug program opened yesterday and all senior citizens should
review their current drug plan and other options – some new – that are
available to them. Many plans have changed (prices and/or benefits) and
for many seniors their personal situations may have changed. For
example, some took no drugs in 2006, but see a need in 2007, which would
drastically change the type of plan they choose.
One senior, for example, took no drugs in 2006 but
wanted to join Medicare Part D to avoid future penalties for not
enrolling in the first year of eligibility. This senior chose a drug
plan with a low monthly premium, high deductible and high co-pay. All
that mattered to this beneficiary was the cost, which meant a low
premium, since the deductible and co-pay amounts had not impact for this
non-drug user.
This year, however, this same senior has been put
on a regular monthly prescription for a statin drug, and has other
problems developing that will require medication. So now the strategy on
choosing a drug plan changes. The aging senior needs to lower the
deductible and co-pay with the lowest monthly premium possible.
An even more important consideration is the dreaded
"donut hole." Many seniors were shocked when they fell into this gap in
coverage - the provision of the drug benefit under which beneficiaries
are responsible for 100% of prescription drug costs between $2,250 and
$5,100. What really perplexed many is that their monthly premium
continued, despite no coverage.
Only fifteen percent of plans included coverage
during the doughnut hole in 2006. But, 29% will provide the coverage in
2007. Plans with donut hole coverage typically charge higher premiums
and coverage most often only applies to generics.
Here, again, a senior that did not reach the donut
hole in 2006, may have the need for this coverage in 2007, if
anticipating a greater need next year.
Wall Street Journal: Although beneficiaries who are
satisfied with their current plans do not have to take any action if
they do not wish to switch plans, "the drug benefit landscape is
changing enough that even enrollees who are content may want to review
how their plan stacks up against new offerings," the Wall Street Journal
reports. One change is the increase in plans that are offering coverage
during the doughnut hole, the provision of the drug benefit under which
beneficiaries are responsible for 100% of prescription drug costs
between $2,250 and $5,100.
Surprisingly, many seniors are taking another look
at their current plans. One thing some are finding is a substantial
increase in cost for their current plan. A recent survey by J.D. Power &
Associates found that only 20% definitely plan to stay with their
current plans.
There are also millions of seniors, including two
million just becoming 65 in 2007 and four million seniors that did not
enroll in 2006, that need to take a fresh look at the program and the
available choices.
The enrollment period is open until the end of the
year but seniors should be investigating their new options now. There
are an increasing number of sources, many online, that can help and we
have a list on this page.
Check, too, the related stories in the sidebar on
this page for more information.
There is no better time to start than now.
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Links below will take
readers to their state plans available for enrollment Nov. 15