Open Season For Medicare Part D Enrollment

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Main Category: Medicare / Medicaid / SCHIP
Also Included In: Seniors / Aging;  Health Insurance / Medical Insurance
Article Date: 20 Nov 2008 - 11:00 PDT

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From November 15th to the end of December is "open season" for American senior citizens to sign up for another year to benefit from the federal government program known as Medicare Part D designed to help eligible older Americans pay for prescription drugs.

The general advice is that unless you are already on an alternative scheme like a retiree prescription plan or covered by the all-in-one Medicare Advantage, you should sign up even if you don't currently take prescription drugs because you may need them and if you're not in the scheme when you do you will find yourself paying large penalties.

Medicare Part D started in January 2005 and was brought in to help senior citizens by providing a single source for prescription drug coverage. Before that most older Americans had to find coverage for their prescription drugs through a confusing array of private insurers.

With Medicare Part D the senior citizen pays a monthly premium to belong to a plan and then only pays a small part of the cost of the drug. In principle this sounds straightforward, but as Drugs.com, an online information service for consumers and health professionals, explains, there is a lot that can go wrong and it is important that you choose the right package for you when you sign up.

Although generally regarded as a benefit worth having, getting on the scheme and then navigating through the array of options to find a package that is not too expensive is not for the faint hearted.

Expert websites offer help and advice and also suggest that even if you are already enrolled and happy with your current package you should go through the process again and check what's on offer for 2009 because the drug prices will change and the ones you chose last year may not even be in the plans next year.

Townhall.com, a community website with a conservative political flavor based in Arlington, Virginia, offers a step by step guide to navigating your way through the Medicare website. Terry Savage who wrote the guide, said this year there is also a star rating system on the site showing which plans performed best last year, according to a Medicare survey.

Savage also makes a plea for computer literate people to download the guide and go in search of senior citizens who aren't computer savvy and help them enroll because the process is very complicated and unnerving for those not used to going online.

Drugs.com has also launched a new Medicare Part D Guide and Plan Selector Tool to help senior citizens get the best package. The tool will be live during the Medicare Part D "open season" from November 15th to December 31st.

Congress acknowledges that Medicare Part D is not as user friendly as it should be and until it is redesigned the only way to get the best deal is to get good advice: "knowledge is the key to avoiding unnecessary expense" according to Drugs.com.

For example, many of those enrolled in Medicare Part D may not be aware of what has been termed the "donut hole". When the total costs paid by the member and the plan hit the current ceiling of 2,700 dollars, the benefits stop and until the next plan year the member pays the full cost of the drugs unless they reach the other side of the donut hole which is when the total out-of-pocket costs exceed 6,154 dollars after which the plan pays again. Some plans insure against the donut hole.

Both the Drugs.com site and the Medicare site allow the user to compare plans by putting in their zip code and a list of medications. The sites show graph versions of plans giving details of premiums, deductibles, co-payment fees and the point at which the donut hole kicks in.

Phillip Moeller of US News and World Report offers these five tips to help you get the most out of your Medicare Part D:

1. Look for better premiums: they are expected to rise 30 per cent next year.


2. Check the fine print: it's not just about the premiums, plans change the range of drugs they offer and how they are grouped and research shows that few people exercise their right to change their plan every year.


3. Compare drugs across plans: Medicare and other sites have tools to help you compare the same drugs under different plans.


4. Shrink the donut hole: many plans are expected to pull out of insuring members against the donut hole effect next year.


5. Consider generics: find opportunities to fill your needs outside the Part D program using 4-dollar generics and thus reduce your odds of getting into the donut hole.

Click here for step by step guide to picking a Medicare Drug Plan (townhall.com)

Click here to find and compare plans using Medicare website.

Click here to Compare Plans Now Using Medicare Part D Guide and Plan Selector Tool (Drugs.com)

Sources: Drugs.com, Townhall.com, Medicare, US News and World Report.

Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today