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Medicare Part D - Decisions for 2010
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Between November 15 and December 31, 2009 Medicare recipients will have an opportunity to make changes concerning their prescription drug coverage under Medicare Part D for 2010. The open enrollment period will allow policy holders, as well as those enrolling for the first time; to be sure they have the coverage which best fits their needs.
Private companies on a yearly basis revise the plans they offer to position themselves in the market to entice new clientele. For Medicare Part D recipients, this creates the necessity to evaluate if the plan they are currently enrolled in is the best option for them in 2010. Beneficiaries may find significant differences between the coverage they have in 2009 as compared to 2010 if the stay with the same company in respect to the prescription drugs they cover (the formulary), the terms and cost of the coverage.
In 2010 there will be 46 stand alone plans of which a majority offer enhanced benefits (over and above what the Medicare contract requires). The plans premiums range from $20.80 to $104.10. The plans have various deductibles with the highest being $310.
Each Medicare recipient has a unique "prescription profile" (the prescription drugs they take, the dosage and frequency they take the medication), so what plan is appropriate for one person may be significantly different for another person. It is important that individuals check out plans which fit their personal situation.
Individuals who enrolled in a Medicare Prescription Drug policy in 2009 should have received a notice from their company informing them of their 2010 Policy coverage and premium. If individuals had a policy that does not cover a prescription drug they take; if they met the donut hole; if their plan formulary is changing; or if there will be a premium increase, they certainly want to explore 2010 coverage and premium options from all companies offering policies.
Participation in a Medicare Part D policy is optional; individuals who did not select a plan during their initial open enrollment and who do not have "credible coverage", will face a 1% per month penalty added on to their premium for the months they did not enroll when eligible. This penalty will be added on to the premium if they choose to enroll in a Part D Policy for the remainder of their life. The penalty is based on the National Average Premium. Individuals who have not enrolled who have been eligible for coverage since May of 2006, and are not currently covered by "credible coverage", will face a 43% ($13.76) penalty added on to their monthly premium if they choose coverage for 2010. If they do not choose coverage during the open enrollment (November 15 - December 31, 2009), they will not be able to select coverage until open enrollment late next year and will then face a 52% premium penalty for coverage beginning in 2011 unless they qualify for the Low Income Subsidy.
A Low Income Subsidy is available for individuals with limited income and resources. Guidelines for assistance are for those with incomes below $16,245 for a single person and $21,855 for a couple. Resource limits (checking, savings, CD's, investments) are $12,510 for a single and $25,010 for a couple. In most instances individuals/families need to complete an application requesting assistance. Assistance for qualifying individuals is provided in reduced or no premium, and limited/reduced prescription drug cost. Individuals can apply for the Low Income Subsidy at any time during the year through the Social Security Administration, and if they qualify for assistance they can select/change to an appropriate prescription drug policy at that time.
Individuals who currently receive the low income subsidy may have received a letter from the Social Security Administration asking if there has been a change in their resources or income. If changes have been made they may need to reply to the letter sent and subsequent requests. Failure to reply to subsequent requests may result in withdrawal of their low income subsidy.
Individuals or families looking to sort through options have a number of resources to turn to. Part D Insurance policies may be sold/marketed through local insurance agents. If individuals purchase a policy from a local agent they want to know if that agent compared their policy options among all companies, or a selected number as policy coverage and premiums vary significantly.
Personalized Medicare Part D policy comparisons with all plans available are available at www.Medicare.gov, 1-800-633-4227 (Medicare); 1-800-536-8197 (SHIINE); local Extension Offices, some local insurance agents, and selected program sites. Seniors, their family members or authorized representatives may contact any of the agencies previously listed.
Plan finder assistance sponsored by the Cooperative Extension Service and SHIINE will be available at the following:
* Aberdeen, Senior Center, November 19, 24; December 3, 10, 17, 22, & 29 from 10 am - 2 pm
* Aberdeen, Senior Center, December 3 & 17 from 5:30 - 7:00 pm;
* Langford, High School, November 17 and December 2, 10:00 - 11:30 a.m.
* Britton, Extension Office, November 17 and December 2, 1:00 - 3:00 p.m.
* Britton, Senior Center, November 24, December 1, 8, 15, 22, & 29, 1:00 p.m. - 2:30 p.m.
* Ipswich, Extension Office, November 23, 10 - 11:30 a.m.
* Bowdle, High School, November 23, 1:00 pm - 3:00 p.m.
* Leola, Extension Office, December 1, 10:00 a.m. - noon
* Webster, Courthouse Basement, December 7, 10:00 a.m. - noon (includes RSVP)
* Eureka, School, DDN Room, December 9, 10:30 a.m. - 1:00 p.m.
Information needed for personalized plan comparisons include the Medicare recipients Medicare number, a legible, accurate and complete list of prescription drugs, the dosage and the frequency of prescription drugs taken. Information is also needed for the pharmacy they most often go to and if they are currently enrolled in a plan and the name of the plan. A list of prescription drugs taken may also be provided with the most recent copy of their summary of benefits statement from their Medicare Part D company or with a 3-month drug print out from their pharmacy.
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©Marshall County Journal 2010
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