2007 Medicare Part D Open Enrollment

[CarolynS]

It is that time. Open enrollment for 2007 begins soon.

************************************************** ******

Medicare Website
www.medicare.gov • 1-800-MEDICARE • TTY 1-877-486-2048

Online Pamphlet
http://www.medicare.gov/publications/pubs/pdf/11220_alt.pdf

October – Compare and Prepare

Watch your mail for the Medicare & You handbook and for information from plans in your area.Complete the Rx Enrollment Check-up.
In mid-October, review and compare plans on cost and coverage at www.medicare.gov on the web.
Decide what plan you want for 2007. If you’re satisfied with your current plan, there is no need to re-enroll.


November 15 – Open Enrollment Begins
First day you can change your Medicare health or prescription drug coverage for 2007.
Open Enrollment is the one chance this year
most people with Medicare have to make a change in their health and prescription drug plans.

December 8 – Don’t Be Late
If you are going to make a change to your current coverage,
enrolling by December 8 helps to ensure that you can get the prescriptions you need on January 1.

December 31 – Open Enrollment Ends
Medicare’s Open Enrollment ends on December 31.
The next Open Enrollment period will begin on November 15, 2007.

January 1 – 2007 Coverage Begins


************************************************** ******

Medicare Prescription Plan Finder

http://tinyurl.com/yh2o7t
Search includes personalized information about:

* Medicare Prescription Drug Plans
* Medicare Health Plans (that cover drugs)

Supporting Information
http://www.medicare.gov/MPDPF/Shared/Static/tabHelp.asp?activeTab=5&Language=English

Amount the many questions answered:
Can I decide not to join?

Joining is your choice.
However, if you don’t join when you are first eligible, you may have to pay a penalty if you choose to join later.
Like other insurance, you will have to pay this penalty as long as you have Medicare prescription drug coverage

[CarolynS]

Group Says Gap in Medicare Drug Coverage Will Be Costly

By Christopher Lee
Washington Post Staff Writer
Thursday, November 2, 2006; A11

http://www.washingtonpost.com/wp-dyn/content/article/2006/11/01/AR2006110103324_pf.html

Medicare beneficiaries will have to pay substantially more next year for coverage of brand-name prescription drugs that keeps them from falling into the "doughnut hole," according to a new report that government officials swiftly criticized as incomplete.

The report, released yesterday by the advocacy group Families USA, found that average monthly premiums will rise 87 percent, to $103.20, for plans that provide "meaningful coverage" in what otherwise would be a gap in Medicare's prescription drug benefit. Such coverage also will be harder to find -- 13 states will have no plans offering it in 2007, up from four states this year, the report found.

A plan was considered to have "meaningful" coverage if it paid for the top 25 drugs prescribed to seniors, including Lipitor, Prevacid, Zocor and Zoloft, group officials said. Eighteen of the drugs are not available in generic form.

"This coverage gap never made sense for seniors, but now it is getting much worse," said Ron Pollack, executive director of Families USA, who has repeatedly criticized the design of the drug benefit.

The "doughnut hole" refers to a gap in coverage in which Medicare beneficiaries must pay for 100 percent of their drug purchases. About 3 million people are expected to fall into it this year, according to the Centers for Medicare and Medicaid Services. Democrats have criticized the gap as unfair to seniors, but party leaders say they will not be able to get rid of it right away even if they regain control of the House in next week's elections.

Under the standard plan, Medicare picks up most of a beneficiary's drug costs up to $2,250. The coverage then stops until the beneficiary has spent an additional $2,850 out of pocket, after which Medicare covers 95 percent of additional drug costs. Beneficiaries may select plans that do not have a gap, but the premiums are higher than those of standard plans. Low-income beneficiaries get subsidized coverage with no gap.

Leslie V. Norwalk, acting head of the Medicare agency, said the Families USA report "presents a distorted and incomplete picture" because it ignores plans that fill the gap with coverage for generic drugs. Beneficiaries in every state can choose a plan that provides some or complete gap coverage, she said, and they will have even more choices next year.

"The report focuses on a very limited number of drugs used by beneficiaries and does not acknowledge the significant additional savings possible through the use of lower-cost generics and therapeutic substitutes," Norwalk said.

House Minority Leader Nancy Pelosi (D-Calif.) has said Democrats would require Medicare to negotiate with drug companies for lower prices and use the savings to shrink the doughnut hole. "We can and we must make the Medicare prescription drug plan fairer and more cost-effective," she said.

But Norwalk told Bloomberg News yesterday that having Medicare negotiate drug prices with manufacturers would not achieve savings over the current system, in which insurers and pharmacy benefit managers do the negotiating to offer competitive plans.

The national average monthly premium for all plans with any doughnut-hole coverage, including generics-only coverage, will drop from $48.40 this year to $47.40 in 2007, Families USA officials said. But a plan will not help most seniors unless it provides coverage for the brand-name drugs they take, Pollack said.

Sen. Charles E. Grassley (R-Iowa), chairman of the Senate Finance Committee, said erasing the gap would cost more than $400 billion over 10 years: "The Medicare prescription drug program may not be perfect, but beneficiaries now can get affordable prescription drug coverage, and they can choose a plan, including a plan with gap coverage, that best meets their needs."

[CarolynS]

I think it is time for me to buy the bumper sticker my daughter and son in law have on their cars..."If You Aren't Outraged, You Aren't Paying Attending".

I would then insert words to make it read..."If You Aren't Outraged About Medicare's Part D Plan, You Aren't Paying Attending"

So, last night I went to the Finder to begin my search for a 2007 Part D Plan for myself. My current plan with Humana is going from $58 a month to $70.40 a month AND eliminating coverage of the "Gap", except for Generic, which the plan will continue to cover. I have nine Rx, plus two types of syringes...making nine scripts (only my test strips are covered 100% by Medicare directly). Only THREE of those Rx are covered in 2007 during the Gap as they are Generic.

My Results. A whopping 121 plans to pick through:
http://tinyurl.com/y2b9z7

I began the search here:
Medicare Prescription Drug Plan Finder
http://tinyurl.com/ybzczk
Then:
Find & Compare Plans
Then:
Continue after entering data

:mad: :p :confused: :( :rolleyes: :eek: :) :D

[CarolynS]

Decisions about the Rock and Hard Place :(

So, I have reviewed my options and decided to move from Humana to AARP for RX. Primarily because the premium is less. Both cover generics ONLY during the gap.

So, now my challenge to figure out how I am going to obtain the Brand meds that are not covered during the gap...approximately $717.44...a little less than 50% of my monthly income. The one non-covered med that infuriates me is my insulin, which will cost me $80.20 a month. This is a life saving medication, not a medication to help with symptoms...infuriating...and not available as a sample from a physician.

Yes, there are FREE meds programs out there, but they are based on income, typically at poverty level...which I believe is $11,500...and that is far less than my income. So, I don't qualify for those. I will turn now to my personal physicians and request monthly samples from them beginning in March 2007 :eek:, when the GAP hits me hard :( .

Here is detailed information about the PENALTY imposed by Medicare Part D if you don't enroll timely when you become qualified to do so:


Late enrollment penalty of 1% adds up! :eek:

If you choose not to enroll in a Medicare Part D plan when eligible, Medicare may require you to pay a higher premium if you decide to join after your initial enrollment period. Unless you already have prescription coverage that’s as good as a Medicare Part D plan, you could incur Medicare’s late enrollment penalty that is equal to about one percent of the national average premium per month, or 12% per year. To confirm whether your prescription coverage is as good as a Medicare Part D plan, call 1-800-MEDICARE (1-800-633-4227), 24 hours a day/7 days a week. TTY/TDD users call 1-877-486-2048.
Example:

If you decide to join a plan three years after becoming eligible, the late enrollment penalty would cause your premium to be about 36 percent higher (one percent per month x 36 months).
3-year Penalty: 1% per month x 36 months = 36% increase in premium

The national average for premiums offered in 2007 is $27.35 per month or $328.20 per year. With a 3-year late enrollment penalty, you would pay about $37.20 per month or $446.40 per year. Your premium will remain higher for as long as you stay in a Medicare Part D plan, so it pays to enroll when eligible.


:) p.s. I am compiling information about FREE RX programs and will post in the stickie note section as soon as it is complete. If anyone has suggestion to include in that stickie note, please send them to me.:)