The season change is a gentle reminder for beneficiaries to review their Medicare Prescription Drug Plans and Medi-care Advantage Plans.
The Medicare Prescription Drug enrollment period is Nov. 15 through Dec. 31. The 2010 plans will be changing; formularies (the medications that are approved under each plan) can change, premiums generally increase and cost shares continue to rise. Each year it is imperative to review plans for the upcoming year. New plans will become effective Jan. 1, 2010. To illustrate the changes of the beneficiary's cost share, let's use Ms. Lee as an example.
Ms. Lee has a deductible; therefore, she will have to pay the first $310 of her drug costs before her plan starts to pay its share. Ms. Lee pays a copayment, and her plan pays its share for each drug covered until the total drug costs paid by Ms. Lee and the insurance company are $2,830. Once Ms. Lee and her plan have spent $2,830 for covered drugs, she is in the coverage gap. She will have to pay for 100 percent of her drug costs until she has spent $4,550 (called TROOP or True Out of Pocket). Once Ms. Lee has spent $4,550 out of pocket for the year, her coverage gap ends and she hits the catastrophic level. In the catastrophic level, she will only pay a small co-payment.
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In 2010, there are 46 stand-alone Part D plans and multiple Medicare Advantage Plans with drug coverage. Only eight Part D plans this year cover full low-income subsidy premiums.
They are:
Aetna Medicare RX Essentials
Fact Box
Each year it is imperative to review plans for the upcoming year. New plans will become effective Jan. 1, 2010.
BravoRx
First Health Part D-Premier
HealthSpring Prescription Drug Plan-Reg 25
SilverScript Value
AARP MedicareRX Saver
PrescribaRX Bronze
Community CCRx Basic
Each year it is extremely important to compare plans by doing one of the following:
Dial 2-1-1 (Oct. 1Dec. 15)
Call 1-800-Medicare (1-800-633-4227)
Visit (www.medicare.gov)
Call SHIC at 1.888.575.6611
Please remember to compare your plan every year during Medicare Part D annual enrollment season from Nov. 15 through Dec. 31. It could save you money, time and future disappointments.
Cindy Sheldon, of Bismarck, is director of the N.D. Health Insurance Counseling Program.