Do I have to compare my plan during the Medicare Part D annual enrollment period?
No, this is one of those options in life where you can choose to participate or not. So, let's discuss the pros and cons of participating and not participating beginning with choosing not to participate.
These are the kinds of things that can result from choosing to not participate in the Part D annual enrollment period, which runs from Oct. 15 - Dec. 7 this year:
--The Prescription Drug Plans approved by Medicare for North Dakota and all other states are approved for one calendar year (January through December). The private companies offering these plans must apply to Medicare to be approved each year, so plans change from year to year. Example: in 2010, there were 46 plans available from the various companies, while in 2011 there were 33. We do not know at this time how many companies will have plans approved for 2012, nor do we know how many plans each company will submit for approval.
As a result, one downside of not participating in the annual enrollment period is that the company you have a plan with this year may not offer a plan the next year. So unless you act, you could end up without coverage for 2012.
You should be notified 60 days prior to December 31, if the company you were with will not have a plan next year allowing you time necessary to address this, but you must act.
Here's another scenario that may occur if you choose not to participate: If the company you had your 2011 prescription drug plan through offers approved plans in 2012 that are different than your 2011 plan, you may simply be rolled over into another one of their plans if you do nothing.
As a result of such a rollover into a new plan, one of the following situations may occur:
You could end up with a higher monthly premium.
You could end up with a higher deductible (and a higher premium).
Also, your medications that were covered in 2011 may not all be covered in the company's 2012 formulary, which could mean you will end up paying full price for them.
If, on the other hand, you choose to participate in the annual enrollment period for Part D, you will have the opportunity to select from the list of approved plans the one that is the best for you and your unique situation. These plans are very different for each individual based on your current medications and which pharmacy or pharmacies you use.
Reasons you should participate in this annual event include:
First and foremost, by doing so you have the opportunity to actively be involved with decisions that are important to your future health care and well being. This is just as important as discussing issues with your doctor, including asking questions regarding the medication you are placed on or procedures that are recommended.
You can select the best plan that is available for you, with a goal of finding one that is the least expensive. For example, you can choose the one with monthly premiums that work best with your budget and that covers all your prescriptions.
By doing a plan comparison, you may determine that based on your income and assets you qualify for Extra Help from Social Security. If that is the case, you can apply to Social Security for a determination that could result in lower premium and prescription costs.
So when you consider the pros and cons, it should be obvious that it is in your best interest to participate. The only thing that it costs you to do this is some of your time. You can attend one of the Insurance Department's annual enrollment event on Tuesday, Nov. 8, from 9 a.m. to 4 p.m. in the Sleep Inn Convention Center, 2400-10th St. SW, call your information into 211, call the Department, or go online and enter your information at (www.medicare.gov). We are pleased to partner with 211 to provide you with services 24 hours a day, seven days a week. From Sept. 12 through Nov. 23 representatives will be available to gather your medication information and the comparisons will be completed and mailed to you. 211 starts gathering data in September; however, the Department will not be mailing comparisons until Oct. 15, when Medicare's computer program allows us to begin comparisons.
The annual enrollment period is Oct. 15 and Dec. 7. During that time all of the plans approved for North Dakota will be known as will the associated costs of each. The Center for Medicare and Medicaid Services (CMS) has announced that "Medicare prescription drug premiums, on average, will not increase in 2012." We do know that the highest the deductible can be for 2012 has gone up $10 to a total of $320. Remember that every plan has a different deductible ranging anywhere from $0 up to $320. This range, along with the various monthly premiums, is one of the reasons it is so important that you take the time to find out which plan is the best for you.
The schedule of the North Dakota Insurance Department's annual enrollment events is below. There may be other scheduled events throughout the state and we will announce those as soon as the information is available.
David Zimmerman is consumer assistance division director at the North Dakota Insurance Department.