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 to 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; this was the same for 2012. We do not know at this time how many companies will have plans approved for 2013, 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 2013.
You should be notified 60 days prior to Dec. 31 if the company you were with will not have a plan next year, allowing you time 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 2012 prescription drug plan through offers approved plans in 2013 that are different than your 2012 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).
--More importantly, your medications that were covered in 2012 may not all be covered in the company's 2013 formulary (list of covered medications), which could mean you will end up paying full price for those that are not.
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.
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 free annual enrollment events , call your information into 211, call the department (888-575-6611), or go online and enter your information at (www.medicare.gov). We are pleased to partner with First Link so you can once again dial "211" and they will provide service 24 hours a day, seven days a week. From Sept. 10 through Nov. 21, "211" will be available to gather your medication information and the drug plan comparisons will be completed and mailed to you. The 211 service starts gathering data in September; however, the department will not be mailing comparisons until on or after Oct. 15, when Medicare's computer program allows us to begin. Please be patient.
The annual enrollment period is Oct. 15 through Dec. 7. During that time, all of the plans approved for North Dakota will be known as well as the associated costs of each. The Center for Medicare and Medicaid Services (CMS) has announced some of the cost-sharing information for 2013 Medicare prescription drug plans. Also note that in 2013, people who enter the donut hole will save 52.5 percent on brand-name drugs and 21 percent on generics.
The North Dakota Insurance Department will hold an enrollment event in Minot on Tuesday, Nov. 6, from 9 a.m. to 4 p.m. in the Viking/Norse Rooms of the Grand International Inn, 1505 N. Broadway.
Mark it on your calendar-this year's annual enrollment period is Oct. 15-Dec. 7. When you enroll in a plan during this time it will begin Jan. 1, 2013.
David Zimmerman is consumer assistance division director at the North Dakota Insurance Department.