Medicare Part D enrollment period begins Sunday

Help available

Help available

The Senior Health Insurance Counseling for Kansas program at Douglas County Senior Services is offering enrollment assistance regarding Medicare’s prescription drug plans.

Trained volunteers will be available at the Lawrence Senior Center, 745 Vt., from 1 p.m. to 4 p.m. Monday, Wednesday, Nov. 23, Dec. 7 and Dec. 14. They also will be available from 9 a.m. to noon Nov. 24, Dec. 8 and Dec. 15.

Assistance is free and offered on a first-come, first-served basis. Seniors need to take their Medicare card and a list of their prescriptions. They also should take an income statement because they could be eligible for additional financial help.

For more information, contact Douglas County Senior Services at 842-0543.

Bargain hunting season for Medicare prescription drug plans begins Sunday.

Medicare beneficiaries have until Dec. 31 to enroll in one of 46 plans or re-enroll in a different plan.

“It’s important that Kansans look at the various plans each year, even if they have been happy with their current plan,” said acting Secretary of Aging Martin Kennedy. “Plans can change from year to year, so beneficiaries need to make sure their plan still meets their needs.”

Beneficiaries who qualify can get extra help paying for premiums, deductibles and co-pays associated with their Medicare Part D plans.

In Kansas, some Medicare Advantage plans and Medicare Advantage Plans with a Prescription Drug Benefit will no longer be available after this year. This will affect about 7,000 Kansans and they should have received a non-renewal letter from their plan. It is critical that they review their options and enroll in a new plan or they may lose their coverage.

Here’s some information about Medicare Part D, provided by Natalie Myers, health insurance specialist for the Centers Medicare & Medicaid Services:

How does enrollment work?

As beneficiaries become eligible for Medicare they have a seven-month initial enrollment period to enroll in the prescription drug program and choose a plan that will best meet their needs if they don’t already have creditable coverage through another source such as an employer group health plan, the Veteran’s Affairs department or Tricare for Life.

If they decide to enroll in a Medicare plan they essentially stay with that plan for the rest of the year and have an opportunity to change during the annual enrollment period each year. Their new coverage takes effect Jan. 1 of the next year.

What’s the penalty if someone doesn’t enroll when they first qualify?

If beneficiaries don’t enroll in a Medicare prescription drug plan at their first opportunity and they don’t have other means of creditable coverage — coverage that is equal to or better than the Medicare Part D standard plan — they will have to pay a penalty that is equal to 1 percent of the national base beneficiary premium for every month they could have had the coverage, but chose not to.

The base beneficiary premium in 2010 will be $31.94. So if a beneficiary did not have creditable coverage for 10 months, $3.19 will be added to the premium for the plan they choose to enroll in each month.

Is the national average premium increasing?

The monthly premium for Part D will average about $30, a $2 increase over last year’s premium.

How does the standard benefit compare with last year?

In 2010, plans may charge up to $310 a year for a deductible, up $15 from last year.

Then, there is a period of cost sharing between the plan and the beneficiary until total drug spending is $2,830, up $130 from last year.

Then, the beneficiary will enter the coverage gap where the beneficiary would be responsible for 100 percent of the cost of their drugs — unless their plan offers some coverage for generics during the coverage gap — until the beneficiary reaches $4,550 in out-of-pocket spending and then they will hit their catastrophic coverage where their costs drop significantly. Last year, participants needed to spend $4,350.

Can you give me some specifics about what is being offered in 2010 in Kansas?

There are 18 plans that have a no deductible. The lowest monthly premium for a plan is $19. The least expensive plan that offers an enhanced package is $65.30 and it pays for generic prescriptions in the coverage gap.

Where can I get help?

Seniors can compare plans or enroll in one by visiting The Centers for Medicare & Medicaid Services’ Web site at www.medicare.gov or calling 800-633-4227. Seniors also can call the SHICK program at 800-860-5260.