MediCare Part D Open Enrollment

It's that time of the year again! From now through 12/31/09 you can change your Part D plan, which covers your prescriptions. If you haven't been happy with coverage or the donut hole, now's the time to choose something better. If you have been happy with it, now's the time to make sure no changes are going to be made for next year that you wouldn't like.

The Centers for Medicare and Medicaid Services (CMS) has a website for open enrollment.

Here is a table summarizing the 60 different plans available for El Dorado County.

This is a pdf file that you can print off as a worksheet to help you sort out your options on-line or with an insurance broker.

Things to keep in mind:

• Relax. You've got to the end of the year!
• Focus on looking for plans that specifically cover your expensive medications. The inexpensive ones will be covered by any plan.
  
• Think about whether you might be better off paying more in monthly premiums for donut hole coverage than not being able to afford your medications by the end of the Summer.
• Don't be fooled into picking a plan where you make MediCare your secondary insurance! This does not turn out to save you money and seriously limits your heath care!
  

Medicare Part D

You still have time to add prescription drug coverage to your Medicare!

Open enrollment ends at the end of this month.

Until then, you can go on-line or call 1-800-MEDICARE to get help adding this to your Medicare Part A and B (these cover hospital and outpatient medical care).

Basically, these are commercial insurance plans that meet or exceed standards set by the federal government. They are used for covering the costs of you medications.

There are lots of choices, and lots of differences in cost. The last time I looked, there were over 50 plans in California and the average premium was about $45/month.

DO. NOT. PANIC.

First of all, if you have very little money (make less than $14,355/year yourself, or less than $19,245/year as a couple at last count) you may be entitled to Plan D at no cost to you at all as long as you pick a plan that does not exceed the average premium cost for California.

Second, use the available resources to narrow your search:

• You live in California. Only look for plans offered in California.
• Most generic drugs are not a real issue. The ones that aren't generic are the ones that will cost you (such as Actos and Avandia for diabetes, brand name insulins like Lantus and Humalog and ARB's for blood pressure and heart failure like Diovan, Cozaar and Atacand). Generate a list of your expensive drugs, and then look for plans that cover them.
• If you already have Part D and always end up having to pay full cost on you pills before the end of the calendar year, this does not mean that your insurance no longer covers it! This means you've hit the "donut hole" for the year.
• This means Part D has covered $2,250 for the year and that you are on the hook for the next $2,850. If you go past that for the year, then Part D picks up for the rest of the year.
• If this keeps happening to you, pay a bit more for a plan with "donut hole" coverage!

This link shows all the plans available for 2009 in El Dorado county in nice neat columns showing what they are called, how much they cost, whether they are free to low income folks and whether they have gap (donut hole) coverage or not.

It also provides links to the plans so you can see all the details, and toll-free numbers for folks who prefer telephoning.

Use it or lose it!