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Medicare Part D ~ 2009

The annual enrollment period for Medicare Part D (prescription drug coverage) is Nov. 15-Dec. 31 each year.

During the past year I have come across a number of people who were not enrolled in Part D because they thought they were not eligible because they were enrolled only in Medicare Part A and not Medicare Part B.

This is incorrect. Anyone who is enrolled in Medicare Part A or Medicare Part A and B is entitled to purchase a Medicare Part D plan.

2009 will see a number of significant changes in the number of plans, premiums and co-pays available.

It is highly recommended that each and every person review the options annually. This can be done very easily by accessing the Medicare Web site at www.medicare.gov. If you do not use a computer, ask your child, friend or neighbor to assist you. It will take only a few minutes and could save you hundreds of dollars in 2009.

Other resources are available including those wonderful SHIBA volunteers who are at the Sequim Senior Activity Center each Tuesday between 10 a.m. and noon. In addition, numerous insurance agents are willing to assist you. All these services from SHIBA and insurance agents are offered free of charge.

Many people turn toward their trusted pharmacist for advice and, while they are highly knowledgeable about prescription drugs, they generally do not have the time to analyze each of their many patients' drugs and make suggestions about plan specifics.

Now for the major plan changes for 2009.

Washington residents will have a total of 47 plans to choose from in 2009; this is down from the 57 plans available in 2008.

Since the inception of Medicare Part D, Humana and United Healthcare/AARP (UHC/AARP) always have had a major portion of the enrollees - Humana due to the low pricing of their programs and UHC/AARP due to the marketing clout of AARP.

Well, folks, I am here to tell you "the times they are a changing."

The most popular Humana plan, the enhanced plan, is increasing premiums and co-pays well over 50 percent. Premiums are increasing from $22.10 per month to $36.50 per month. The $4 generics are increasing to $7, a staggering increase of 75 percent, and the Tier 2 drugs will increase from $25 to $40 per month, a whopping increase of 60 percent.

UHC/AARP have kept the plans and premiums fairly stable. The big news they have for 2009 is that they will allow independent insurance agents to represent their programs.

They have recognized that Part D is a highly complex program to understand, especially over the phone, and that many seniors are not computer users. For these reasons, they have chosen to partner with local agents to assist in the educational process.

The number of plans that are suitable for people who are eligible for both Medicare and Medicaid (dual eligible) have dropped from more than 20 to just seven plans in 2009. These plans are called "benchmark" plans and if people are unsure of their plan, they need to check, otherwise they may be required to pay premiums and co-pays.

Medicare Advantage plans also are changing in Clallam County. These are Medicare plans that are administered by private insurance companies. They have been a growing part of the insurance landscape for the past three years. At first I was somewhat skeptical about these plans but, after working with close to 100 clients, we have experienced very few problems.

These plans frequently offer benefits that are not covered under traditional Medicare and supplements; these may include dental, health club membership, vision and eye glasses.

This year I was amazed to find five plans available that included Part D drug coverage in addition to the Medicare Part A & B, all for a $0 monthly premium.

These $0 premium plans are offered by Secure Horizons, Coventry Health, Wellcare and UniCare.

I know I will have a lot of fun asking people how they would like to pay their $0 premium, cash, check or credit card. These plans do have co-pays and other out of pocket expenses, in addition to the $0 premium. Most providers on the peninsula gladly will accept any of the Medicare Advantage plans and these have been a good option for a number of our clients.

So whatever your situation, double check that you are in the best plan for you in 2009. Because, if you don't review your options, no one else will do it for you. It is time to be proactive about your health insurance.

Phil Castell is an independent insurance agent in Sequim. He can be reached at 683-9284 or via e-mail at PhilCastell@msn.com.









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