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Am I too late?

I hate it when people ask me a question and I can't answer it with a definite answer but rather with an "it depends" or "yes and no."

Every question to do with Medicare seem to fall into the "yes and no" category, as there are so many rules and so many exceptions to those rules, it can get very confusing.

We have just finished the annual enrollment period for Medicare Part D, prescription drug coverage, the AEP runs from Nov. 15-Dec. 31 each year.

So, does that mean you are locked into your existing drug plan for 2009? Well guess what folks, the answer is "yes and no."

This is because as soon as the annual enrollment period closed at the stroke of midnight on Dec. 31, the open enrollment period opened and this period will run until March 31.

OK Phil, I can hear you say to yourself, now you have confused me. What the heck is the difference between the annual enrollment period and the open enrollment period?

Most people are aware that during the Nov. 15-Dec. 31 annual enrollment period they may enroll or change their Medicare Part D prescription drug coverage. This is very highly publicized on TV, in newspapers and by direct mail. They also may enroll or change their Medicare Advantage plans during this period.

Now, during the open enrollment period of Jan. 1-March 31 each year, people either can enroll in or change their enrollment in Medicare Advantage plans. However, during this period a person cannot add Part D drug coverage if he/she had not already enrolled prior to Dec. 31, 2008.

So, if a person did not have Part D coverage by the end of the year and he wanted to enroll in a Medicare Advantage plan during the open enrollment period, he could do so but only in plans that did not include Part D coverage.

If a person was enrolled in a Part D plan and a traditional Medicare Supplement and she wanted to enroll in a Medicare Advantage Plan, she would have the choice of either a complete plan that included medical as well as Part D drugs, or just medical and leave their existing Part D coverage alone.

Also, if a person enrolled in a Medicare Advantage Plan effective Jan. 1, 2009, he also would be entitled to change plans to a different Medicare Advantage Plan. This may be worthwhile for people to consider, once they have had an opportunity to review the details of a plan they may have enrolled in without doing any real comparison shopping.

If a person procrastinated about changing her Part D coverage during the recently closed annual enrollment period, she can not change to another Part D plan unless that new plan also included her medical benefits. So, if you go to the drug store and get sticker shock at the price of your co-pays under your 2009 drug plan, you always can review a complete Medicare Advantage plan that would include Part D coverage.

Now you can see why my answers are usually "yes and no." There usually is an exception to every rule and with Medicare there usually is more than one exception.

If you are confused and have questions, please seek advice from a trained professional. Talking about trained professionals, I would like to extend a public "Get well soon" to Margie Stewart of SHIBA who broke her wrist during the recent snowy weather. She is the driving force behind the excellent work done by numerous volunteers all across the peninsula in the SHIBA organization. SHIBA is the acronym for the Statewide Health Insurance Benefit Advisors, a primarily volunteer group under the auspices and direction of the Washington State Office of the Insurance Commissioner.

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



















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