Consumers should be smart when choosing a plan because premiums can vary widely, from $10.30 a month to as much as $136.80 a month. Most people should be able to find a plan in the lower premium range, according to the Kaiser Family Foundation.
Most Part D participants who don't qualify for a low-income subsidy and who don't switch plans will see an increase in their monthly premium, according to the foundation. Twenty-seven percent will see premium increases of at least $120 per year.
Premiums aren't the only consideration when choosing a plan. Another important issue is making sure the plan you choose covers the drugs you take. Covered drugs and restrictions on drugs vary from plan to plan, so it's important to review each plan before making a choice, Precht said.
One of the most serious issues in choosing a plan is the coverage gap, or so-called "doughnut hole." While in this gap in coverage, most Part D participants must pay 100 percent of their total drug costs. For most plans this will total $3,454 in 2009, according to the Kaiser Family Foundation.
In 2009, nearly all Part D plans have a coverage gap, but one in four plans offers limited coverage in the gap -- generally coverage for some or all generic drugs, though some plans also cover some or a few brand-name drugs, according to the foundation.
Considering the price of drugs in a plan is also important, Precht said. "There are a number of plans that charge quite a bit more for generics than other plans," he said. "Particularly for people who take multiple drugs, that can make a difference between getting in the doughnut hole or not getting in the doughnut hole."
Precht said some people use a combination of strategies to reduce their drug costs. "They rely on the cheap generics, if you can get it from some of the 'big box' stores, using Part D for brand name drugs, plus buying drugs from Canada as an opti
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