Navigation Links
Medicare Part D: What to Expect This Open Enrollment Period
Date:11/13/2009

Plans are boosting premiums, adding deductibles and offering little gap coverage

FRIDAY, Nov. 13 (HealthDay News) -- Seniors enrolled in private, standalone Medicare prescription drugs plans (PDP) could encounter significant changes this open enrollment period, which begins Sunday.

Monthly premiums will rise 11 percent to $38.94, on average, according to an analysis published by the Henry J. Kaiser Family Foundation. That's up 50 percent from 2006, the first year that Medicare Part D drug benefits were offered.

"But these changes vary considerably by plan," added Jack Hoadley, a research professor in the Health Policy Institute at Georgetown University in Washington, D.C., and one of the report's authors. "Just among the five most popular plans, the premium for one is up by 22 percent for 2010, while the premium for another is down by 3 percent," he said.

So is Medicare Part D still a good buy? It all depends, experts say.

"The general advice is you do have to look beyond the premium and look at what's covered, what your expenses are for the course of the year and whether it works for you with the drugs that you take," said Paul Precht, director of policy and communications in the Washington, D.C., office of the Medicare Rights Center, a nonprofit consumer counseling and advocacy group.

Seniors can access Part D one of two ways. If they're in traditional Medicare, they can select a private PDP from a wide array of options. Or, if they are enrolled in a Medicare Advantage plan, like an HMO or PPO, with prescription drug coverage, they can receive Part D benefits through that plan.

Of the nearly 27 million Medicare beneficiaries in Part D, two-thirds are enrolled in standalone PDPs, according to the Kaiser Family Foundation analysis, which examines changes in the PDP marketplace.

With dozens of PDPs from which choose in every region, sifting through the various options can be a pain. For 2010, a total of 1,576 plans will be offered nationwide -- 113 fewer choices. Yet seniors will still have anywhere from 41 to 55 alternatives from which to choose in every region.

"I think it's a good trend that the number of plans is going down. I do think there is a thing as too much choice," said David Lipschutz, staff attorney for California Health Advocates, a nonprofit Medicare advocacy and education outfit.

Seniors will get little relief, however, from cost-sharing requirements. Sixty percent of PDPs, up from 45 percent in 2009, will require an annual deductible in 2010, for example. The maximum deductible that a plan may charge is $310.

Plan coverage of costs incurred in connection with Part D's infamous "doughnut hole" is getting stingier, too. In 2010, many beneficiaries will have to foot the bill for the coverage gap, which begins after the enrollee has incurred $2,830 in drug spending. Coverage resumes for drug costs above $6,440.

The House of Representatives on Nov. 7 passed a sweeping health reform bill that provides gap relief beginning in 2010 and eliminates the gap by 2019. However, the Senate must act before any health reform legislation is enacted.

There are also changes in store for seniors in "benchmark" plans, which offer basic Part D coverage to individuals who qualify for a premium. Of the 7.9 million getting extra financial help, 2.2 million must switch plans or pay a portion of their premium. If they want to stay in their current plan, their share of the premium will run roughly $8 to $10 a month, Precht said.

Part D experts urge seniors to take time during the open enrollment period to consider all of their options.

"It pays to do your homework," Lipschutz said. "The plan you're in now could change significantly next year, not only premium-wise but also the drugs it covers, the cost-sharing it charges for the drugs, the rules it imposes on accessing those drugs, [and] the pharmacy it contracts with."

More information

For help comparing Part D plan options, call 1-800-MEDICARE (1-800-633-4227) or go to www.medicare.gov.



SOURCES: Paul Precht, director, policy and communications, Medicare Rights Center, Washington, D.C.; David Lipschutz, J.D., staff attorney, California Health Advocates, Los Angeles; Jack Hoadley, Ph.D., research professor, Health Policy Institute, Georgetown University, Washington, D.C.; Medicare Part D Spotlight: Part D Plan Availability in 2010 and Key Changes Since 2006, Henry J. Kaiser Family Foundation, Menlo Park, Calif.


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. GAO Report Confirms: Medicare Underpays for Anesthesia Services; Nurse Anesthetists Assure Seniors Access to Safe Anesthesia Care
2. Texas Supreme Court Rules Against Medicare HMOs in Hospital Reimbursement Fight
3. Owner and Operator of Florida Durable Medical Equipment Company Convicted of Medicare Fraud
4. Just Completed Studies Reveal Impact of New Medicare Reimbursement Regulations
5. AHCA: Rescinding $2.7 Billion Medicare Cuts Top Issue for Fall Legislative Agenda
6. University of Texas Study Details Lengthy Payment Delays for Medicare Part D Prescription Drug Claims, Confirming Need for Legislative Fix
7. Medicare Spending Caps Cause Seniors to Stop Meds
8. Medicare Prescription Drug Benefit, Nonprofit Hospitals, Ambulatory Surgery Centers, Statistical Methods, and Pay-For-Performance Highlighted In the Latest INQUIRY Journal
9. Medicare Every Diabetic Counts Project Gears Up for Kick-Off
10. Medicare Cuts to Physicians Will Harm Washington Seniors
11. More than 10,000 Medicare Patients in Montana Could Be Hit by Proposed Cuts to Home Oxygen Therapy; Access to Power Wheelchairs Would Also Decrease
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/26/2017)... ... May 26, 2017 , ... Rob Lowe acts as ... production of the series is on hiking in American. Viewers can reconnect with America ... great benefits of hiking. , Many consumers have looked for an inventive new place ...
(Date:5/26/2017)... ... ... FAMILY-Our Journey to the Cross”: the personal journey of Bob Massey and his faith in ... authors, Bob and Margaret Massey. Bob Massey is small in stature but big in ... His love for others is apparent in all of his life decisions. , ...
(Date:5/26/2017)... ... ... “Cactus Jack: Against All Odds”: the story of Coach Cactus Jack and the ... is the creation of published author, Walter Hubbard, a retired wildlife and fisheries biologist ... Jane. Walter. Walter and Jane have three adult children and a granddaughter. ...
(Date:5/24/2017)... ... May 24, 2017 , ... In ... choosing the most appropriate instruments for research and understanding the basic principles that ... webinar will focus on innovations in stereo microscopy for brightfield and fluorescence typically ...
(Date:5/24/2017)... ... May 24, 2017 , ... NucleusHealth ™, ... has received U.S. Food and Drug Administration (FDA) 510(k) clearance for ... secure cloud platform for medical image management. At the core is patented streaming ...
Breaking Medicine News(10 mins):
(Date:5/9/2017)... , May 9, 2017 Zimmer Biomet Holdings, ... musculoskeletal healthcare, today announced it has earned a spot ... 2017" list. The Company was ranked among 500 U.S. ... Employers and Healthcare Equipment and Services. The ... on an anonymous, independent survey of over 30,000 employees ...
(Date:5/9/2017)... 2017  Oramed Pharmaceuticals Inc. (NASDAQ: ... company focused on the development of oral drug ... Property Office has granted Oramed a patent titled, ... The patent covers Oramed,s invention of an oral ... an incretin hormone that stimulates the secretion of ...
(Date:5/8/2017)... NEW YORK , May 8, 2017 ... in the transition from fee for service reimbursement. Black ... April 2017. 1.       The Market for ... 77% of physician practices with 3 or ... Compliance Technology Solutions by Q4. "Given the magnitude of ...
Breaking Medicine Technology: