"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
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