Column 23 Medicare Part D Open Enrollment Closes Dec 7

Medicare Part D Open Enrollment ends Dec. 7.  This is the last week to make changes to your Medicare Prescription Drug plan. It is important to understand that these plans change annually; not only the rates, but the formularies as well.  So the plan you had last year may not serve you as well as another plan this year, even if your medications have not changed.

 

The best way that I know to evaluate the plans is to go to the Medicare website:  www.medicare.gov and look under Part D prescription drugs.  There you can input your current medications and run a personalized report that shows you the lowest cost option based on the medications you are taking today.  Of course, we are all one doctor visit away from a new medication, but I believe this is an excellent tool to evaluate and compare plans.  The report can be sorted by lowest cost using retail and mail order.  If you want to check the lowest prices also with different pharmacies, simply change the pharmacy and rerun the report. 

 

It's interesting to see how the price differs for the same medication at the same pharmacy, but under a different plan.  We are accustomed to price shopping among stores, but now you have to add the variable of 31 different drug plans.

 

The site will also show the star ranking which is similar to a quality ranking of each plan for your reference.  If you are currently insured by Silver Script you will notice that they do not come up on the report. This is because they are not allowed to market new plans to the public at this time.  So you will need to contact the carrier directly and ask for assistance to run a report on that vendor. By now you should have your materials showing the formulary and Rx tiers for your medications if you want to do the estimate on your own. 

 

Another vendor update is the Humana Rx family.  The former Humana Wal-Mart plan is now called Humana Preferred and the monthly premium has increased to $22.80.  They are offering a new 2014 Humana Wal-Mart plan that has the lower $12.60 monthly premium.  So if you are not taking any prescriptions and simply want the lowest cost option to avoid the penalty, you will want to change plans.  And there is no short application for plan change. 

 

Speaking of Medicare, folks need to know that delaying enrollment in a special Medicare program can trigger heavy late fees. If you do not sign up for Medicare Part B at age 65 and you are not working and covered by an employer plan, you could incur a 10% late penalty on the premiums for every month that you delay.  This penalty lasts for the rest of your life under Medicare.

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Medicare Part B covers medically necessary outpatient professional services such as doctor visits, lab costs, mental health counseling, health equipment and home services. The cost to enroll is based on your income.  For example the premium payments are about $105 monthly if your income is under $85,000 for single or $170,000 married filing jointly. 

 

Veterans who are receiving VA benefits often thing they do not need to sign up, but this is not true.  If income is low enough, they may be considered Medi-medi, meaning they qualify for Medicare and MediCAL. So when Medicare sends the questionnaire to determine if you need extra assistance, be sure to complete and return it properly. 

 

If a veteran is under 65 and covered by the VA, they are considered to have qualifying coverage for the purposes of the Affordable Care Act (ACA) and would not be subject to a penalty if they did not obtain other coverage.

 

A reminder about the Affordable Care Act deadlines.  For coverage to be effective 1/1/2014, applications must be received by December 23, 2013 and premiums paid by January 5.  With the holidays approaching, I expect most of us will want to get this taken care of as soon as possible, so we can concentrate on family festivities.  Also, if you have a Blue Shield of CA plan and want to extend benefits to March 31, 2014 you must notify them by December 6.  This can be done by calling 855-836-9703.  To obtain more information www.blueshieldca.com/coverageoptions.  I suggest that if you call the number directly you ask for a confirmation number.  If you are one of the 9% of Anthem insureds that have the option to continue you would have received a letter. 

 

*Information provided in this column is "to the best of my knowledge based on press deadline