Medicare Part D sign-up to begin

November 13, 2006|By The Orlando Sentinel

ORLANDO, Fla. -- The annual barrage of TV ads, mailings and community events starts Wednesday with the new enrollment period for Medicare's prescription-drug program.

Sign-up runs through Dec. 31, and advocates are urging people to review their options carefully before making changes to their drug plans or joining for the first time.

Even those who are happy with their current insurer need to find out how the coverage will change next year and shop around to see whether they can get a better deal elsewhere. Then, if they're still satisfied with their existing plans, they don't have to do anything else. Coverage starts Jan. 1.

Called Part D, Medicare's prescription-drug coverage was offered for the first time this year. Nearly 23 million people are now covered by Part D plans nationwide. According to federal statistics, the average enrollee will save about $1,200 this year compared with someone with no prescription coverage.

Critics, however, continue to deride the program for its inherent complexity. People must sort through the multitude of plans available in their regions and choose one that suits their needs.

Medicare estimates that monthly premiums will increase about $2.28 in 2007 for plans that solely offer drug coverage. However, the average monthly fees for joining a Medicare managed-care organization will drop about $9.

Still, according to the government's estimates, the average cost for monthly premiums next year will be about $24, which remains well below projections last year that premiums would run about $37.

However, advocates say premiums are just one factor - in some cases, a minor factor - to consider in reviewing the plans. Even with a low monthly fee, people still could face hundreds of dollars in co-payments every time they fill their prescriptions, depending on the specific medications they use.

Advocates also are advising people to dig deeper when checking to see whether a plan covers specific medications. Bob Hayes with the Medicare Rights Center, a New York-based advocacy group, said many recipients found out the hard way in 2006 that they had to jump through hoops to get medicines.

"One of the things that has proved to be a trap door for people in the past year is restrictions on the drugs that the plans claim to cover," Hayes said. "But many people found that a so-called `covered drug' was, in fact, only covered after their physicians essentially waged a legal battle to prove it was medically necessary."

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