Time to review Medicare health coverage for 2010

By Janet L. Taylor

Monday, November 23, 2009 6:05 PM EST

Everyone who is enrolled in a Medicare private health plan or stand-alone drug plan should review their coverage options for 2010, advises the Medicare Rights Center, a national consumer advocacy group. Even people who are happy with their current plan should do so, because many plans change their costs and benefits from year to year.
From Nov. 15 through Dec. 31, people with Medicare have the right to change their health plan and prescription drug plan. “New data on health and drug plans for 2010 show that plan selection will continue to be a complicated process for people with Medicare and the many caregivers who try to help them,” says Joe Baker, president of the Medicare Rights Center.

There are resources available to assist in the decision-making process of choosing a Medicare Part D drug plan. Before you start, make a list of the medicines you take, the dosages and how much you currently pay. Make a list of pharmacies you use regularly. Then decide what type of drug plan you need. Ask questions, such as: Does the plan cover all the medications I am taking? If the plan does not cover a medication I take, does it cover one that will work for me? (Ask your doctor.) Does the plan require that I get special permission before it will cover the medication I need (such as prior authorization or step therapy)? How much will I pay at the pharmacy (co-payments or co-insurance) for each drug I need? Be aware that certain drugs may cost a lot even if they are covered. How much will I pay in monthly premiums and annual deductible? Will I have to pay the full cost of my drugs at some point after the deductible (coverage gap)?

Then use the Medicare Drug Plan Finder tool at www.medicare.gov or call (800) MEDICARE (633-4227) to review your options. If you have Original Medicare, choose a stand-alone prescription drug plan if you want to continue to receive your other health benefits through Original Medicare. If you have a Medicare private health plan (such as an HMO or PPO), generally, you must get Part D drug coverage as part of your private health plan's benefits package.

Through the Health Insurance Information Counseling Assistance Program, the Cayuga County Office for the Aging offers assistance to seniors and their families seeking to obtain objective, understandable information to help to compare and evaluate their options regarding Medicare and Medicare D plans. Trained counselors provide free and confidential counseling, assistance and advocacy on these and other health insurance topics. For an appointment, call 253-1226.

In addition, the Medicare Rights Center offers resources, at no charge, to help beneficiaries and their caregivers choose a Medicare private health plan or stand-alone drug plan that best meets their needs. One quarter of callers to the Medicare Rights Center's consumer hotline were caregivers seeking help with a coverage problem experienced by the person they care for. Medicare Interactive, www.medicareinteractive.org, is a web-based counseling tool providing consumer-friendly information about Medicare benefits, rights and options. Telephone counseling is also available at their toll-free hot line at (800) 333-4114. Counselors are available Monday through Friday, 9 a.m. to 5 p.m. (eastern time).

Janet L. Taylor is an aging services specialist for the Cayuga County Office for the Aging

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