The purpose of this column is to give those who are eligible for Medicare, or soon to be eligible for Medicare, some understanding of their insurance options and how it could impact their health and finances.

iii

Question: I have been using Medicare Part D and have saved money with the plan I chose. I am curious how I handle the new year of 2009. Does the same plan continue on? Do I have to sign up again? What do I need to do?

Answer: This is a question with multiple answers. Each year the insurance companies involved in Medicare Part D need to announce to their enrollees and the general public what their plans will consist of for the new year. This announcement is given by Nov. 1, so most of you have heard how your current plan will change. This information includes: do their plans continue, what their premiums are, what the formularies are, what are the deductibles and co-pays, etc.

The Centers for Medicare and Medicaid determines the minimum standards for these plans, but each company and plan can offer more than the minimum. That means the fall begins a season of large amounts of mail. The insurance companies are going to be sending information about their plan to their enrollees, and they also send out information to potential enrollees.

The annual enrollment period is from Nov. 15 to Dec. 31. This means that if you want to change your plan, you do so during this period of time and the new plan you choose will start Jan. 1. During this time, you can switch from one plan to another, you can add drug coverage or you can get rid of your drug coverage.

You can certainly stay with the plan you have if the information the insurance company sends to you looks to give you continued good coverage. If you want to research your options, you may do so now by calling (800) MEDICARE or going to www.medicare.gov. These tools are available all the time, but are especially useful during the annual open enrollment period. If you research your options, you may find that an alternate plan covers you more effectively.

In 2008, there were 55 Stand Alone Medicare Part D plans offered in our region. In 2009, there will be 51 Stand Alone Medicare Part D plan offered in our region. We have seen many changes during the three years of Medicare Part D, and this year is no different. The premiums for the most part have increased. In 2008, the average price of premiums was $24.17. This year it was more than $30. For those individuals who have their drug coverage as part of a Medicare Advantage Plan - HMO, PPO or PFFS - your premiums are much different than these averages.

The 2009 minimum level of coverage includes the following: the deductible has increased to $295 each year. The initial coverage starts at $296 and covers you until the total cost of your medication reaches $2,700. If you reach that amount, you then pay full price with most plans. There are a few that cover some or all generics during the coverage gap, but most do not. Once you have spent $4,350 on the cost of your medications, you reach the catastrophic level where you only 5 percent of the cost of your drugs. Many of the 51 stand-alone plans cover more than these minimum standards - for example, they have a smaller deductible or no deductible at all.

iii

Janell Sluga is a geriatric care manager certified and works for Senior Life Matters, a program of Lutheran Senior Housing.

You may submit questions to be answered in later columns to Janell Sluga, at Senior Life Matters 737 Falconer St., Jamestown, NY 14701 or by e-mail at janells@lutheran-jamestown.org. Please remember that not all questions can be answered in this format, but as many as can be, will be.