Last Updated: November 7, 2008
Call it D-Day. On November 15, Medicare's 45 million beneficiaries will be able to sign up for the Medicare Part D drug plan or change plans if they are already enrolled. For those who are signing up for coverage under Medicare's drug plan for the first time, as well as those planning to switch plans, this "opportunity" can be daunting.
"Determining the appropriate health care coverage and options for people with Medicare is not a simple process," wrote the authors of the Journal of Financial Planning article on the subject of Medicare Part D plans that appeared in January 2006. "Health status, unknown future health needs, and both present and future ability to pay out-of-pocket medical and prescription costs are key issues to analyze in determining the most feasible plan for seniors."
For those unfamiliar, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) established a voluntary outpatient prescription drug benefit for people on Medicare, known as Part D, that went into effect January 1, 2006. According to PlanForYourHealth, a public education program from Aetna and the Financial Planning Association®: "Part D simply provides coverage for prescription drug benefits. The prescription drug plans will generally require you to pay a monthly premium and co-payment or co-insurance for each prescription you fill. Plans vary by cost, number of drugs covered and pharmacies you can use, but all plans must meet a minimum standard for drug coverage set by Medicare. Medicare prescription drug plans work with all types of Medicare health plans including the Original Medicare Plan, Private Fee-for-Service Plans and Medicare Advantage Plans (like HMOs)."
Deciding whether to enroll in a Medicare Part D plan is one difficult task. Indeed, the authors of the aforementioned Journal of Financial Planning article noted that "individuals who incur substantial prescription medication expenses (more than $5,100 a year) may benefit considerably by participating in Medicare Part D. Healthy people who do not have a family history of illnesses occurring in later years may receive few initial benefits from Part D. But by failing to participate at initial enrollment, individuals could face devastating medical bills in later years if they become ill, and delayed enrollment could result in a premium penalty."
Picking the plan that best meets your prescription drug needs is yet another difficult task. Indeed, beneficiaries have to analyze a plethora of issues when evaluating the dozens upon dozens of Medicare Part D plans available to them, including something called "doughnut hole," the gap in coverage for which beneficiaries are responsible for 100 percent of their drug costs.
Thankfully, the Henry J. Kaiser Family Foundation has issued a series of reports and resources that can help you analyze the critical aspects and notable trends in the Medicare Part D marketplace, nationally and by state for 2009. The resources include:
- Three new Medicare Part D reports that analyze key aspects of the 1,689 Part D plan options that will be available to beneficiaries across the country, focusing on premiums, coverage in the gap, and low-income subsidy plans
- A two-page 2009 State-by-State Fact Sheet with state-specific information about Medicare Part D plans offered in 2009
- The Henry J. Kaiser Family Foundation's online consumer guide, Talking About Medicare, updated to include changes in Medicare for 2009, including information about the Medicare drug benefit
Those resources can be found at the Henry J. Kaiser Family Foundation. Other noteworthy resources include: