Now is the time

In October of each year, participating insurance companies publish the Medicare Part D (drug benefit) plans that they will offer for the coming year. The enrollment period then begins on November 15. Even if you are happy with the plan you currently have, you should always review what is being offered by your current plan and by the competition for the next year. Each year plans can change what is charged for the monthly premium, what drugs are covered, what tier (co-payment level) those drugs will have, what quantity limits they set and what other enticements they will offer. For example, some drugs may carry a zero co-payment, while others may only be offered at a zero co-payment after you reach a set deductible.

The website,, gives you tools to do a side-by-side comparison of plans. You can also visit the insurance sites directly, but the site has everything in one place. General Medicare information is available by calling 1-800-633-4227.

Most companies offer incentives (e.g., lower co-payment) for the use of generic drugs. If you are on name brand drugs it might be helpful to learn if any of them are scheduled for a generic release in 2010. It could impact your bottom line. We keep a list of generic launch dates as we learn of them. Another consideration in your plan choice involves the infamous “donut hole.” In the past plans have offered coverage when a member is in the donut hole, but it is usually only on generic drugs, and these plans will cost more. The first year Part D was offered, one company offered coverage of name brand drugs in the donut hole and they went bankrupt. No one wants to follow that path. Keep one thing in mind if you reach the donut hole: it was not the generic drugs that put you there; it was the expensive name brand drugs that racked up your spending total. If you don’t join a Medicare Drug Plan when you are first eligible, you may have to pay a penalty if and when you finally do sign up. Therefore, even if you have no current drug needs, we strongly suggest that you sign up for the least expensive plan. The penalty for 2010 is $0.32 multiplied by the number of months that you weren’t enrolled. That amount will be added to your monthly premium. If you were eligible four years ago but did not sign up, your monthly premium would increase by $15.36 (48 x .32); that’s $184.32 per year. If you have “creditable coverage” from your current insurance provider (employer), that employer must provide you with a letter each year stating that its coverage is creditable (equal to or better than a Medicare plan). You may need to produce that letter if you have to sign up for a Medicare plan later in the year.

The deductible for 2010 will be $310.