Medicare Part D Coverage Will Cost More in 2009

For several weeks older Americans enrolled in the Medicare Part D (prescription drugs) program have been receiving an influx of mail concerning their current policies, and advertisements for other policies. Open enrollment for Part D Medicare is mandated to be from November 15th – December 31st every year. Some insurers have already notified their subscribers that they will have increases in either co-pays, deductibles, or both, and in at least one instance a company notified at least some subscribers that their plan would not be available in 2009.

Prior to 2006 there was no prescription plan for those on social security unless they had money for expensive supplemental plans which might offer prescription drug benefits. The addition of Part D benefits to Medicare was a welcome addition for those on limited incomes with medical problems.

With all insurance plans the price of prescription drugs and the co-pay depends greatly on the number and types of drugs which are purchased by enrollees. Most of the approximately 26 million seniors and Medicare beneficiaries that could change plans during the open enrollment period have not elected to do so in previous years, but with so many plans changing for 2009 it pays to do some research. Cheryl Matheis, senior vice president for health strategy at AARP, says, “It always pays to do the search again, if your plan’s cost is going up, then you really do need to make sure you have the best deal.”

AARP’s MedicareRx Preferred plan sponsored by United Health Group, Inc., and the largest of the Medicare Part D plans, is expected to boost premiums by around 18% to $34.92 a month. The anticipated co-pay for generic drugs will remain the same, but those on the preferred drug list will have increased costs for subscribers. Humana, the third largest plan expects premiums to jump an average of 51% per month. Co-pays for generics will increase 75% and 60% for preferred drugs. This would bring the co-pays to $7 and $40.

Companies must get approval from the Centers for Medicare and Medicaid Services before they can market their plans, but the government doesn’t regulate how insurers set their premiums. The area of the country that participants live in will have a factor on their drug costs, as will the specific drugs in use.

All consumers should compare the drugs they take and use available programs to calculate their increase in costs or savings if they change plans. Only with the specifics of each individual can the costs be calculated. A list of programs to help with the analysis can be found at www.medicare.gov. Those who have trouble navigating the internet should get help from family or friends to make sure they are getting the best benefit for their money.

Insurers will continue cutting back on supplemental coverage in the ‘doughnut hole’ when consumers must begin paying the full cost of their medications, according to Tricia Neuman, vice president and director of the Medicare policy project at the Kaiser Family Foundation.  Premiums are going up, more plans have deductibles, over all the picture seems to be less benefits and more costs.

During the presidential election campaign neither candidate seemed to have a plan that would stabilize Medicare and Social Security but according to the Government Accountability Office, the longer action on reforming is put off the more painful and difficult the choices will be. Medicare costs are rising rapidly, according to the GAO largely because medical technology is overused and people generally do not shop for the best prices when it comes to health care for chronic health problems.

There is no one right answer for everyone; each consumer must take responsibility for their own benefit program. Shop responsibly and ask question when prescriptions are written for your benefit. Is the drug really necessary, what will it do, is a generic available? Shopping the local pharmacies for the best price could also save money. Don’t be afraid to ask questions. It is your health, and your money.
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