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Paynesville Press - December 28, 2005

Medicare prescription drug coverage to start next week

By Michael Jacobson

New prescription drug coverage from Medicare - called Medicare Part D - begins on Jan. 1, 2006.

Anyone with significant drug needs or without coverage currently should strongly consider signing up right away. (The sign-up period for Medicare Part D began on Nov. 15, 2005.) The deadline for signing up (without penalty) is May 15, 2006.

Medicare Part D is complicated, it's certainly not perfect, but it is the best plan yet to help seniors with their prescription drug costs, said Dorine Fuchs, a state certified volunteer health insurance counselor for Senior Linkage in the Paynesville area.

Fuchs said seniors who take a lot of drugs should jump on this new plan. If seniors do not take many drugs or if they have had trouble figuring out the program, getting help, or signing up, they should not panic, as the program merely starts in January. "It's not like a panic," said Fuchs. "It's not like we have to (sign up)." Seniors, she reminded, have until May 15, 2006, to sign up.

Mike Hansen, 74, who considers himself moderately healthy and "computer illiterate," was able to sign up in November and December. The first step is to calculate the drugs you take and the dosages as you can't weigh your insurance options accurately without knowing what drugs you take when comparing them with the formulary of the various insurance plans.

Hansen calculated his drugs and dosages, and his wife's, by reading their prescription drug bottles. Then he was able to go to and type in medicines and dosages and find plans for him and his wife.

Identifying the best plans was easy; both plans - for him and his wife - were through the same company. But signing up was hard. "That's when the confusion started," he said.

First, he tried the Internet, but that was overloaded. Then he tried to telephone the company but waited for hours listening to horrible hold music. Finally, by chance, he was at a retail store when he heard that a representative from the insurance company was there.

It took only a half an hour to sign up with the company representative face to face, he said. The agent talked him into getting the same plan for both him and his wife. Actually, the cost of regular medications is about the same with the new insurance as what the Hansens used to pay for their prescription drugs. By upgrading, they should save money for any extra prescriptions that are needed for acute illnesses.

The Hansens, who go south in the winter, also wanted to be able to purchase drugs both in Minnesota and in Florida on their plan.

Anyone who is confused or needs help should go and get a couple quotes from local insurance agents and then pick a plan, said Hansen. This is also the easiest way to sign up. Face to face is "by far the simplest way to do it," he said.

Insurance agents cannot solicit for Medicare Part D, but they can provide information and contact their existing clients.

Signing up with a certified agent of Medicare Part D is an easy way, agreed local agent Rick Paul. He contacted all his clients and asked them to bring a list of their medications, dosages, and current costs when they looked at potential plans.

His clients ranged from extremely knowledgeable about Medicare Part D - having a plan picked out and just wanting to confirm their choice and sign up - to extremely confused.

He was surprised to have clients spending as much as $140 per month for drug coverage currently and followed a philosophy of picking the cheapest premiums possible (to save premium payments where possible). He was also surprised by the number of people who did not sign up for a plan (roughly 10 percent).

One reason Paul preferred lower premiums is because seniors can change plans once before May 15 then again during the yearly change period (Nov. 15-Dec. 31). They do need to stay vigilant on how their plan continues to meets their prescription drug needs, especially as their health deteriorates, but being able to switch plans should prevent any drastic mistakes in selection.

The yearly option to switch plans is "one of the really beauties of the program," agreed Hansen. Seniors can hardly lose, he explained. If their prescription drug needs are minimal, they can pick an inexpensive plan and then can switch to a better insurance as their needs grow.

Medicare Part D is insurance, offered by private companies and partially funded by the government. Like any insurance, you buy it not only for immediate needs but for future ones, said Hansen. "You want to be insured because you don't know how many drugs you're going to have to take in the future."

He already takes more drugs now than he did at age 65 or 70, and "there's no question: I'll need more not fewer (in the future)."

After May 15, 2006, any eligible senior who does not have "credible" insurance will incur a one percent premium penalty per month if they sign up later.

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