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29 September 2011
As we approach the final quarter of 2011, folks enrolled in Medicare prescription drug plans ought to be prepared for some changes to their open enrollment period this year.
First and foremost, the period in which you are allowed to change traditional Medicare Part D plans has moved up to the period beginning October 15, 2011 and ending December 7, 2011. In previous years, this period ran from November 15 through December 31.
For those of you in Medicare Advantage plans, you are allowed to switch Medicare Advantage plans between October 15 and December 7, and you have the option of switching to a traditional Medicare plan during that same period, and again from January 1 to February 14, 2012.
The last application you submit in 2011 before the December 7 deadline will be the plan that becomes active on January 1, 2012. In other words, if you submit an application on November 30, but change your mind the following week, you may still submit another application before December 7. The second application will trump the first.
Unfortunately, marketing activities from Medicare providers can not begin until October 1, leaving a shorter window of time to evaluate options and make decisions in 2012. This not only means that companies can not begin marketing their products to you until October 1, but also means that agents and advisors are not made aware of plan changes and new offerings until the marketing period begins.
One of the more controversial issues surrounding Medicare and prescription drug plan involves the so-called “donut hole”. This gap in coverage has changed slightly in 2012 and will begin after you and the insurer have paid $2,930 for covered drugs and continues until you have spent $4,700. In 2012, there will be some continued relief in the form of discounts in that gap. Brand name drugs will become available at a 50% discount, while generics will receive a 14% discount.
As you are considering your options, there are several factors you want to ensure that you are paying attention to:
• Your current formulary
• The tiers your drugs are placed in
• Co-pays for brand names and prescription drugs
• Deductibles
• Make sure that your pharmacy is an in-network provider
• Alternative options, such as mail-order, that may reduce your costs
• Pay particular attention to your total out-of-pocket costs rather than focusing on premiums
With an earlier enrollment period beginning in just over a month, it is important to begin planning and organizing your information now to ensure you can make a smart decision in the weeks ahead.
