MORRISON REMINDS MONTANANS THAT MEDICARE OPEN ENROLLMENT WINDOW IS CLOSING
Time running out to select/revise plan -- Open enrollment ends Dec. 31
Montana State Auditor John Morrison is reminding Montanans that now is the time to get smart about Medicare Part D coverage plans and options. The 2008 open enrollment for Medicare Part D Prescription Drug Coverage ends on Dec. 31, 2007. The open enrollment period provides beneficiaries with the opportunity to enroll in a Medicare prescription drug plan or, if they have already enrolled, to switch to another Part D or Medicare Advantage plan.
“A Medicare prescription drug plan can provide substantial savings, beneficiaries should seriously consider their options when making enrollment decisions,” said Morrison. "Many plans are available so beneficiaries can best match their prescription drug needs with their budget. With the deadline for enrollment or revisions to Medicare Part D coverage fast approaching, I would urge those interested in making changes or in signing up to do so very soon.”
Coverage will begin January 1, 2008. The Insurance Department along with the Department of Public Health and Human Services together run the State Health Insurance Program (SHIP) which is the state's lead agency for Medicare prescription drug coverage information and enrollment assistance.
Trained SHIP volunteers are available at 1-800-551-3191 to answer any questions and to provide enrollment assistance. Montanans can schedule an appointment with a local SHIP counselor by contacting their local Area Agency on Aging at 1-800-551-3191. This toll free telephone number will ring into local agencies.
Before selecting a prescription drug plan (PDP) or changing existing coverage, Morrison suggests Montanans get smart about coverage options. Here are several key points to consider:
What are Medicare Prescription Drug Plans?
In 2003, the federal government enacted a Medicare prescription drug coverage benefit for Medicare beneficiaries. Private insurance companies, whose plans have been approved by Medicare, sell Medicare PDPs. Everyone with Medicare is eligible to enroll in a PDP, regardless of income or assets.
What if I am already enrolled in a Medicare prescription drug plan?
Plans might change from year to year. Therefore, you should carefully examine all available plans during each open enrollment season, as you may find that your current plan no longer best meets your needs. Be sure to check the features of your plan, including the list of drugs covered and the amount of premium you pay. If you are satisfied with your current plan, you do not need to do anything to keep your plan. If you take no action, you will remain in your current plan.
What if I am enrolled in a Medicare Advantage Plan with prescription drug coverage?
Medicare Advantage plans might also make changes to important features of your plan from year to year, including the list of drugs covered, the premium you pay, cost-sharing requirements and provider networks. Your plan options should be carefully reviewed during each open enrollment season. If you take no action, you will remain in your current plan.
Do I need a Medicare prescription drug plan?
A Medicare prescription drug plan may provide more coverage than a Medicare supplement insurance (Medigap) policy or employer-provided prescription drug coverage. If Medicare considers your employer-provided drug coverage “credible” – meaning, coverage that is as good as the Medicare prescription drug coverage benefit – you are permitted to keep your current coverage without incurring future penalties. Check with your employer.
What about my drug coverage through my Medigap policy?
The benefit of a Medigap drug coverage plan is generally not as good as the new Medicare prescription drug plan, so carefully review the benefits of your Medigap drug coverage. If you are considering a change, you will need to make a decision during the enrollment period, or you could be subject to late enrollment penalties if you decide to enroll in a PDP later.
Enrollment Dates and Late Enrollment Penalties
Voluntary enrollment for Medicare prescription drug plans for 2008 began Nov. 15 and ends Dec. 31, 2007. If you enroll by Dec. 31, you new Medicare prescription drug coverage will begin Jan. 1, 2008.
If you are eligible, but wait to enroll after Dec. 31, you may be subject to late enrollment penalties. These penalties are generally 1% per month for every month you delay enrollment. That means if you wait until March, you would pay a 3% late enrollment penalty. There is no limit on the penalty, so the longer you wait to enroll, the higher the premium you will pay.
What are my options if I want to enroll in a Medicare prescription drug plan?
You can enroll in a stand-alone prescription drug plan (Medicare Part D) or you can choose a Medicare Advantage plan (Medicare Part C) that includes the new drug benefit.
You will want to compare plans and select the one that best meets your individual needs. Here are a few things to check:
- See if all of your prescriptions are on the plan’s list of drugs (called a formulary).
- Check for your preferred pharmacy.
- Find out what co-payments you will be responsible for paying when filling a prescription.
- Is the premium for your preferred plan affordable?
Unfortunately, not everyone who contacts you about switching to a Medicare drug plan has the best intentions. To protect yourself from scam artists intent on taking advantage of your situation, here are some tips to avoid becoming a victim:
- Beware of door-to-door sales people. Agents cannot solicit business at your home without an appointment.
- Do not let uninvited agents into your home.
- Check with the Policyholder Services Division of the State Auditor’s Office to make sure the salesperson is a licensed agent.
- Do not give out personal information, such as Social Security numbers, bank account numbers or credit card numbers to anyone you have not verified as a licensed agent. People are not allowed to request such personal information in their marketing activities and cannot ask for payment over the Internet. They must send you a bill. Once you decide to purchase a plan and have verified that the agent is licensed, you may give the agent personal information to assist in enrollment and billing.
- Verify that the plan you have chosen is an approved Medicare plan. All of the approved plans are available at www.medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227).
Financial Assistance with Premiums
Financial assistance with premiums is available to Medicare beneficiaries who meet certain income requirements. To find out more, check out the State of Montana’s Big Sky Rx Program at www.bigskyrx.mt.gov or call 1-866-369-1233.
"This is the time for Montanans with Medicare to evaluate their prescription drug needs and to assure they are utilizing the services of a trusted advisor or the state's SHIP program at 1-800-551-3191 when making a coverage decision," said Morrison. “In addition, we urge people not be pressured into making quick purchase decisions. We are reminding agents that we will enforce federal and state marketing requirements, including the prohibition against high-pressure tactics and selling unsuitable products."