Part D – 2011 Renewal

Yes, it is that wonderful time of year once again when people on
Medicare get inundated with paperwork.  All Medicare Part D companies are required to send out an Annual Notice Of Change (ANOC). This notice is usually comprised of several booklets each of 40 pages or more in length.

Most people will glance at the booklets and think “Well my plan worked pretty good this year, I will stick with it another year.”

You may be OK if you do that, but on the other hand you may miss some very important information. Please take a few minutes to at the very least check out the following two bits of information buried in the fine print.

1) What will my premiums and deductibles be for 2011 ?
2) Will all my medications be covered ?
Just because a medication was covered this year does not necessarily mean it will be next year. If all you take are inexpensive generics, chances are they will still be covered. But if you take some pricey tier 2 or 3 brand name drugs please check the formularies you have received.

In last month’s column I gave you the highlights of the 2011 Part D offerings from AARP and Humana. It is now a month later and I have had plenty of chances to review the other plans available.

Most surprising are the plans offered by Aetna including the popular co-branded product with Costco.  This plan was priced at $36.50 for 2010 and it will be $61.40 in 2011 an increase of over 65%.  Yikes.  To make matters even more confusing Aetna has been placed on restriction by CMS the parent organization of Medicare. They are listed as having plans available for 2011, but as of Nov. 1st their plan details including formularies and co-pays are not on the wonderful web-site.  This makes a comparison virtually impossible.

In 2010 First Health Part D offered the lowest priced plan in the state at $8.80, if people do not read their packages they may be surprised to see that figure will change to $30.30 for 2011.  The plans and benefits have also changed along with the premiums.

If you take nothing at all, the lowest priced plan is once again with Humana.  This is the plan that is co-branded with Wal-mart and is available nationwide at the same low premium of $14.80.

A company whose name I may not have mentioned previously is popping up quite frequently as I run peoples drugs and that is Wellcare.  They have a plan called the Wellcare Signature with a higher than average monthly premium of $61.30, it has a $0 deductible (and so it should at that price) but then the co-pays on many generic’s are $0.  That is right I said $0. I see many people who take 6, 8 or even 10 different prescriptions that are all generic. They could pay the $61 premium each month and then walk out of the pharmacy without shelling out a single penny for all their medications.

Talking about $0 co-pays, have I told you how you can get Lipitor with a $0 co-pay. What I can hear you gasping, $0. For Lipitor. The Community CCrx Choice offered by Universal American has a monthly premium of $79, has no deductible and a $0 co-pay for Lipitor. Most people who are on Lipitor realize it is not a generic and is also quite expensive so this will be welcome news for some.

Talking of Lipitor a few plans do not cover it at all so this is yet another reason to review the formulary you received in the mail.

I will finish up with a couple of quick comments about Medicare Advantage Plans in Clallam County for 2011.  

With the demise of the Sterling Medicare Adavantage plans, Sterling agents are pointing out that they are not leaving the county they just have different plans.  That is 100% correct they are offering a traditional Medicare Supplement as an alternative. I did not intend to mislead or confuse people when I said Sterling MA Plans would not be available in Clallam County in 2011. Also the Sterling Medicare Advantage plans are still available in Jefferson County.

A company called Community Health Plan of Washington is new to this county and they have three Medicare Advantage plans available in Clallam County, even one with Rx included for a $0 premium.  It is an HMO based plan where you have to see a primary care physician before they will refer you to a specialist.

“Wow, a $0 premium plan including Rx, what a screaming deal, sign me up” is a variation of comments I have heard when I tell people about it. Unfortunately, there is a downside.  They currently only have three providers in Clallam County and all three work in Clallam Bay and Forks. Not a single provider in Sequim or Port Angeles. Folks, I am sorry if I got your hopes up.

The bottom line is, read any material you receive to make sure the plan will be suitable for you for next year. If you need any assistance you may call Medicare at 1-800-633-4227 seven days a week, 24 hours a day. State Health Insurance Benefit Advisors (SHIBA) can be reached at 452-3221 or your local friendly insurance agent

Posted on: November 1st, 2010 at 10:47pm by aveadmin12. Filed under: Uncategorized