June 23, 2018
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Time to decide

By Meg Haskell, BDN Staff

ORONO, Maine — The annual open enrollment period for the Medicare Part D prescription drug program runs from Nov. 15 to Dec. 31, offering current enrollees their once-a-year opportunity to make changes to their coverage.

This year, unlike past open enrollment periods since Part D took effect in 2004, officials are urging seniors to be especially critical in examining their coverage options, because some plans have significantly altered their premiums, their co-pays, the drugs they cover and other specifics.

On Monday, national Medicare officials and local experts were in Orono to urge Medicare enrollees to pay extra attention to the plans they choose.

Tevi Troy, deputy secretary of the U.S. Department of Health and Human Services, told residents of the Dirigo Pines retirement community that the 46 plans available in Maine change every year in terms of the medications they cover, the monthly premiums they charge and other factors.

In addition, he said, people’s coverage needs change in response to changes in their health status. A baseline plan that provides minimal coverage may be appropriate for an individual during a period of good health, but an illness or injury may indicate the need for more comprehensive benefits, he said.

Troy emphasized the need to “shop and compare” during the open enrollment period to ensure seniors find a good match for their needs.

A quick comparison between plans in 2008 and 2009 shows that most policies available in Maine will change some in the cost of monthly premiums, the medications they cover and other particulars. But the Humana Enhanced plan, as one example, which has been popular with Maine enrollees, is more than doubling its monthly premiums, from $19.20 in 2008 to $42.50 in 2009.

Humana spokesman Jim Turner said Friday evening that the premium increase is needed to cover the cost of providing the Enhanced plan and that the new premium is still within the average range of Part D premiums.

Stacie Sparkman, a Medicare expert with the Bangor-based Eastern Agency on Aging, said it’s not unusual to see a modest increase in a plan’s monthly premiums, but that such a dramatic rise will be troublesome for many enrollees in the formerly low-cost plan.

“That’s why we’re really encouraging folks to review and compare this year,” she said. Sparkman, who did not know how many Mainers are enrolled in the Humana Enhanced plan, noted that there are several less costly plans available that may meet the needs of Humana enrollees.

The federal government reports that Medicare Part D, designed and implemented in 2004, enjoys a high level of public satisfaction and is less costly to provide than originally projected. But the program has been sharply criticized for its complex, bureaucratic design, its failure to negotiate lower prices from drug companies, and the profit-driven private companies that provide the actual coverage.

Referring to the coming change of leadership in Washington, D.C., Sparkman said the Eastern Agency on Aging and other senior advocacy groups “are eagerly looking forward to what the next four years may bring” in terms of improvements to the Medicare Part D program. But for now, she said, “we have what we have” and seniors should take advantage of the current program.

The Eastern Agency on Aging has scheduled more than 40 public clinics to assist seniors and their families in finding the most appropriate prescription coverage through Medicare Part D. Nine of those events are in Bangor; the others are scattered throughout the four-county region served by the agency. More information about the clinics is available online at www.eaaa.org or by calling 941-2865 or 877-353-3771.



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