BANGOR, Maine — Medicare beneficiaries have until the end of this month to re-enroll in Medicare Part D, the portion of the national health care plan for seniors that covers prescription drugs. The annual open enrollment period runs from Nov. 15 to Dec. 31.
Medicare officials are particularly concerned this year about a group of about 1,500 Mainers who are enrolled in certain private health management plans called Medicare Advantage. Several companies doing business in Maine will be dropping Medicare Advantage from their offerings in 2010. Enrollees in those plans who do not enroll in new Medicare Advantage plans will be covered by original Medicare for hospitalization and outpatient medical care, but will lose their prescription coverage if they do not choose a Part D plan.
“If they don’t take action before Dec. 31, they could have no prescription coverage for a full year,” Carol Maloof, acting administrator of the Boston regional office of the Centers for Medicare and Medicaid Services, cautioned Monday during a tour of Maine aimed at raising public awareness. When enrollment opens again next November, she said, those who have failed to enroll in Part D this year could face a financial penalty.
The Part D prescription drug portion of Medicare was enacted in 2004 and took effect in 2006. Participants must re-enroll at the end of each year, selecting from a number of insurance providers with different benefit packages. Those who are satisfied with their current plan automatically will be re-enrolled in it.
There are 43 Medicare prescription drug plans available in Maine, each with a changeable list of medications covered, out-of-pocket costs and other features.
“Every year at this time, this is what you do,” said Maloof. “You need to look at your individual situation and determine if you are in the right [prescription] plan for you.”
About 252,000 Mainers are enrolled in the Medicare program. Of these, 16,930 are enrolled in Medicare Advantage plans, 4,000 are enrolled in Medicare Advantage plans that will cease to do business in Maine after the end of this year, and 1,500 will lose prescription coverage when that happens.
Maloof said Medicare Advantage plans must provide comprehensive health management services as opposed to the fee-for-service structure of the original Medicare program. Medicare requires the companies that offer Medicare Advantage to provide access to a full network of health care providers and to have enrolled more than 100 individuals, she said. Companies that don’t meet these requirements are being screened out of the federal program.
All affected plans should have sent letters last month to enrollees regarding the change, Maloof said.
“Our fear is that all Medicare enrollees get so much important-looking correspondence, it would be easy to overlook [the letter],” Maloof said.
Seniors needing help with Medicare Part D should contact their nearest Agency on Aging for one-on-one assistance. The service is free, according to Dyan Walsh of the Eastern Area Agency on Aging in Bangor, but it is important to set up an appointment as soon as possible by calling toll-free 877-353-3771.