Guidelines for selecting a 2010 Medicare Part D prescription drug plan
By Margie Ware
Drum roll, it’s that time of year when we unveil the new prices of Medicare Part D prescription drug plans. As always there are some changes, mostly in terms of pricing.
First, some plans are no longer available. If you are a person with a Wellcare plan (either Classic or Signature), then you will have to pick a new plan. SHINE volunteers areavailable to assist you in that process. We will also check for any other programs, such as Extra Financial Help, Prescription Advantage or the Medicare Buy-In Program, which may offer you additional benefits.
Second, a new set of plans is available from Tufts. They have introduced three plans, but with the lowest premium being $50.60 it is not clear whether any of these will meet the needs of Region Two, which includes the Berkshires.
Third, there are some surprising bargains. Last year’s lowest-priced plan, First Health Part D Secure (2009 price, $19.40), has been reduced even further to $10.80 with a $175 deductible. This plan will appeal to individuals who take no medications and want a low-cost plan that prevents them from receiving a penalty for non-enrollment.
Another surprise is Aetna Medicare Rx Plus. For our area, it is the lowest-priced drug program without a deductible. In 2009 this plan was more than $60; now it is available at $35.70. This plan may be useful for members of Prescription Advantage (PA) who want a plan with no deductible. And because the price is only $1 over the “benchmark” price that PA is willing to subsidize, it will be affordable for people in Categories 2 and 3 of PA.
There are more Humana changes this year. Last year some people were unpleasantly surprised when their old stalwart Humana Standard, which had debuted at $7.32 in 2006, raised its 2009 price to $41.40 and still included a full deductible. Humana Standard has now been “replaced” by Humana Value, which is priced at a more palatable $30.70 and carries a $150 deductible. Currently, it is not clear whether all Humana Standard members will be automatically re-assigned to this new plan.
SilverScript has changed the names of two of its plans. Their Plus and Complete products now carry the brand name “CVS Caremark.” On the other hand, the prices went down so perhaps this new branding will have some benefit for consumers.
And then there’s the bad news. Blue Cross Value Plan, which originally qualified as a benchmark plan and attracted numbers of subscribers with its familiar name brand, has increased its 2010 premium to $47.70, with a $310 deductible. This is approximately $13 more than the benchmark, so individuals who have been carrying this for a number of years and absorbing extra premiums might want to look at other alternatives. The Blue Medicare Value Plus and Premier products are also showing substantial increases.
Watch out if you have Health Net Orange Option 2, because it has no deductible and was chosen by many last year as an alternative. The new plan price of $64.50 is likely to give some individuals pause – if they open up their mail and read it, that is!
Medicare Rx Rewards Standard has not increased dramatically, but it no longer qualifies as a benchmark plan. MassHealth members and individuals on Extra Financial Assistance will need to pay a small premium if they wish to stay with this plan. First Health Part D Premier is still a benchmark plan with a reasonable price, but they have abandoned their $0 deductible and put in one for $150, (which is still approximately only half of the standard deductible of $310.)
It is easy to get lost in the details of all these changes. The most important things to remember are the following:
Open all the mail you receive from your present Medicare drug program. Your ANOC (Annual Notice of Change Letter) will describe changes in both pricing and formulary composition. People who ignore these communications often find themselves in for nasty surprises in January.
If you don’t understand a letter you have received from Social Security (Department of Health and Human Services), Prescription Advantage, Mass Health or your Part D plan, ask someone to assist you. A SHINE counselor, case manager, housing coordinator or family member may be able to decipher the information. If not, they will probably know who to call to ask for help. If you take more than four medications, especially if one is a brand name, we encourage you to call us so we can re-evaluate your plan. Changes in formularies and new plan requirements such as prior authorization can mean that you spend the month of January trying to figure out what went wrong. Prior planning can avoid many of these pitfalls.
Check with your local Council on Aging about informational programs and the availability of SHINE counselors to answer your questions. Please consult the schedule of outreach events above and contact Elder Services’ SHINE Program at 499-0524 or 1-800-544-5242 to make sure that your questions are answered and your needs addressed. Remember, it’s our busy season, so it may take us a couple of days to get back to you. But don’t give up! Also, use your local Council on Aging to help you navigate the system.
Margie Ware is Elder Services’ Regional SHINE Program Coordinator.
