Medicare Part D 2010

Medicare Part D in 2010 remains essentially the same as in 2009. Part D coverage is available to all Medicare beneficiaries who have either Part A or Part B or both. Joining a Medicare drug plan is optional and is in no way mandatory, and declining Medicare drug coverage will not in any way compromise your Medicare Part A and B benefits. To join, you must sign up with an insurance company or other private organization approved by Medicare during one of the enrollment periods designated by Medicare. If you choose to sign up for Part D coverage, you have the choice of enrolling into a stand-alone plan or receiving coverage through a Medicare Advantage plan, which bundles drug coverage together with your other Medicare Part A and B benefits. In order to enroll, you can either either call up 1-800-MEDICARE and let a customer service representative submit an application or sign up through the plan. If you let Medicare submit the application, a computer record of the enrollment is generated, and that can he lp track the enrollment should there be any questions regarding the validity of the application.

It is important to understand that the costs of the plans vary, and that means the premiums, co-payments, deductibles and costs of the drugs can all be different depending on the plan. There are generally two ways of getting medication coverage. You can sign up with a stand alone Medicare prescription drug plan (PDP), or you can sign up with an Advantage plan that bundles drug coverage into one package with its other benefits. If you have limited income, you might be able to qualify for extra help provided by either Medicare or through your state department of medical assistance.

If you already have a prescription drug benefit through your employer insurance or through retiree supplemental policy, it may be unneccessary for you join a Medicare PDP if your other coverage is creditable. Likewise, if you have VA benefits, Tricare, or Federal Employee Health Benefits, your drug coverage is considered to be creditable coverage, and it is not necessary for you join a Medicare drug plan for as long as you carry your other creditable coverage.

Joining, switching, or disenrolling from a plan is relatively easy, and Medicare has appointed 4 basic enrollment periods for this purpose:

• >Your initial enrollment period. Anyone newly eligible for Medicare can join a plan 3 months prior to their 65th birthday, the month of their birthday, or during the 3 months following the month in which they turn 65. If you have Medicare because of a disability, you can join 3 months before or after your 24th month of disability.
• The Annual Election Period. Anyone with Medicare can join, change plans, or disenroll between November 15th and December 31st of each year, and the change goes into effect January 1st or the following year.
• The Open Enrollment Period for Medicare Advantage Plans. Between January 1st and March 31st of each year, anyone who already has prescription coverage may make one change to their enrollment.
• Special Enrollment Periods. Enrollment periods for people whose circumstances all outside of the regular enrollment periods described above. Anyone who qualifies for extra help may join, switch plans, or disenroll at any time and are not subject to the enrollment periods described above.

Generally speaking, if you need to change or switch your enrollment, you only need to join a new plan. Your new election choice will automatically disenroll you from your old plan, and your new PDP will go into effect the first of the following month. You will not need to contact the old plan or inform them of your decision. Once you or 1-800-MEDICARE submits the new application,the process the automatically terminate the earlier plan.

One question upper most in the mind of everyone looking for Part D coverage in 2010 concerns the out-of-pocket costs. First, keep in mind that it isn't possible to quote on figure for all drug plans. Precise costs and levels of coverage are different from plan to plan. No two plans will be the same. However, all plans must meet the minimum requirements for coverage as established by Medicare. Having said that, the basic schedule of costs include the following:

*The monthly premium. All stand-alone plans charge a flat monthly rate that varies by plan. The premium is your monthly "sign-up" fee that allows you to receive coverage. In contrast, some of the Medicare Advantage plans charge no additional premium for the Part D plan.

*Yearly deductible. Medicare allows the plans to charge a deductible that applies to the calendar year. In 2010, the maximum deductible that a plan may charge is $310. However, many plans charge either a reduced deductible or no deductible at all.

*co-payments. These are the amounts you pay at the pharmacy for your prescriptions. If your plan has a deductible, you will first pay the deductible for your medications and then pay co-payments. The co-payments will be a fixed share of the cost of the drugs..

*coverage gap. Almost all of the plans have a coverage gap. This is a period of time during which you may have to pay 100% of the costs for your prescriptions. In 2010, this means that once the amount of money you pay plus what the insurance pays equals approximately $2830, you must pay the all costs out of your own pocket until you reach the yearly limit. In 2010, you must pay approximately $3843 out of your own pocket before the plan begins to pay again. If you do not finish paying the yearly limit by December 31st, the yearly limit goes back to zero on January 1st of the following year. If you are eligible for extra help, you will not have coverage. Instead, you will continue to pay the small co-payment amounts determined either by your state or Medicare, depending on the source of the extra help.

*Catastrophic coverage. When you finish paying out the plans out-of-pocket limit during the coverage gap for the year that you are in, you get what Medicare calls catastrophic coverage. This means that the plan starts paying approximately 95% of the costs and you pay $5% coinsurance.

To wrap up, Medicare drug coverage is available to all people enrolled in Medicare and is available either through stand alone plans for through the Medicare Advantage program. Though joining a plan is not mandatory, to get coverage you would have to sign up during a valid enrollment period.

 

 

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