In a month, on 15 November, the six-week enrollment period for 2010 Medicare Part D plans begins. The Medicare Prescription Drug Plan Finder is now available at the Medicare website. It is not too soon to investigate the details of plans available in your state particularly because most insurance companies have increased premiums for next year and some have added deductibles.
Remember too, that there will be no cost-of-living increase in Social Security next year, so keeping down costs is essential.
The Kaiser Family Foundation has issued a report on availability of plans for the new year and analyzed the changes. Among them for stand-alone (not Medicare Advantage) plans:
- Monthly premiums average 11 percent above those for 2009
- If you stay with the plan you have now, average monthly premiums will be $38.85, up from $35.09 this year
- 80 percent of plans have no doughnut hole coverage
- 61 percent of plans charge a deductible, up from 45 percent in 2009
The Kaiser report notes that premiums for some of the most popular plans have increased dramatically since Part D went into effect in 2006. The AARP Preferred plan premium has doubled since then; Humana PDP Enhanced premium has tripled.
If you take more than two or three prescription drugs, deciding whether to keep your current plan or find a new one can be difficult. It's a good idea to make a chart to compare drugs covered, their costs, monthly premiums and deductibles. The Medicare Part D website is well designed. You can plug in the drugs you use and the software will pop out the plans that cover them in your state and give you cost comparisons for the variables.
People generally believe the doughnut hole (during which there is no coverage for out-of-pocket costs between $2380 and $4550) is the worst aspect of Part D. I disagree. Although the doughnut hole is cumbersome, unfair and expensive, created only as a giveaway of billions of dollars to pharmaceutical companies, there is another problem that is worse, a giant flaw in the logic of the system:
It is not possible to predict what new drugs one might need during the year of enrollment.
Different Part D plans cover different drugs. Might I suffer a stroke? Or be diagnosed with cancer? Perhaps I will develop heart disease. Even if I could predict the future, there are thousands of drugs physicians can choose from to treat health problems. Perhaps the one my physician believes is best for my condition is not available through my plan.
So choosing Part D coverage is no different from betting on a roll of the dice at a craps table.
When I realized this unconscionable flaw during last year's Part D enrollment period, I was paying a $29.90 monthly premium and $75 for a three-month supply of the single, brand-name drug I was taking. I was also facing a substantial increase in the premium for 2009.
In discussing this with my doctor, she suggested that I switch to a generic drug, purchase it for $4 per month at the local supermarket's pharmacy and buy the cheapest Part D plan. Smart woman. How much more of a crap shoot is it to HOPE my Part D plan will cover any new drugs I may need than trying to GUESS what terrible disease requiring additional drugs might occur?
Either way, hope and guess are dreadful, possibly life-threatening criteria on which to base health care. Every Part D plan should be required to cover all drugs.
The premium for that cheap drug plan I have now will double in price for 2010, and a deductible has been added. Checking the Medicare Prescription Drug Plan Finder, I discovered that the monthly premium for the least expensive plan in my state for 2010 is $1.20 more than I'm paying now and includes a $175 deductible. But the premium for the least expensive plan without a deductible is so high that I save by enrolling in the first one if during the year, I need new brand-name drugs.
If that plan does not cover new drugs I may need, I will deal with it then. There is no way to know if even the most expensive plan ($87.20 monthly premium) would cover them. Meanwhile, if my drug needs remain the same, I will pay nearly $200 next year for nothing, for a just-in-case scenario that may not happen and if it does, may not meet my needs.
The best thing I can say about my Part D coverage is that due to taking only one drug, it is not complicated to work out the best (cheapest) plan for me. If your prescription needs are more complex, it's time to start working on your crapshoot coverage. You will find the Medicare Prescription Drug Plan Finder here.
At The Elder Storytelling Place today, Johna Ferguson: Claustrophobia