Mercy Health Love County - News

Medicare Part D Volunteer Finds That Most Switch Plans

Posted on Tuesday, January 22nd, 2008


Almost three out of four people enrolled in a Medicare Part D prescription drug plan would probably be better off in a different Part D plan, says the volunteer enroller in Love County.
Don Sessions arrived at his conclusion based on results for 83 Love County participants during the open enrollment period that ended last December 31.
All had sought assistance in comparing their 2007 Part D enrollment with the plan choices available for 2008.
Sixty-one of the 83 participants, or 73.5%, wound up switching plans in order to achieve the highest savings for 2008.
The average plan-switcher will save $641 more than what their 2007 plan would have delivered had they stayed with it in 2008, Sessions’ data showed.
Most participants are now locked into their current plan for the rest of 2008. The next chance to change plans will be November 15-December 31, the open enrollment period for 2009.
An exception is low-income seniors, who may make plan changes anytime of the year.
Any Medicare participant seeking plan assistance may ask for it at Mercy Health/Love County Hospital and Clinic, Marietta Pharmacy, Retired Senior Volunteer Program (RSVP) at Big 5 Community Services, or the Love County Health Department.
They refer plan evaluation inquiries to Sessions, a Medicare Part D Volunteer through the Oklahoma Insurance Department, under sponsorship of the hospital.
The Falconhead man, a retired CPA, plugs the person’s prescriptions into the official “plan finder” tool on the Medicare website, The tool ranks the plans that cover those particular prescriptions in annual cost order from low to high.
There were a total of 52 prescription drug plans from which to choose in 2008. Many of them existed in 2007 but had changed the drugs they covered, or the costs they charged, such as premiums, deductibles, and copays.
The hospital, health department, and pharmacy are particularly interested in enrolling low-income seniors, because, for many of them, under the “extra help” provision, Medicare Part D pays 95% of prescription drug costs.
They are asking the public to help point out the benefits of the program to neighbors and loved ones they believe fall in the low-income category. Low income for purposes of Medicare Part D means annual income of less than $15,315 (individual) or less than $$20,535 (married) and assets (not counting home or car) of less than $11,710 (individual) or less than $23,410 (married).
Sessions said Community CCRx Basic misled many extra-help participants by showing on the plan finder a co-pay of $0 for generic drugs in 2008 when, in fact, he has learned from observing the plan in action in January that the plan is actually charging them $2.25 per prescription.
He said he contacted Medicare and has been advised how to lodge a formal complaint in behalf of the affected partipants. Meanwhile, he is welcoming extra-help participants enrolled in Community CCRx Basic to contact him to conduct a plan finder search to see if there is a more favorable plan for them for the rest of 2008.