Time for Yearly Review of Medicare Part D Enrollment Plan


This time of year is marked not only by holiday, but by Medicare’s annual enrollment period. Even though the Robert Wood Johnson Foundation has noted that only 10% of seniors change plans annually, it is important to do a yearly review.

Changes can occur both in the individual drug plan and in which prescription drugs the individual is taking. Don’t let inertia keep you in the same plan year after year when you might save money by changing plans.

This year many will have to change plans as the federal government directed insurers to eliminate duplicative Part D prescription drug plans and plans with low enrollment.

The enrollment period to pick a Part D plan for 2011 is the six-week period from Nov. 15 to Dec. 31. It is important to note unlike previous years, individuals enrolled in Medicare Advantage plans can no longer switch to other Medicare Advantage plans during January, February and March. Individuals will still be able to leave their Advantage plan and go back to the original Medicare even after January 1, 2011.


There will be relief for the “doughnut hole” in 2011 as a new 50% discount on the formulary's brand-name drugs takes effect. Plans will also pay 7% of the cost for generic drugs in the gap. Note this applies to drugs that are on the plan's formulary. If the drug isn’t on the formulary there may be no discount.

Insurers may change drug formularies each year. Review your prescription list with your plans formulary to make sure your Part D plan covers your medications.

Comparing plans can be overwhelming, but resources are available to help. Talk with your insurance agent, your pharmacist, your local Agency on Aging for help.

One of the best sources for a beneficiary to determine their share of the bill is to visit Medicare's Web site at www.medicare.gov and use the Plan Finder tool. There you can enter the drugs you'll take next year. The Plan Finder will then give you a cost comparison of out-of-pocket costs under different plans.

Another easy-to-use online tool can be found at www.PlanPrescriber.com. Here you will be taken through a four step process to narrow down your options and identify the most cost-effective plan. If you have a low income and struggle to pay for your prescription drugs, you may qualify for the Extra Help/Low-Income Subsidy (LIS) program.

Robert Wood Johnson Foundation