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Did You Pick Your Medicare Drug Plan Yet?


The end of 2009 is nearly here, and some older Americans have not yet chosen their Medicare prescription drug plan for 2010. Open enrollment ends on December 31 for everyone except those who qualify for a special enrollment period, including those in a low-income subsidy program.

Even if you are satisfied with your current prescription drug plan, experts generally encourage everyone to review all of their options each year. One reason is that plans change, as do a person’s drug needs. Although it is not possible to predict exactly which prescription drugs you will need for the coming year, it pays to investigate your choices in case another plan can offer you better services and/or save you money. Many insurance companies have made changes to their plans and premiums.

Generally, older adults have two types of prescription drugs plans from which to choose: a stand-alone plan for those who are already part of the traditional Medicare program, or drug coverage that is part of a private Medicare health plan. Plans that are offered by insurance companies and other private companies approved by Medicare add coverage to original Medicare, some Medicare cost plans, some Medicare private fee-for-service plans, and Medicare medical savings account plant.

Some people get their drug coverage from the Veterans Administration or from TRICARE. In most cases, it is to their advantage to stay with these plans without making any changes, unless they have limited resources and income, in which case they may qualify for extra help from Medicare.

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Those who have health insurance through a current or former employer or union need to check with the employer or union. Medicare does help employers and unions continue to provide drug coverage that meet Medicare’s standards for retirees. The employer or union or the plan that administers the coverage should provide written information to retirees about the drug coverage and how it compares to Medicare’s drug coverage.

If your state pharmacy program pays for your prescriptions, you need to check with your State Pharmacy Assistance Program. Each state decides how its program works with Medicare prescription drug coverage. Some states provide extra coverage when you join a Medicare prescription drug plan, while others have a separate state program that helps with prescriptions.

If you are in a Medicare Health Plan (e.g., HMO, PPO), you are usually required to get your prescription drug coverage from your current health plan if you decide to remain in the plan. Individuals who have a Medigap policy with prescription drug coverage should check their coverage to see which prescription drugs are not covered and what costs they are required to pay themselves. Anyone who gets their prescription drug coverage from FEHBP should probably stay with that plan unless they have limited resources and income, in which case they may get some extra help from Medicare.

To help you make a decision about Medicare prescription drug coverage, you can visit the Medicare.gov website and click on “Compare Drug Plans.” You will be asked to enter personal information, including which medications you take. You will then receive back information on the most cost effective plan for you, as well as which drugs the plan covers.