Medicare participants face choices for drug plan

11/6/2007

Multiple options for Medicare prescription drug plans coupled with potential changes in premiums and coverage await participants, but there doesn't seem to be as much anxiety as with previous enrollment periods, officials said.

Medicare participants, however, should carefully consider insurance options before making changes and have loved ones confirm products meet their needs, some warned.

The Ohio Department of Insurance has handled a number of complaints this year about agents enrolling Medicare participants into unaffordable plans and other predatory marketing tactics, practices that likely will increase during the open-enrollment period, said Mary Jo Hudson, department director.

"We do caution folks to be very careful of aggressive sales tactics," she said.

Medicare participants nationwide have from Nov. 15 to Dec. 31 to either keep their current prescription drug coverage or select a new one, whether it be a stand-alone plan or part of a managed-care option.

The Ohio Department of Aging advises Medicare participants to make any changes by Dec. 8 to ensure they get needed prescriptions on Jan. 1.

Even if Medicare participants are satisfied with their prescription drug plans, they should look them over and compare them to their other available options, because drugs covered and monthly premium costs may have changed for next year, said Roland Hornbostel, deputy director for program and policy for the Ohio Department of Aging.

Some plans may even require Medicare participants to use different pharmacies next year, Ms. Hudson said.

"You need to take the time to review the coverage you have to make sure you're satisfied with it," Mr. Hornbostel said.

For next year, there are 58 stand-alone prescription drug plans being offered in Ohio, and their monthly premiums range from $16.60 to $98, according to the Henry J. Kaiser Family Foundation.

In Michigan, 55 stand-alone prescription drug plans are being offered for next year, with monthly premiums ranging from $17.90 to $97.50, according to foundation statistics released last month.

Of Medicare managed-care offerings, meanwhile, 29 companies in Ohio and 25 in Michigan include prescription drug coverage with plans, according to the foundation.

To avoid predatory sales practices, do not give insurance agents personal information - including name and Social Security number - until certain of making a purchase.

Also be wary of agents who sell Medicare products door-to-door or claim to work for Medicare, which doesn't enroll beneficiaries by making house calls, the Ohio Department of Insurance advised.

Medicare participants should contact their doctors and other health-care providers to make sure they accept plans under consideration, it added.

Nearly 2 million low-income Medicare participants nationwide may be assigned to different prescription drug plans for next year.

However, they can change at any time if the replacement does not have the coverage they need, Mr. Hornbostel said.

Medicare participants have become more accustomed to weighing prescription drug plans since the first enrollment period two years ago, he said.

"People have been through this, so we're not getting the panicky calls," Mr. Hornbostel said.

Still, with so many options available, many people need assistance with comparing plans, said Sally Davies, of the Area Office on Aging of Northwestern Ohio, which is among agencies providing such assistance.

"We're getting a lot of calls, a lot of inquiries," said Ms. Davies, coordinator for the Ohio Senior Health Insurance Information Program in Lucas County.

"People want to get started looking at what's available."

Contact Julie M. McKinnon at:

jmckinnon@theblade.com

or 419-724-6087.