Important Update Concerning Medicare Part D (Prescription Drug Program)
Each year Medicare beneficiaries should re-evaluate their Part D (Prescription Drug) coverage. The 2011 Open Enrollment period (Oct. 15th– Dec. 7th) allows members to make this evaluation and possibly change carriers to meet their personal needs. Your medications may change from year-to-year, as can the carriers’ formularies (list of covered medications). The cost of your Part D plan can therefore change as well. These are the reasons that make the annual evaluation an important process.
What is Medicare Part D?
A prescription drug plan that helps Medicare beneficiaries pay for their prescriptions.
What is the “Donut Hole”?
The “Donut Hole” is a gap in prescription drug coverage on a Part D plan. A Medicare beneficiary would reach the donut hole if they had prescription costs in excess of $2,840 in calendar year 2011. The $2,840 includes the member’s copays and the cost of the drugs paid for by the carrier. When a beneficiary enters the donut hole, he/she is responsible for the full cost of the medications until the donut hole maximum is satisfied.
What has changed with the “Donut Hole” for 2011?
Due to the federal health care law known as the Patient Protection and Affordable Care Act (PPACA), Medicare beneficiaries who reach the donut hole will receive a 50% discount for covered brand medications and a 7% discount for covered generic medications.
When can Medicare beneficiaries make plan changes?
Each year, there is an “Open Enrollment” period to allow Medicare beneficiaries to re-evaluate their Part D plans and to make changes in carriers. In 2011, the Open Enrollment Period will be from October 15ththrough December 7th. Plan changes would be effective January 1, 2012. It is imperative for each Medicare beneficiary to re-evaluate their Medicare Part D drug plan for 2012.
How can the changes be made?
Visit the Plan Finder Tool on the Medicare website to determine which Part D plan is most appropriate for you. You can enter in your specific medications and the tool can sort through the 30 different Part D Plans that are available to determine which plan offers the best value for your prescription drug needs.
You can enroll in the new Part D plan by calling the carrier, enrolling online (either through the Plan Finder tool or through the carrier’s website), filling out a paper application, or by calling Medicare. Medicare’s phone number is 1-800-MEDICARE (1-800-633-4227).
Our office will be mailing you an annual Open Enrollment reminder in September. If you or a family member needs any assistance with determining the appropriate Part D plan in 2012, please do not hesitate to contact Liz Johnson of Frett Barrington, Ltd. at 262-696-5010.
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