Our Senior Centers   Medicare Basics and An Update on the Medicare Part D Benefit By Carl Burke, Executive Director, Upper Shore Aging, Inc.                 The open enrollment period for Medicare Part D prescription drug plans to be offered on the Eastern Shore in 2007 is fast approaching. I’d like to review some Medicare basics and update Seniors on several impending changes in the Part D benefit for 2007.             For an increasing number of older persons who do not enjoy robust employer-sponsored health insurance plans, Medicare offers a comprehensive health insurance program. At least in theory, mid-Shore Seniors – especially those with plenteous resources or which are poor enough to qualify for public assistance – can cobble together several Medicare parts to effect a comprehensive health insurance program. Traditional Medicare Part A (which covers hospitalization, blood, skilled nursing home care of limited duration, hospice and some other services) and Part B (which covers doctors fees, other services not covered in Part A, outpatient care and preventive services) can be complimented with a Part D prescription drug plan and supplemental Medicare insurance (Medigap). A second alternative is enrollment in a Part C Medicare Advantage plan, typically operated by a Health Maintenance (HMO) or Preferred Provider Organization (PPO) that bundles traditional Medicare Part A and B benefits. Some Part C plans offer a prescription drug benefit, but many do not, in which case Part C beneficiaries may add a Part D prescription drug plan.             Wealthier mid-Shore Seniors will pay more for Medicare Part B premiums in 2007. And, for the first time in some years, Part C Medicare Advantage plans will be available; tentatively, eight such plans will be offered in Talbot County and five in both Caroline and Kent counties. Seniors interested in enrolling in one of the new Part C plans are reminded that several years ago, a number of such plans were available on the Shore. However, they suddenly ceased operation – and left a lot of Seniors unhappily inconvenienced. Medicare may offer in 2007 Medical Savings Accounts, similar in concept to private Health Savings Accounts. Such plans, if indeed offered, would involve beneficiaries paying a high annual deductible on the front end, with a Medicare-funded savings account supporting later health care expenses during the calendar year.             Between November 15th and December 31st, 2006, mid-Shore Seniors can enroll in, or change their current plan to, one of the fifty-six tentatively offered prescription drug plans for 2007. As was the case last year, Seniors who already have a non-Medicare creditable coverage plan (with benefits equal to or better than those of Medicare Part D prescription drug plans) need not enroll in Part D, nor will they incur a penalty for enrolling later. I strongly recommend that all Seniors who are eligible to enroll in a Part D plan do so immediately, for there is a constantly increasing penalty for late enrollment in the absence of a plan with creditable coverage.             Last January, many Part D enrollees missed needed drugs when they went to the pharmacy to fill their prescriptions and did not have plan ID cards. I strongly encourage Seniors to enroll in a new plan no later than the first week of December 2006 so that the plan provider has adequate time to process enrollment and mail out a plan ID card. Seniors who enroll late in December and then go to the pharmacy after January 1, 2007 without a plan ID card should at least have with them a copy of their confirmation or welcome letter, or the plan’s name and a telephone number for it. The best Medicare Part D plan for one Senior is probably not the best one for his or her spouse, or friend. A good way to choose the best plan is to access the user-friendly Medicare website, www.medicare.gov, by way of the Internet. For those lacking a computer, skills in using one or Internet access, I encourage a visit to the Senior Information & Assistance staffperson at the local Senior Center. Seniors enrolling in a Part D plan will need an accurate list of the prescription drugs they take, with dosages, and basic income and asset information. Many Seniors may find that they are eligible for extra help that can pay for either Medicare or Part D premiums, deductibles and copays.
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