December 19, 2008

Medicare choices need to be made before Jan. 1

By Mayte Prida

This holiday season seniors have important choices to make about their healthcare. Medicare prescription drug plans may be making changes to premiums, cost sharing and coverage that will be effective January 1. If you or someone you care for is eligible for the Medicare prescription drug benefit, it’s critical that you review the changes being made by your current prescription drug plan and compare it to other plans to make sure it still meets your needs. You may change plans between now and December 31.

Every year brings new changes – perhaps to your health, family situation, or income level. Even though you might only need one or two medications now, prescription drug needs may change, especially if you have a chronic condition like hypertension or high blood pressure. Consult with your doctor and take the time to check out each prescription drug plan’s formularies and their preferred drugs, with lower cost sharing, carefully.

If you are eligible for a Medicare prescription drug plan, the Centers for Medicare and Medicaid Services (CMS) recommend you consider these areas to determine which plan best meets your needs:

· Review next year’s premiums, co-pays and deductibles for your current plan.

· Compare the cost and coverage to other plans in your area.

· Check to see if other plans cover your medicines, pharmacy, doctors and other services you need.

When it comes to healthcare coverage – and nearly everything else these days – cost is an important consideration. Fortunately, when it comes to Medicare’s prescription drug plans, 97 percent of beneficiaries enrolled in a Medicare drug plan in 2009 will have access to drug plans that cost them the same or less than their coverage in 2008, according to CMS. What’s more, the 9.4 million beneficiaries who receive the low-income subsidy generally don’t have to pay any premiums.

These savings stack up for millions of people all over the country. On average, those enrolled in the program save more than $1,200 every year, according to CMS! What’s more, it’s one of the few government programs that actually cost taxpayers less than expected – to the tune of $200 billion in savings. In this economic climate, how are these savings possible? Patients and taxpayers are saving money – and have more healthcare choices – because private companies are competing with each other and negotiating prices on behalf of millions of patients.

For the first time, the vast majority of seniors – 90 percent of Medicare beneficiaries – now have comprehensive prescription drug coverage thanks to Medicare’s drug plans. If you are eligible for Medicare and don’t have prescription drug coverage, sign up during this open enrollment period. You’ll be in good company: independent surveys from organizations such as J.D. Power, the Kaiser Family Foundation and The Wall Street Journal show that nearly 8 in 10 seniors are satisfied with their Medicare prescription drug plan.

Whether you’re eligible for Medicare or not, making changes to your healthcare plan can be confusing. If you need assistance choosing the right plan for you, contact a Medicare counselor at 1-800-MEDICARE, or visit

Mayte Prida, a nationally recognized television personality, producer and author, is a national spokeswoman for the Partnership for Prescription Assistance (PPA), a patient assistance program clearinghouse launched in April 2005 by the Pharmaceutical Research and Manufacturers of America (PhRMA).

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