Part D Open Enrollment: 12 Questions

Nov. 16, 2007 -- Medicare's Part D prescription drug plan is about to enter its second year. The open enrollment period lasts from Nov. 15, 2007 to Jan. 1, 2008. It's the time for new Medicare beneficiaries to choose a plan for the first time and for existing beneficiaries to look over their plans and see if they need to switch. For some help navigating Part D's enrollment period, we talked to Deene Beebe, spokesperson for the Medicare Rights Center, an advocacy group based in New York.

(What questions do you have about Part D? Ask our expert, Marisa Scala-Foley, on the Medicare and You message board.)

Have Part D plans changed since last year in a way that makes a difference to beneficiaries?

Yes. Everybody who has a Medicare drug plan needs to review their current plan for 2008. Plans are changing. Premiums are changing; the list of covered drugs known as the formulary is changing, so are coverage restrictions and drug costs. So don't assume that if you have a drug plan that worked for you this year, it will work for you next year.

What's the easiest way to do that?

The best way is to use the Medicare Part D Plan Finder at www.Medicare.gov. If you're not computer savvy, don't go it alone. It will tell you which plan is the best buy based on the drugs you take in the dosages you use. Only by entering that information into the prescription plan finder can you know what plans provide your drugs at the best price or at least with the fewest restrictions. But don't sign up until you call the plan you choose and confirm the benefits. Sometimes what is on Medicare.gov is not exactly what the plan actually offers. You can also use the Medicare Interactive feature on our Web site, www.MedicareRights.org.

Are there a lot of new plans out there, or is it just that existing plans might be changing?

There are new plans. Some plans have left, others might be coming in for the first time. The bottom line is the details in your current plan can change, and so can what's on offer from new plans. I always stress to the beneficiaries that they should assume nothing. You have to get some help and take a look at the plan finder. You can also call (800) MEDICARE. They can help you with the plan finder, and they can also refer you to your state's health insurance assistance program. Every state has one, and counselors are on hand to help you.

Have out-of-pocket costs changed much, or is it just the selection of plans that's changing?

There are a lot of plans, so price changes vary a lot. But premiums at two of the biggest plans, one by United Health and another by Humana, have gone up by more than 60% on average. So people may see higher premiums generally. Of course, you need to check if your drugs are still on you plan's formulary. But you also need to look at which tier your drug is on. A tier is a benefit level that plans use to decide how much coverage each drug gets. How much you pay for a drug can go way up or down if it moves tiers.