It could affect you

Like most of you, I am watching and reading about various proposals for health care change in our country. Because the Senior LinkAge Line is the State Health Insurance Program in Minnesota, I am particularly interested in potential changes for Medicare beneficiaries.

There has already been some news about a proposal to change the "Donut Hole" or "Gap." Currently, a beneficiary falls into the donut hole when the enrollee and the drug plan have met the Initial Coverage Limit as defined by Medicare. This year that amount is $2,700. The plan is responsible to inform the plan holder about progress towards hitting that limit. Beneficiaries who fall into the donut hole, pay 100 percent of the drug costs until the out-ofpocket threshold is met. In 2009, the amount is $4,350. Once the out-ofpocket threshold is met, the beneficiary is eligible for catastrophic coverage where the plan pays 95 percent of the drug costs and the plan holder pays 5 percent.

With the suggested proposal, beneficiaries would pay 50 percent of their drug costs while in the donut hole and drug manufacturers have agreed to donate half the cost of their brand name drugs. The cost savings would be realized right at the pharmacy without any paperwork to fill out. This may be effective as early as July of 2010.

We also have heard there may be a change in the Annual Open Enrollment. This is the designated time when beneficiaries may make a Part D drug plan change. Currently, plan changes can be made from Nov. 15 through Dec. 31 each year. The new plan takes effect on Jan. 1 of the coming year. It has been suggested those dates be moved up several weeks to earlier in the fall. Experience has shown us at Senior LinkAge Line that the current dates are not the most practical from a beneficiary or an agency standpoint. November and December are typically very busy months with two holidays and family events, so a Part D plan change may not be a top priority for many people. Hopefully moving the dates ahead a few weeks will help beneficiaries take advantage of this opportunity to seek the most cost effective plan for their current needs.

Speaking of drug plan changes, it is not too early to remind people of the Open Enrollment time coming up in just a few months. There are several ways to get assistance with this very important decision. The Senior LinkAge Line is (800) 333-2433 and the Disability LinkAge Line is (866) 333-2466 will offer assistance as they have for many years. Beneficiaries also may call Medicare at (800) 633-4227 to get help.

Watch your Community Education bulletin for an opportunity to learn how to manage the drug plan decision each year using the Medicare Internet tool. Watch for more details on this topic in the future.

KATHIE PHILLIPS is a senior advocate for the Senior LinkAge Line.