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Choices hard for Medicare recipients PART D PROGRAM BY THE NUMBERS MEDICARE HELP

December 13, 2008 12:36 am

BY JIM HALL

The last six weeks of the year are stressful for Medicare recipients. It's when they must decide what to do about their drug coverage.

Now in its third year, the Medicare Part D prescription drug plan asks participants to pause during November and December and choose a plan for the new year.

Participants can stick with the plan they have or pick a new one. If they don't already participate in the optional Part D program, they can decide whether to join.

"This is the only time that people have to find a plan that fits their needs," said Valerie Hopson-Bell, owner of ElderCare Connections, a local consulting company.

More than 98 percent of those 65 and older participate in the Medicare health insurance program. The Fredericksburg area is home to almost 29,000 participants, a third of whom have joined a Part D program.

Local seniors can choose from 48 different Part D plans, all offered by private insurance companies. Each plan also has a monthly premium, yearly deductible, co-payment, coverage gap and formulary to consider.

"I get confused with all these Medicare choices," said Shirley McChesney, 70, of Fredericksburg.

McChesney gets her drug coverage through a Medicare Advantage plan from Humana. She has been happy with it, she said last week, but the cost of the plan is going up, and she wonders if a Part D plan would be better for her.

McChesney is a retired Boeing worker who moved to the area three years ago to be near her children. She lives on Social Security and retirement income that totals $18,535 a year.

"My biggest problem is being able to meet the monthly premiums," she said.

McChesney went to the Lloyd F. Moss Free Clinic in Fredericksburg last week to get help with her decision. The clinic had arranged with Hopson-Bell and a team of volunteers to meet with seniors about Part D. The counseling sessions were free.

McChesney met with volunteer Donya Currie. Together they looked at several Medicare plans, using the medicare.gov Web site.

McChesney does not use any medications regularly, and her drug bill so far this year is only $64. So she and Currie agreed that her best option was to pay the higher premium and stay with the Humana plan.

Mike Burleigh, on the other hand, learned that he could save money by switching plans.

Burleigh, 67, of Spotsylvania uses four medicines regularly and will pay $1,242 next year for his current Part D plan from Anthem.

With the help of another volunteer, he found a Community CCRx plan that provides the same coverage for $852 per year.

"That's a darn sight cheaper than what I'm paying now," Burleigh said.

He also found a plan from Rx America for his wife, Diane, who turned 65 in October. She plans to sign up for Medicare this month.

She takes six prescription drugs. If she chooses the Rx America plan, it will cost her about $4,800 per year.

"This has been extremely helpful," Burleigh said of the review session.

Hopson-Bell tells seniors to check their Part D plan each year to make sure its costs are still in line, and its drug formulary has not changed.

Part D is so confusing, she added, that it's tempting to sign up with a plan and just forget about it.

"People give up on trying to figure it out," she said, "and I'm talking really smart people."

Jim Hall: 540/374-5433
Email: jhall@freelancestar.com