December 2010— www.sunlakessplash.com
CLASSIFIEDS 107 Medicare Prescription Drug Coverage Your guide to what’s new and what to
do for 2011 (Family Features) Whether you’re
approaching age 65 or already enrolled in Medicare, the annual enrollment period for 2011’s Medicare plans is an important time. When it
comes to prescription
coverage, seniors are seeing some of the biggest changes since the Medicare prescription benefi t became available in 2006.
The changes — from having fewer
options to premium increases to new discounts on brand-name drugs — are enough to make anyone’s head spin. But, seniors who don’t take the time to research their options and choose the plan that best suits their needs could leave hundreds of dollars in annual premium savings on the table. In fact, according to a recent study by
the Robert Wood Johnson Foundation, only about 10 percent of participants change plans annually. Staying put and not investigating your options, however, could impact your overall costs. But how do you know if you have the best plan already or if you should consider a different plan? Luckily, there are a few tools that can help with
the decision-making process. But
fi rst, let’s start with the basics and what is changing this year.
Access to private plans Benefi ciaries have access to the
Medicare drug benefi t, known as Part D, through private plans approved by the federal government, either through stand- alone prescription drug plans (PDPs) or Medicare Advantage prescription drug plans (MA-PDs). According to a Kaiser Family Foundation study in October 2010, of those who purchase Part D coverage, 38 percent, or 17.7 million benefi ciaries, opt for stand-alone plans. Twenty-four percent, or 11.1 million, are enrolled in Medicare Advantage plans.
Plan options in 2011 While shopping around could save
many seniors money, some benefi ciaries have no option other than to fi nd a new plan for next year. For 2011, the federal government directed insurers to eliminate duplicative Part D prescription drug plans and plans with low enrollment. That means a third fewer prescription drug plans will be offered nationwide next year compared to 2010, according to the Kaiser Family Foundation, and many of the remaining options may come with higher premiums. And with
the federal government
changing the way it reimburses health plans through Medicare Advantage, some insurers have quit offering their Medicare Advantage plans for next year. If your plan
How to compare plans Each plan has different features and
each person has unique prescription needs so it’s important to fi nd the plan that is best for you. Here are some things to keep in mind: Cost and coverage: Plans vary in the
coverage offered and how much they cost. Consider the cost of premiums and whether it includes prescription coverage while in the gap. Pharmacy: Some plans restrict where
you can use your drug plan. Determine whether your
desired pharmacy is
included in the plan you choose. For example, new this year are some plans whose monthly premiums fall well below the average price for Part D policies. However, these lower-cost plans come with some restrictions. The copays and coinsurance for prescription drugs are lowest when using preferred pharmacies; they increase for outside pharmacies. Formulary changes: Insurers may
change drug formularies each year. Make sure you enroll in a Part D plan that covers your medications. Other limitations: In some cases, a plan
may limit the circumstances under which a drug is covered. Certain medications may only be covered after prior authorization, after you’ve tried other drugs through a process called step therapy, or in certain doses and quantities. Comparing plans can be overwhelming,
but there are easy-to-use online tools such as www.PlanPrescriber.com
CMGA ________________________________ - continued from page 87 Results of Ace of Aces Qualifier on
November 6 First flight - Low gross: Paul Brauer.
Low Net: 1st Larry Mullins, 2nd (tie) Dennis
Bockelman and Brad Reis.
Second flight - Low gross: Dave Tjosvold. Low net: 1st Roger Hargus, 2nd (tie) Gene Wenger and Ron Olsen. Third flight - Low gross: Bill Irwin. Low net: 1st George Papaioannou, 2nd Carl
is no longer being offered, you may need to fi nd alternative coverage. Enrollment periods Benefi ciaries have a six-week annual
enrollment period — from Nov. 15 to Dec. 31 — to pick a Part D plan for 2011. For Medicare Advantage enrollees, it is especially important to pick the right plan during that period. Unlike previous years, people enrolled in Medicare Advantage plans can no longer switch to other Medicare Advantage plans during January, February and March. However, while this “open enrollment period” will not be available in 2011, after Jan. 1, enrollees can still leave their Advantage plan and go back to original Medicare.
“Doughnut hole” relief Here’s some good news: there is a new
50 percent discount on the formulary’s brand-name drugs for those who land in the program’s coverage gap, also called the “doughnut hole.” In addition, plans will pay 7 percent of the cost for generic drugs in the gap. This applies to drugs that are on the plan’s formulary. If they aren’t on the formulary there may be no discount, so make sure you check.
take you through a four step process to narrow down your options and identify the most cost-effective plan. If you have a low income and struggle to pay for your prescription drugs, you may qualify for the Extra Help/Low-Income Subsidy (LIS) program. For more information, go
medicare-part-d/extra-help/ or https:// secure.ssa.gov/apps6z/i1020/main.html
. For additional resources on Medicare, go to Medicare.gov
. Though it may seem overwhelming taking the time to research your
at fi rst,
best option for Medicare prescription drug coverage could really pay off.
How to maximize your cost savings In 2011, there are lots of changes on
tap when it comes to Medicare Advantage and prescription drug plans. But open enrollment is a great time to review your coverage. These DOs and DON’Ts can help ensure you are maximizing your cost savings. DO check to ensure your medications
are still covered. Check your prescription drug plan each year because insurers may change which medications are covered. You can enter your medications on websites like www.PlanPrescriber.com
to see which drugs are covered and compare the projected costs with other plans. DO pay attention to the drug limitations
in your plan. Even if your medication is on the formulary, a plan may limit the circumstances under which a drug is covered. They may only be covered after prior authorization, after you’ve tried other drugs through a process called step therapy, or in certain doses and quantities. DO consider all your options. Medicare
supplemental plans, or Medigap, have their own six-month open enrollment period, beginning the day you turn 65 and are enrolled in Medicare Part B. The enrollment period for Medicare Advantage and stand-alone prescription drug plans is Nov. 15 to Dec. 31 2010. DON’T go on auto-pilot. Many plans
change cost and drug coverage annually. What worked last year for you could cost you more money this year in terms of higher prescription drug costs and other out-of-pocket expenses. DON’T be afraid to ask for help from
qualifi ed professionals. You can get help through your State Health Insurance Assistance Program (SHIP), PlanPrescriber, licensed health insurance agents who are certifi ed to sell Medicare, family members or by calling 1-800-Medicare. DON’T think that
= stable coverage. Just because your premiums haven’t gone up doesn’t mean that you are getting the same plan for the same price next year.
PARTY __________ - continued from page 91
Armstrong, 3rd Chuck Bakeman. Fourth flight - Low gross: Bob Pippitt. Low net: 1st Michael Peterson, 2nd Beryl Willits, 3rd John Bell. A reminder concerning membership
renewals. Renewals were due November 1 with a final deadline of December 31. Thanks to a temporary cut in the dues to AGA, dues paid by December 15 will be $55. After the 15th they will be $65.
TOYS _________________________________ - continued from page 91
this all year. For many of these little children this will be the only gift they receive,” says Shirley Shalett who brought the idea of Toys From The Heart to Sun Lakes when she moved here from the East Coast 11 years ago. Supporters are welcome to attend the gift distribution at the Frye Elementary School. Call co-chairs Shirley at 883-9159, Marilyn at 895-7750, Trudie at 883-7749, or Denise at 895-8665 to join the group. There is another benefi t to this charitable
effort. Certainly the children understand that these gifts are not coming from Santa Claus. Most of them probably don’t know where they are coming from. But they do know that someone out there cares about them enough to make their holiday just a little more special. Donations can be mailed to Phyllis at 3495
E. County Down Drive, Chandler, AZ 85249. Make your check payable to SLJC Sisterhood and memo it Toys From The Heart.
SUN LAKES SPLASH
at Oakwood. Sun Lakes Jewish Congregation
Sisterhood channels all its fundraising projects to community outreach and charity. On the morning of December 8 members will bring wrapped holiday gifts to the kindergarten kids at the Frye Elementary School in Chandler. Organizing the visit are co-chairpersons Shirley Shalett, Marilyn Behr, Denise Ingel and Trudie Goldstein. Anyone who wants to join the crowd on that day should call 883-9159, 895-7750, 895-8665, or 883-7749. Anyone interested in joining Sisterhood
(dues are $25 a year) should call Ruth at 802-8901.
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