Opinion

Only a few days are left

Wednesday, December 12, 2007

Whether you are talking about the number of days left for shopping before Christmas, the number of days left in 2007, or the Open Enrollment Period for Plan D and Medicare Advantage Private Fee For Service, there are not many left.

The conception of times changes as a person has more years behind them. As a child, it seemed that Christmas would never arrive. Now, it seems like that we only got over last Christmas and it is about to arrive once again.

It is realized that most readers are not on Medicare; still others need to be aware of what the Medicare Beneficiaries are facing. This is especially true if you have parents on Medicare. For others, there are only a few years left before going on Medicare. In a sense it is a major element of our society.

Once a year during the Open Enrollment Period from Nov. 15 to Dec. 31 those with Part A and/or Part B may enroll in a Medicare Part D Prescription Plan or change plans. That period now nears the two thirds mark, with only one third of the period left.

If a person is eligible to sign up and does not have another prescription plan there is a penalty of one percent per month when they do decide to sign up. This may not sound like much, but it accumulates and that penalty has to be paid for life. The exception is for those who have their premium subsidized. It is recommended that each one enrolling in Part D to apply at the Social Security Office to determine they might qualify for a subsidy.

There are those who become eligible for Plan D and do not have any other coverage, yet they are not taking any prescriptions. These people are faced with a decision of either taking out a plan and avoiding paying out a premium later or not enrolling into a plan. There may not be any right answer on this one. If you could determine the future, then a person would know which the proper thing to do is.

One lady wrote a letter to the editor in the Kansas City Star. She had paid premiums for two years and had not had any claims above her annual deductible. Her opinion was that she had wasted her money during these two years. She was dropping her Plan D -- which is a choice she has.

That is similar to having car insurance or any other insurance plan. I have not had any claims on my car insurance for the past two years, so that was a waste of money and I would have been financially ahead by not having the insurance. But, what if …? The insurance is a protection.

I heard about one lady who did not take out a Plan D two years ago because she was not taking any prescriptions. About two or three months later, she had major prescription bills.

When setting up the Plan D, the idea was that there would be healthy members that would be paying the premium and having little or no prescriptions. These members help to keep the cost down and the premium down. Thus, that is the reason for the penalties when Plan D is not taken at eligibility, to offset those lower premiums that were never paid.

As I have stated previously, most on Plan D are saving approximately 50 percent on their prescriptions compared to not having the plan. Saving this amount on the prescriptions is also true for those going into the doughnut hole, which less than 10 percent reaches. About 70 percent are pleased with the Plan D, more than originally expected. Still, there are many eligible to sign up for Part D has elected not to sign up. The experts have recommended that most people are advised not to take the plans that have coverage during the doughnut hole, because of the higher premiums. Some will invest in the higher premium and never reach that stage and need the coverage during the doughnut hole.

One of the leading companies's had a low premium plan in comparison to others. The premium for that plan has been raised significantly and is now higher than the premiums of another plan. The best plan to have is the one that has the best formula for the medications being taken.

The Plan D enrolled in on Dec. 31 has to be taken and plan participants cannot take names off the roll until the Open Enrollment Period at the end of 2008. The experts have suggested that for most people there are some good Medicare private fee-for-services plans that are available during this Open Enrollment Period. Those enrolled on the average saves $1,000 a year. It is not advantageous for everyone to enroll in one of these plans. Still, others may find it beneficial and may want to give it consideration.

There are plans that are Specific Need Plans. They are similar to the PFFS plans but are designed for a specific chronic condition such as diabetes.

The clock is ticking. Do not wait until New Year's Eve to make a decision. It may not get to the company on time. Give it thought and make sure you are enrolled in the best plan for your situation. Younger people can help counsel those who are involved as well.