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5 Questions: Enrollment time

By Staff Report - | Oct 19, 2011

The open-enrollment period for Medicare Prescription Drug Plan and Medicare Advantage plans began Oct. 15 and ends Dec. 7. The Kansas Insurance Department answers questions below about the plans.

Q: What are Medicare Prescription Drug Plans (PDPs)?

A: In 2003, the federal government enacted a Medicare prescription drug coverage benefit for Medicare beneficiaries. Private insurance companies, whose plans have been approved by Medicare, sell Medicare PDPs.

Q: What if I am already enrolled in a Medicare PDP?

A: Plans might change from year to year. Therefore, you should carefully examine all available plans during each open-enrollment season, as you may find that your current plan no longer best meets your needs. Be sure to check the features of your plan, including the list of drugs covered and the amount of premium you pay. If you take no action, you will remain in your current plan.

Q: What if I am enrolled in a Medicare Advantage Plan with prescription drug coverage?

A: Medicare Advantage Plans might also make changes to important features of your plan from year to year. Your plan options should be carefully reviewed during each open enrollment season.

Q: What are my options if I want to enroll in a Medicare PDP?

A: You can enroll in a stand-alone prescription drug plan (Medicare Part D) or you can choose a Medicare Advantage plan (Medicare Part C) that includes the new drug benefit. You will want to compare plans and select the one that best meets your needs. Here are a few things to check:

• See if all of your prescriptions are on the plan’s list of drugs (or formulary).

• Check to see that your pharmacy participated with the plan.

• Find out what co-payments you will be responsible for when filling a prescription.

• Is the premium for your preferred plan affordable?

• Check the Medicare.gov “Finding Plans” section on the Internet.

Q: What if I am eligible but wait to enroll?

A: If you do not enroll at your first opportunity, you may be subject to penalties. These penalties are generally 1 percent per month for every month you delay enrollment. There is no limit on the penalty, so the longer you wait, the higher the premium you will pay.