YOU�VE PROBABLY DEVOTED far too
much time over the past few months
trying to sort out Medicare�s new Part D
prescription-drug benefit. Think of it as
carefully plotting, scheming and cajoling to get tickets
for the opening of a long-awaited Broadway show.
Now, the curtain is rising�25 months after a controversial
three-hour vote in the House of Representatives
to okay the biggest expansion of Medicare
benefits since the program was created four decades
ago. So it�s time to shift your thinking from �How in
the heck do I choose a plan?� to �How in the heck
does my drug plan really work?�We�ve asked an array of experts�Medicare officials,
insurance- and drug-industry sources, consumer
advocates, and providers�for answers to questions
you�ll likely be asking in the weeks ahead. First off,
two trends retirees will see in the months ahead:
Second-guessing. �A lot of beneficiaries lured into a
PDP [prescription-drug plan] by promises of low
premiums may be shocked the first time they go to
the pharmacy and have a high co-payment,� says
John Gorman, a former Medicare official who now
runs Gorman Health Group. Whether you�ve fallen
into such a trap or discover other shortfalls with your
plan, most beneficiaries get a free do-over, the opportunity
to switch plans one time before May 15.
Remain flexible. �There�s no doubt this market will
be radically different at the end of 2006 than it is
now,� says Robert Hayes, president of the Medicare
Rights Center. Some plans are likely to flee; others
will change their pricing and benefits structure.
Meanwhile, Congress could make changes the program.
The result: There�s a good chance you�ll need
to reexamine your options later this year.
A Quick Part D Recap
Medicare�s voluntary Part D prescription-drug benefit
started January 1. Beneficiaries with coverage considered
to be as good as or better than the new Part D
benefit�either through a former employer, union or
other means�should not enroll in Part D. All other
beneficiaries probably should. Most retirees have
until May 15 to do so. Failing to enroll in Part D by
that time will trigger a 1% premium penalty for each
month you dally. The program requires you to spend
$3,600 out of pocket before you hit so-called catastrophic
coverage, with Medicare paying 95% of subsequent
drug costs. Now, answers to the questions
that are bedeviling beneficiaries.
