DELPHOS — The Delphos Senior Citizens Center is hosting open enrollment for Medicare Part D. Now through Dec. 7, Medicare recipients can change their health plan. After that date, they will have to wait a year before changing coverage. In 2013, drug coverages, premiums and co-pays will change after the first of the year.
Outreach worker Alice Barnes Curth encourages all Medicare recipients to evaluate their health care plans.
“For example, coverage for insulin and heart medications may apply this year, but change the beginning of 2013,” Curth emphasized. “The difference between coverages may be $2,000-$3,000.”
Ohioans covered by Medicare who want to choose a 2013 plan have many options:
• 100 percent of the people with Medicare have access to a Medicare Advantage plan that does not charge a premium;
• 33 Medicare Pre-scription Drug Plans (PDPs) are available;
• 83 percent of people with Part D have access to a plan with a lower premium than in 2011;
• 30 percent of people with Medicare Part D get Extra Help (also called the low-income subsidy, or LIS);
• 16 PDPs have $0 deductibles;
• $15.10 is the lowest monthly premium for a prescription drug plan;
• $62.40 is the lowest monthly premium for a prescription drug plan with coverage for generic drugs in the coverage gap; and
• 8 PDPs have a premium of $0 for people who qualify for Extra Help.
When evaluating Part D Costs for 2013, there are a list of considerations:
• All plans have a different cost structure;
• Late enrollees may incur a 1-percent penalty for each month of delay;
• Those with limited incomes/resources may qualify for extra help (Limited Income Subsidy-LIS) through the Social Security Administration;
• Average Monthly Premiums - $30;
• Annual Deductible - $0-$325;
• Co-pays- 25 percent or flat co-pay amounts based on formulary;
• Coverage Gap (doughnut hole)- $2,970-$4,750 in total drug costs;
• Coverage Gap discounts: 52.5-percent discount on brand name medications and 21-percent discount on generic medications during the coverage gap;
• Discounts to increase each year until gap is closed in 2020; and
• Catastrophic Coverage - Approximately 5-percent co-pay after coverage gap.
For information or to make an appointment with Curth, call 419-692-1331. She is certified by the Ohio Senior Health Insurance Information Program (OSHIIP) to provide insurance counseling. If transportation is not available, seniors may call the center to schedule an in-home visit or transportation to and from the center to discuss plan coverages.
OSHIIP has been the state’s lead educational program for Medicare information and counseling since 1991. Contact the Medicare experts at the Department of Insurance at 1-800-686-1578 and also learn about OSHIIP’s many statewide outreach events at www.insurance.ohio.gov. Additional information about Medicare is available at www.medicare.gov and by calling 1-800-MEDICARE (1-800-633-4227).