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Medicare Part D drug changes to begin in October

Published: Wednesday, Sept. 21, 2011 11:33 a.m. CST

Several important changes relating to Medicare Part D prescription drug coverage will start taking place this October.

Most important are the new dates for the Part D “Open Enrollment Period.” The new dates are Oct. 15 through Dec. 7. This is the time when individuals can change Part D plans for 2012, enroll in a Part D plan or drop coverage. Choices made during the open enrollment will go into effect Jan. 1, 2012.

“This is a change from past years when the open enrollment was November 15 through December 31,” said Kris Gross from the state of Iowa’s Senior Health Insurance Information Program (SHIIP). “We’re asking everyone to remind family, friends and neighbors that the dates for changing have moved up a month. We don’t want anyone to miss the opportunity to make their choice of plans for 2012.”

Plans can change their coverage and costs from year to year so comparing plans during the open enrollment is critical.

The “Annual Notice of Change,” sent out by plans to explain formulary (drugs covered), benefits and cost changes for 2012 is due in mailboxes Sept. 30. “Notice of Creditable Coverage” are also due Sept. 30. This is a notice from employer/union and other group health plans which tell Medicare eligible enrollees if their drug coverage will be “as good as or better than Medicare’s coverage” in 2012.

The 2012 Medicare drug plans will be available at www.medicare.gov on Oct. 1. Plans not renewing their contract with Medicare for 2012 must notify their members by Oct. 2.

Two other important changes are coming to Part D next year. The “doughnut hole” or “coverage gap” will continue to close. Once again you will pay 50 percent for brand name drugs covered by the plan, but your cost for generic drugs will be reduced from 93 percent to 86 percent. Each year these costs will drop until the doughnut hole is closed.

Currently, anyone in a nursing home on Medicaid and Medicare does not pay anything for drugs covered by their Part D plan. In 2012, the same will be true for individuals who qualify for the Medicaid Elderly Waiver Program.

If you have questions about Medicare Part D contact SHIIP, a free, confidential service of the state of Iowa at (641) 791-4899.