published Saturday, January 9th, 2010

Phillips: Medicare Part D poses dilemma


by Ellen Phillips

Q: I start Social Security benefits this spring, and I'm pretty frantic about what to choose for Medicare Part D, especially with all the hoopla about insurance plans. Is this a topic you can help me with? -- Dave Dither

A: Dear Mr. Dither: Quite frankly, I'm almost as much at a loss as you. However, investigating the Part D dilemma, I came upon pretty much identical solutions -- at least generally -- which I'll offer for your scrutiny. Part D plans vary enormously from state to state. Please check out all your options thoroughly before making a decision that affects both your physical and financial health.

* Which plan covers the drugs you must take? Just as with "regular" insurance, plans can drop or add drugs each year, especially if no generic medication is available. Perhaps you need a visit soon with your prescribing doctor(s) to switch prescriptions away from brand names.

* What about affordability? Even though we're assured specific Medicare rates won't soar, we know for sure Social Security cost of living is frozen for 2010. Because Part D enrollment may rise to as much as 6 percent to 47 percent a month, it's essential enrollees be able to afford their meds and groceries.

* Will prescription copays escalate? I know this is an area my husband and I will look at carefully when time to do so, as a couple of our monthly 'scripts total as much as $50-$70 out of pocket. Be sure you understand where each prescription falls within the "tier" categories; for example, least expensive generics ("preferred") cost less than all other drugs, and the most expensive brands ("nonpreferred") cost the most. Plus, we all need to watch out for a 2010 trend: a switcheroo from traditionally-fixed copays for a prescription drug to a percentage of the actual drug cost. Ouch!

* So is Medigap coverage necessary? This so-called "doughnut hole" forces millions of elderly patients with especially high medicine expenses to pay for much of it on their own. According to statistics, 80 percent of standalone plans won't offer doughnut hole coverage in 2010. Of the remaining 20 percent, almost all coverage entails generics only and usually for a higher premium. To try to avoid an ever-widening hole, please seek out the services of a knowledgeable professional to help you decide which plan benefits you the most.

A correction

Please forgive my mistakes in last week's column and many thanks to a sharp-eyed reader who brought them to my attention. My first paragraph answering Thelma Taxwise's question about new vehicle deductions should have read "Uncle Sam takes many taxpayers' interests to heart for their 2009 returns." Also, in the final paragraph: "On the other hand, if you itemize and deduct your state sales tax ..." should have declared "your state income tax" (And, no, I didn't have any New Year's Eve bubbly while researching this question).

Ellen Phillips is a retired English teacher who has written two consumer-oriented books. Her Consumer Watch column appears on Saturdays in the Business section of the paper. An expanded version is at www.timesfreepress.com under Local Business. E-mail her at consumerwatch@timesfreepress.com.

about Ellen Phillips...

Ellen Phillips is a retired English teacher who has written two consumer-oriented books. Her Consumer Watch column appears on Saturdays in the Business section of the paper. An expanded version is at www.timesfreepress.com under Local Business.

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