Medicare Part D

MEDICARE PART D

Starting Thursday, Minnesota's 740,000 Medicare beneficiaries may start comparing prices and coverage of more than 100 competing Medicare Part D drug plans available for 2008.

They may use Medicare's plan-comparison tool at www.medicare.gov, or call counselors at Medicare, the Minnesota LinkAge Line or other agencies offering help.

HOW PLANS WORK

• Any Medicare beneficiary may enroll in the drug program.

• There are three types of plans: Drugs only, "special needs" plans for people on both Medicare and Medicaid, and Medicare Advantage plans combining Medicare health and drug coverage.

• Enrollees typically pay the first $275 in annual costs, then 25 percent of each drug's price until the total paid by the recipient and the plan hits $2,510. Then the recipient pays all costs until total hits $5,726 -- a gap often called the "doughnut hole." After that, the recipient typically pays 5 percent of a drug's cost.

• Plans costs and drug coverage vary widely. Some have no deductible, and some offer coverage in the doughnut hole, most only for generic drugs.

CHANGES FOR 2008

• Drugs-only plans: 52 plans (down from 53 this year) available in each county; four new plans, five dropped from 2007.

• Average premiums. They will rise about $4.70, or 12 percent, to $41.35. Gap coverage offered by 16 plans (15 this year), each covering only generics; in 2007, one covered all formulary drugs.

• Special needs plans: 16 plans (13 this year). Managed care plans combining drug and health coverage for people on Medicare and Medicaid. Three plans are targeted at disabled people younger than 65. Those enrolled have very low co-pays, with no deductible, monthly premiums or gap in coverage, but drugs covered vary among plans.

• Medicare Advantage plans: 56 plans combining Medicare health and drug coverage; premiums $0 to $271, with a wide range of coverage and costs. Plans include HMOs, preferred-provider networks and other types. Not all plans available in each county.

Gap coverage by 15 plans, including eight covering all generics and three covering all drugs.

LOW-INCOME SUBSIDY

• People on Medicare with low incomes may qualify for a subsidy that cuts costs sharply. With the full subsidy, recipients pay no monthly premium or deductible and receive drugs for as little as $1.05 for generics and $3.10 for brand-name drugs.

• To qualify, a beneficiary must have income below $15,315 ($20,535 for a couple), and savings below $11,710 (or $23,410 for a couple).

IMPORTANT DATES

• Oct. 11: Medicare is scheduled to put up a plan-finder tool on its website, allowing people to compare costs and coverage among plans.

• Nov. 15-Dec. 31: Open enrollment. Any beneficiary may join or change plans.

WHERE TO GET HELP

• Counselors can offer general information now. Starting Thursday, they can help people compare plans and enroll.

• Minnesota LinkAge Line: 1-800-333-2433, 8 a.m.- 4:30 p.m. weekdays. Counselors also can help people apply for the low-income subsidy.

• Medicare: 1-800-633-4227 (TTY/TDD 1-877-486-2048) 24 hours a day, or go to www.medicare.gov.

• Disability Linkage Line: 1-866-333-2466, 8:30 a.m.-5 p.m. weekdays.

• Minnesota Senior Federation: 651-783-5045 or 1-866-783-5045, 10 a.m.-noon, 1-3 p.m. weekdays.

WARREN WOLFE