Medicare lets people compare drug costs

As he does every autumn, Kay Kramer, 70, of Brooklyn Park, is reexamining his Medicare drug benefit options to see how much his costs will rise in the new year and decide whether to switch plans when open enrollment begins on Sunday.

But unlike previous years, a new Medicare online comparison tool indicates, the retired Honeywell factory worker is getting good news: His costs will drop by about $1,000.

In St. Paul, retired teacher Ann Johnson, 67, also is looking forward to next year, when prescription costs under her plan will drop by almost $400.

About to start its fifth year, Medicare Part D drug plans have sliced the cost of prescription drugs that many of the 17 million older and disabled beneficiaries used to pay before the benefit began in 2006.

Still, advocates say, many beneficiaries -- even Kramer and Johnson, with the unusual price cuts they'll get under their current plans -- could do better by switching insurers during open enrollment, which lasts through Dec. 31.

One study, by CVS Pharmacy, which offers its own competing drug plan, estimates beneficiaries on average could save $612 a year.

Typically, however, beneficiaries buy a drug plan and stick with it without comparing costs. Some find themselves in trouble later in the year when they hit the "doughnut hole," a $3,610 gap in coverage when they must pay full price for their drugs.

With no cost-of-living increase next year in Social Security payments, "we're concerned about this," said Jean Wood, executive director of the Minnesota Board on Aging. "Many people can do better" by switching plans.

The medicare.gov website offers the only tool to compare total estimated costs for a set of drugs under more than 100 private drug plans approved by Medicare for Minnesotans.

Many individuals or their families use that tool. So do government and nonprofit phone counselors who help beneficiaries consider their options.

The Board on Aging sponsors the Minnesota Senior LinkAge Line, a statewide information, counseling and referral service that last year helped about 85,000 Minnesotans compare and buy drug plans. It also arranged in-home counseling for about 13,000 more who needed extra help.

Lower projected costs for next year appear somewhat unusual, said LinkAge Line officials, who already have begun helping beneficiaries sort through their choices for 2010.

In Johnson's case, her AARP Medicare Rx Saver costs will drop to $1,572 for her eight prescriptions. Her premiums and deductible will rise, but her savings will come primarily because the plan is moving the estrogen drug Prempro to a lower-cost tier of drugs.

"Drug costs are something you worry about, so this is pretty good," she said. "Of course, at my age, I may need some more expensive drugs, and that will push my costs back up again."

She could cut $250 more from her costs by switching to a different drugs-only plan, First Health Part D Secure, "but I know AARP," she said. "I'd rather stay with people I know."

Kramer's 13 prescriptions cost him about $4,340 this year under his HealthPartners Freedom Plan II enhanced Rx. Next year, that will drop to about $3,340.

"I guess that's a good thing," Kramer said. "I'll have some new drug costs next year because I was diagnosed with pancreatic cancer." He just finished radiation treatment and soon will start chemotherapy.

Kramer could cut costs another $450 if he switched back to a UCare plan in which he was enrolled a few years ago.

"But I'm sticking with HealthPartners," he said. The Medicare Advantage plan covers both his drugs and his medical care. "They've been very good on medical coverage, and I have a lot of issues -- emphysema, epilepsy, migraines. Plus this is the only plan that covers all their drugs in the doughnut hole, and I like that."

The "doughnut hole" clicks in when the total outlay by the client and drug plan hits $2,830. The beneficiary pays all costs until the total hits $6,440. After that, the insurance plan pays about 95 percent of the costs. Some plans cover generic drugs in the gap; most don't offer any help.

At the Senior LinkAge Line, the calls about the Medicare drug benefit are picking up.

"We had close to 7,600 Medicare calls last month, and we know it will increase a lot after [Sunday], when people can actually enroll," Wood said.

"Right now we have no backlog, but call sooner rather than later," she advised. "Pretty soon, it's going to get very intense."

Warren Wolfe • 612-673-7253