THIS COLUMN IS going to be about Medicare.
If you are relatively new to Medicare or teetering on the brink thereof, it might be genuinely helpful to you.
If you’re an “old hand” at this Medicare stuff, you probably know this already, but you could use your time productively by vowing to assail your friends (who think they’re old hands at Medicare but really aren’t) with this same information.
Ready?
It’s almost Oct. 15 (no, there’s more to this than that).
Time for changes
On Planet Medicare, we care deeply about Oct. 15 because it signals the beginning of what most of us politely refer to as “Part D open enrollment,” which will extend through Dec. 7, the symbolism of which has not been wasted on many of us.
Let’s back up: Medicare Part D is the prescription drug coverage part of Medicare.
Now, it’s true that some folks on Medicare get their prescription drug coverage through a Part C managed care plan, but because there aren’t many of those available in our neck of the woods, I’m going to ignore it for now (and remember, you can always call any of the numbers at the end of this column, and decent people will help you — for free — without trying to sell you anything).
Most of us Medicare types have Part A (think hospital), Part B (think doctor) and, if affordable, a Medicare supplement plan (aka MediGap, MedSupp, etc.) that picks up all or part of what Medicare doesn’t pay.
Prescription drugs
We also have a separate Part D plan that covers only prescription drugs.
We did this because a) we wanted the prescription drug coverage and b) we didn’t want to incur the penalty that comes with not doing it.
Different Part D plans have different premiums, different out-of-pockets (deductibles, etc.) and cover, in some cases, different drugs.
If you’re a recent newbie, you probably signed up for a Part D plan, and now, just a few months later, this guy in the paper is telling you to worry about it again.
Whassup?
Part D open enrollment is the one time per year (unless you move or do something equally dramatic) that you are allowed to change from one Part D plan to another.
“But I just did this,” you mourn. “Why do I have to do it again?”
Don’t have to change
You don’t. But you might want to, and here’s why: Every year, Part D plan premiums can (and often do) change.
Similarly, their associated out-of-pocket costs can change.
But here’s the one that is often the most important to many of us: The drugs on any plan’s “formulary” (i.e., the list of drugs the plan actually covers) can change, so think about those three things.
Potentially, the Part D plan that was just swell for you six months ago might not be so swell come January 2018.
Hmm …
Now, if you do absolutely nothing, nothing will change.
Thus your current Part D plan will continue into 2018, which might be fine.
But if you discover along about March that your plan stopped covering the drug you need, too bad.
Because there’s nothing you can do about it until Oct. 15 to Dec. 7, 2018, and that change won’t take effect until Jan. 1, 2019.
Ouch.
I know: Lots of us have headaches.
So, what do you do if you want to do something?
Well, first remember that if you get lost, overwhelmed or terminally disoriented, you can call any of the numbers at the end of this column for help — free, no sales.
But if you’re reasonably comfortable navigating websites (and you don’t wait until 10 p.m. Dec. 6), you can go to http://tinyurl.com/PDN-Medicare-PartD and learn a whole lot real quick.
The preferred approach is to have a friendly beverage readily available so you can just take your time and cruise the site.
It’s really pretty well done and answers a lot of questions.
When you think you might be ready to actually jump in, click on “Find Health & Drug Plans,” which is what many of us call the “Plan Finder.”
It will ask you some questions, such as where you live, what drugs you take, etc., then, based on what you told it, it will give you what appear to be your top few, best plan choices and you can start comparing.
When you decide, I suggest that you call the plan’s company directly to enroll.
That’s it.
Face-to-face help
No? You’d like some help face to face with a real, live (smart) person?
OK, as of Oct. 15 through Dec. 7, help can be found at:
• Port Townsend Community Center, 620 Tyler St., from noon to 3 p.m. the first and third Tuesdays each month.
• Tri-Area Community Center, 10 West Valley Road in Chimacum, from 9:30 a.m. to 12:30 p.m. the second and fourth Tuesdays each month.
• Quilcene Community Center, 294952 U.S. Highway 101, 10 a.m. to 1 p.m. the fourth Wednesday each month.
• Sequim Senior Center (aka Shipley Center), 921 E. Hammond St., from 9 a.m. to noon every Tuesday.
• Port Angeles Senior & Community Center, 328 E. Seventh St., from 9 a.m. to 1 p.m. every Friday.
• Forks “Information & Assistance” office, 481 Fifth Ave., during regular business hours, 360-374-9496.
It’s possible that you could go through this exercise and discover that the plan you have is still your best bet.
Yes, you could have avoided this had you carefully scrutinized the mailing you got from your current plan’s company informing you of upcoming plan changes.
That would be a good idea.
Most of us don’t, because most of us aren’t exactly strangers to not doing things that we should do, but you’ll decide that for yourself.
The real point here is to remind all of us who live on Planet Medicare that something (potentially) relevant is about to occur, but if you choose to do nothing, please proceed, remembering that “trick-or-treat” might happen for you on New Year’s Day.
________
Mark Harvey is director of Clallam/Jefferson Senior Information & Assistance, which operates through the Olympic Area Agency on Aging. He is also a member of the Community Advocates for Rural Elders partnership. He can be reached at 360-452-3221 (Port Angeles-Sequim), 360-385-2552 (Jefferson County) or 360-374-9496 (West End), or by emailing harvemb@dshs.wa.gov.
