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The Honolulu Advertiser
Posted on: Tuesday, December 26, 2006

Medicare enrollment deadline: Six days

StoryChat: Comment on this story

By Christie Wilson
Advertiser Neighbor Island Editor

COVERAGE, COST, CONVENIENCE

When considering different prescription drug plans, the Medicare Rx Access Network of Hawai'i suggests that you know your "Three C's":

Coverage: Does the plan cover your medicines? Does the plan have a coverage gap? Will you be needing more comprehensive coverage in 2007?

Cost: What is a plan's monthly premium? Does the plan have a deductible? How does the plan handle co-payments?

Convenience: Is your local pharmacy in the plan's network? Does the plan have a mail-order option?

For comparisons, see the prescription drug plan finder for Hawai'i on the Medicare Web site at www.Medicare.gov.

Enrollment and plan changes can be completed through midnight Sunday, Hawai'i time, by calling (800) 633-4227 or visiting the Medicare Web site.

For more information, call (800) 633-4227) or Sage PLUS at (888) 875-9229.

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Seniors who want to participate in the Medicare Part D prescription drug program have until Sunday to enroll or possibly face higher prices.

Medicare beneficiaries who already are enrolled and are satisfied with their Part D plan don't have to do anything, but those who want to sign up for the first time or change their current drug coverage must do so by the end-of-the-year deadline. The next enrollment period doesn't begin until Nov. 15, and officials warn that premiums and drug prices could rise by then.

Tony Fisher of Kihei said he didn't need any convincing to join the Medicare Part D program during last year's enrollment campaign. Even though he's healthy and vigorous at age 73 and takes few prescription medicines, Fisher sees the federal drug benefit as an insurance policy against unexpected costs in the event of a serious illness, just as consumers buy insurance protection for their autos and homes.

"This is the same thing. It's just a matter of having this coverage if there is a catastrophic illness," he said. "I'm a great fan of it."

Fisher and his wife pay a total of $40 per month in premiums for Part D coverage, and Fisher estimates they saved about $100 in drug costs over the first year.

Medicare already was covering hospitalization and doctor visits for the elderly and disabled when the prescription drug benefit was started in January to provide its 43 million beneficiaries with savings on their prescription medicines. Participants pay a monthly premium and have an annual deductible, and Medicare pays for part of their prescriptions.

Statewide, an estimated 184,000 seniors or people with disabilities or chronic disease are eligible for Medicare Part D. As of June, 172,000 of these eligible participants or 93.5 percent had some type of prescription drug coverage, said Medicare spokesman Jack Cheevers in San Francisco.

Those who rely solely on Medicare Part D number about 11,000, he said. Others who get the coverage include 53,000 participants in Medicare Advantage plans that include HMOs, 25,000 who are dual Medicare/Medicaid beneficiaries and 33,000 who work for employers that receive Part D subsidies to continue drug coverage.

Officials do not know how many Hawai'i residents have signed up during the current enrollment period that ends Sunday, but nationally, 240,000 have enrolled just online since Nov. 15, Cheevers said.

Anyone with Medicare is eligible for the coverage, regardless of income and resources, health status or current prescription expenses. Low-income participants may be eligible for help with paying some or all of the monthly premium, the deductible and most of the cost of prescriptions.

Pamela Cunningham of the Sage PLUS program in the state Executive Office on Aging said more health plans and drug coverage options are available in Hawai'i for 2007, and that's why officials are urging Medicare Part D participants to review their plans.

"A lot of people are happy with their plans but you should still review the plan you have and compare it to what's available now," she said. "You may be able to find something that works better for you this go-round or you may find that your plan is fine as it is."

A federal report said participants in poor health with common chronic conditions will see far greater savings in their prescription drug costs in the next year.

Many of the seniors who did not sign up for 2006 coverage weren't taking a lot of medications and didn't feel they needed additional drug benefits, Cunningham said. This time around, she said, those folks have realized that Medicare Part D coverage is a good thing to have, just in case. And the premiums can be as low as $10.80 per month for someone who isn't taking prescription drugs.

"We have reached quite a few who didn't sign up. Some people weren't taking any medication and it just wasn't a priority for them, but now they are looking at it as a piece of insurance, and if they don't sign up now, the next opportunity won't be until next Nov. 15, a year away," she said.

Cunningham conducted a final series of enrollment events last week to publicize the approaching deadline. She said there hasn't been a great rush to enroll or make changes before the end of the year. Only five people signed up during an event at the KTA Super Store in Hilo, Hawai'i, she said.

"Many folks we have talked to plan to continue in their plans. There's still a little bit of confusion, but I think people saw the necessity of it and are happy with it. If their plans are working, they don't want to mess with it," she said.

Reach Christie Wilson at cwilson@honoluluadvertiser.com.