Q:  “Do you believe Part D is a good choice for Medicare beneficiaries?  I don’t like my plan.  Can I transfer back to Medicare in November?  Now I’m enrolled in a Medicare Advantage plan.

A:  Based on the cases that I’ve worked with, for most beneficiaries who used the Medicare Drug Plan Finder to compare and select plans, Medicare Part D can save significant amounts of money.  But even if you don’t use a single prescription today, remember, Part D is insurance.  The cost of prescriptions can be financially devastating should you suddenly develop a serious health condition.  In addition, should you drop out of Part D now, then later change your mind and wish to re-enroll, you would have to pay a stiff late enrollment penalty.  That penalty would drive up the cost of your Part D premiums, by 12% per year for the period in which you are not enrolled in Part D.

It is quite likely, however, that you could find a much better deal on your supplemental and prescription drug coverage.  This is especially true if you get trained, unbiased help, and use the Medicare Drug Plan Finder to select the most appropriate drug and supplemental health plan for your situation.  Without both, it’s virtually impossible to make an informed decision about your coverage, and you could just go from bad to worse.

Medicare beneficiaries can switch Part D drug plans during the Open Enrollment Period from November 15 through December 31, 2006.  But be careful when you do.  If you don’t fully understand how the plan that you are already in works, as well as Medicare’s confusing rules, you may inadvertently lose your drug or other health coverage when you try to change.  If things go wrong, you could lose coverage, get billed inappropriately, or be penalized with Medicare Part D late enrollment penalties later.

Medicare Advantage plans offer coverage for all Medicare Part A and Part B hospital and doctors’ services, and you need no other Medigap or supplemental policy.  Some Medicare Advantage plans also offer coverage for Part D drug benefits. 

Should you wish to transfer back to Original Medicare, in order not to lose your Part D coverage, and be penalized if you enroll later, you will need to shop for two plans — a Medigap policy, and a Part D prescription drug plan.  There are standard Medigap policies to choose from, but the premiums in each category of coverage can vary widely.  You are likely to have dozens of Part D prescription drug plans to choose from whose coverage and costs also vary significantly.  In addition, should you receive your current coverage through a former employer, special rules may apply to you, since you are in a Medicare Advantage Plan. 

Your situation raises plenty of red flags, don’t try to make the switch alone!  I strongly recommend that you get one-on-one help from a trained Medicare benefits counselor through your State Health Insurance Assistance Program.  Many local Area Agencies on Aging provide this assistance at no charge.  You can find the number in your local phone book.

November 2006