EagleTribune.com, North Andover, MA

October 29, 2012

Elder Q&A: Learning when and how to file for Medicare

Roseanne DiStefano Elder Q&A
The Eagle-Tribune

---- — Q: I will be celebrating my 65th birthday the middle of November. I am eligible for both Medicare A and B and have decided to enroll in a Medicare supplemental plan. I am still somewhat vague about the additional plan for prescription drugs. Do you have any tips for choosing the right Part D plan?

A: The annual open enrollment for Medicare Part D started Oct. 15 and continues until Dec. 7. You actually have a little flexibility in that you were eligible to enroll three months prior to your birthday and have an additional three months after your birthday to complete your decision. To provide sufficient coverage it would be to your advantage to go ahead and find a plan at this time.

In general it is important to remind other individuals if they do not sign up for a Part D plan when they first become eligible they would be subject to a late enrollment penalty if they do not have creditable coverage through another source. The penalty is applied to the monthly premium for the remainder of the time you are enrolled in a Part D plan...this is not a one time only penalty.

There are several things to consider when choosing a plan. The first point is to look for a plan that covers the drugs you are currently taking. It is impossible to predict what conditions may develop in the future and realistically your medications may change later on, but do the best you can by focusing on the here and now.

Next year you will once again have the opportunity to change plans if you require a different plan with a more comprehensive formulary (list of drugs covered). Also give some thought to whether the plan is accepted at a local pharmacy you frequent or if there is a mail order option.

Understandably the overall cost of the plan may impact your decision, take into account monthly premiums, yearly deductibles and co-payments if they apply.

For single individuals with an annual income of less than $15,324-$17,004 (partial to full assistance) or couples whose income does not exceed $20,676-$22,944 (partial to full assistance) they should determine if they are eligible for Extra Help to lower their out of pocket expenses (premiums, deductibles and co-pays). Call Social Security at 1-800-772-1213 to apply by phone or get a paper application.

Anyone who might find this experience a little confusing and can not find the information on their own there are resources to help them through the process. Certified SHINE Counselors are available to offer assistance (1-800-892-0890, Medicare customer service representatives can be found by calling 1-800-633-4227 or go on-line to www.medicare.gov/find-a-plan .

If you have a question or comment direct them to ro@esmv.org or Elder Services of the Merrimack Valley, Inc. 360 Merrimack Street B#5, Lawrence, MA 01843.