Senior Spotlight
Sign Up Period For Part D Rx Aid In '07 Starts

Last Wednesday, November 15, marked the start of the sign up period for the Medicare Part D drug prescription program for seniors who are Medicare members.

Beneficiaries have until December 31 to sign up for a plan, but federal officials who set the December 31 deadline advise members to sign up by December 8 to avoid the crush of late applications which helped to foul up the system last year.

Anyone who's satisfied with the plan they had during 2006 doesn't have to notify anybody about anything, just continue in their present plan.

But be forewarned: premiums for many plans have changed, deductibles and drug choices in many plans have changed. So if you're standing pat with your 2006 plan, check out all these details to determine if there are changes and if you agree with them.

The Bush Administration says the average premium for Part D will be $24 for 2007. In New York state 61 plans are being offered with monthly premiums ranging from $9.50 to $82.10. The standard annual deductible is $265.

Premiums and deductibles are very important in selecting a plan, but more important is the drug coverage available. Experts in the field advise beneficiaries to make a list of the drugs they take and must have, than use the drug plan finder at the Centers for Medicare and Medicaid Services (CMMS) to see which plans offer the drugs they need. The CMMS Web site is medicare.gov.

Another important detail to be aware of: many companies are providing some

coverage in the so-called "doughnut hole". The hole starts when you have paid for the first $2,400 worth of drugs under your plan. This means you then have to pay out of your own pocket for the next $3,850 worth of drugs.

If a plan is going to pay part of that $3,850 in the doughnut hole, that should interest you if you want to avoid paying all of that out-of-pocket expense.

Also, pay close attention to whether a plan you're interested in will offer generic drugs when you're in the doughnut hole. Generics are cheaper than brand name drugs, while still of the same quality.

DEATH DOESN'T END MEDICAID COVERAGE: That's what state Comptroller Alan Hevesi found out recently. Hevesi said a recent audit by his office discovered that New York state had paid out $3.6 million in Medicaid claims over the past three years for dead people.

Hevesi's office referred its findings to the state health department to determine

whether those who benefitted from the scheme violated any law. An official said the health department would review the cases to try to determine whether the agency would seek to get the money back from those who collected it.

The monies that were paid out unnecessarily went to pharmacists and in some cases, to a nursing home.

Hevesi's office said the problem was that the health department had no effective program to learn when someone on Medicaid has died so they can remove his or her name from the Medicaid rolls. The audit found that 5,487 persons who had died were still on the Medicaid rolls.

The audit also found 4,277 people for whom payments for Medicaid services continued after death and discovered that almost 17,000 claims were honored and paid after people's deaths.