Three weeks after suffering a heart attack, Bernie Hollander came to a recent meeting at Leisure World in Silver Spring with his wife, Rose, to learn about the Medicare drug plans being offered next year.
“I’m a heart patient, I’m a diabetic — I have a lot of problems,” said Hollander, 81, who lives in the retirement community. But getting the expensive medications he needs isn’t one of them.
Several dozen seniors crowded into a recent Silver Spring meeting to learn about the options they have for Medicare prescription drug plans next year.
He was at the meeting to get updated advice from Leta Blank, head of the Montgomery County Senior Health Insurance Assistance Program. SHIP, as it is commonly known, helped him sort through dozens of insurance policies last year to find one that would cover the eight drugs he takes. His medications cost $14,000 through the end of September, and his share of the bill was $5,000.
“The SHIP program tells you basically what is your best value for your dollar,” he said.
Funded by the federal Older Americans Act and local jurisdictions, SHIPs help people navigate Medicare, the federal health-care program that serves 46.5 million older or disabled Americans. There is a SHIP in nearly every county, providing advice over the phone, in person and at public meetings. Some SHIP counselors even make house calls.
This is their busy season: The annual open enrollment period for Medicare drug plans — also known as Part D plans — began last month and runs until Dec. 7. Although drug coverage is optional, millions of Medicare beneficiaries enroll in a plan, and choosing the right one can be tricky.
Seniors who want drug coverage must sort through dozens of policies covering different drugs from different pharmacies at different prices. For 2012, there are 30 drug plans offered in Virginia and 31 in Maryland and the District. Insurers can modify benefits and pricing from one year to the next. And drug prices can change as often as every four weeks. SHIP counselors can help untangle the details.
Surveys have shown that once seniors choose a drug plan, most stay in it even if there are cheaper alternatives as years go by. But they would be smart to take a fresh look every autumn: In a study presented in October, researchers examined the plans used by about 270 California seniors and found that three-quarters of them would save an average of $450 if they changed plans in 2011.
“Never, ever assume that if your drugs are covered this year they will be covered next year,” said John Glowacky of the Arlington office of the Virginia Insurance Counseling and Assistance Program, which is part of SHIP. “And just because you have a no-deductible plan now, there’s no guarantee that it will remain a no-deductible plan.”
In the District and Maryland, premiums for six of the top 10 drug plans will rise in 2012 by as much as 16 percent, according to an analysis for Kaiser Health News by Avalere Health, an independent research firm. In Virginia, premiums for half of the 10 plans with the highest enrollment are going up by as much as 17 percent next year.
To help find the best buy, SHIP counselors use the online “plan finder” at the top of Medicare’s Web site, www.medicare.gov. Users enter their Zip code and the names of the drugs they are taking, plus other information. The Web site then produces a list of plans covering those drugs at nearby pharmacies and their estimated annual cost. (Before choosing a plan, SHIP counselors recommend calling the insurer to verify the information.)
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