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Medicare drug plan changes coming for 2014

Published: Friday, Oct. 4, 2013 11:44 a.m. CDT

Don’t miss the Medicare annual open enrollment period for Part D drug plans that begins Oct. 15 and runs through Dec. 7.

“With all the interest and activity around the new health insurance marketplace this fall, we don’t want Iowans on Medicare to miss the Medicare annual open enrollment period,” said Kris Gross from the Senior Health Insurance Information Program (SHIIP).

In 2014, Iowa will have 29 stand alone drug plans, three less than 2013. Even the plans that continue from 2014 may have changed their premium, deductibles and co-payments, so comparing plans is important for everyone.

Five new plans were added, and six plans changed names. Seven plans show reduced premiums, and 16 plans have increases. The lowest premium will be $12.60 per month.

The Part D deductible for 2014 will be $310, down from $325 in 2013. The amount members have to spend out of pocket to get out of the donut hole is going down $200 to $4,550.

Once again, in 2014, drug manufacturers will provide a 50 percent discount on covered brand name drugs in the gap, and the plan will provide a 2.5 percent discount, so cost for brand name drugs will be 47.5 percent of the drug’s full cost. The amount members will pay for generics in the gap will be reduced from 79 to 72 percent. These discounts will increase each year until 2020, when the gap will no longer exist.

Some plans that are not available in 2014 are transferring members into another plan with the same company for next year. These individuals have been notified via the annual notice of change. Those not being transferred into another plan are considered to be in a nonrenewing plan. Members should have received a plan termination letter by Wednesday. There is additional time to choose a Part D plan through February.  Choosing a plan by Dec. 31, however, assures coverage for Jan. 1. Members should read all information they receive carefully. 

On Tuesday, Medicare will announce the plans that receive its highest rating of five starts. It will also identify the– “low performing plans.” These are plans that have had a rating below three stars for three consecutive years. Medicare rates plans from five (highest) to one (lowest) star.

The other important changes members need to be aware of are found on the Medicare website. This is the only place where members can find out which of the 29 plans cover the prescription drugs they are taking, what co-payments will be, restrictions on drugs and an estimate of total costs for 2014.

Go to www.medicare.gov and do a comparison of 2014 Medicare drug plans.

SHIIP has step-by-step instructions for doing a comparison of plans on its website, www.therightcalliowa.gov.  Go to the “Find Health and Drug Plans” section. If members don’t use a computer, SHIIP can do a comparison.

SHIIP is a free, confidential service of the state of Iowa insurance division with counselors available across the state to help individuals compare Medicare drug plans. For the SHIIP site nearest you, call 1-800-351-4664 (TTY 1-800-735-2942) or go to www.therightcalliowa.gov.

Should members choose to change plans or enroll in a plan if they missed an earlier deadline, they must enroll in the new plan between Oct. 15 and Dec. 7. SHIIP counselors can assist with enrollment.

For those choosing not to change plans, enrollment will continue into next year.

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