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Senior Center offers help with Medicare prescription plans

Tuesday, November 25, 2008

Medicare's open enrollment program is underway for area seniors. Those who use Medicare have until December 31 to make changes to their prescription programs or for those who have not enrolled to do so.

The Putnam County Senior Center is offering help to those who don't know or haven't decided what program best fits them.

"There are over 350 companies in Indiana taking part in the drug benefit program. Medicare has provided a computer and the software for seniors to plug their information into and we provided a place to set up and volunteers to be trained," explained Senior Center Director Jim Stevens.

Trained volunteers are available at the center every Tuesday or arrangements can be made for an appointment on another day if necessary.

"It takes about an hour and a half to plug in all the information in the software program. People do need to bring their actual prescription bottles with them and not just the information," said Stevens.

"It's not a gimmick or anyone trying to sell you anything. It's here to help people figure out which prescription program works the best for them. There are over 350 Indiana companies offering services in the Medicare program. It's hard for a lot of people to know what to do," he continued.

Prior to passage of the Medicare Modernization Act of 2003, which created the Medicare prescription drug benefit, millions of Medicare beneficiaries lacked coverage for their prescriptions.

Today, 39 million of the 44 million Medicare beneficiaries have prescription drug coverage, and as of January 2008, over 25 million beneficiaries got their prescription coverage specifically through Medicare Part D.

Forty-eight prescription plans and 15 Medicare plans will be available to those who qualify in Putnam County in 2009.

Insurance companies offer Medicare prescription drug plans and other private companies approved by Medicare. They add coverage to the original Medicare plan, some Medicare cost plans, some Medicare private fee-for-service plans and Medicare medical savings account plans.

With a Medicare prescription drug plan people generally pays less for prescriptions. They receive a plan member card when they enroll.

Seniors then use the card to fill prescriptions and will pay a co-payment, co-insurance or deductible. Those with limited income and resources may get extra help to pay for drug plan costs.

Medicare health plans (like HMOs and PPOs) often cover prescription drugs. Medicare health plans include both Medicare Advantage plans and other Medicare health plans.

Medicare Advantage plans (like HMOs and PPOs) that include prescription drug coverage as part of the plan are health plan options that are approved by Medicare but run by private companies. They are part of the Medicare program.

With Medicare Advantage plans people generally get all Medicare-covered health care through that plan. They may get extra benefits, such as coverage for vision, hearing, dental and health and wellness programs.

Individuals usually will have to pay some other costs (such as co-payments or co-insurance) for services. Out-of-pocket costs in these plans are generally lower than in the original Medicare plan, but vary by the services used. They may have to see doctors that belong to the plan or go to certain hospitals to get covered services and they don't need to buy a Medigap policy.

Medicare Advantage plans include HMOs, PPOs, private fee-for-service (PFFS) plans, Medicare medical savings account (MSA) plans and Medicare special needs plans (SNP).

There are also other Medicare Health Plans that include prescription drug coverage, as parts of the plan, but that aren't part of Medicare Advantage. These are still part of the Medicare program. With these plans, a person generally gets all Medicare-covered health care through that plan.

To set up an appointment to determine which plan works best for you call the Putnam County Senior Center at 765-653-3076. For information about the Medicare prescription plans go to www.medicare.gov and look under Medicare plans and prescription plans. You can also call 800-633-4227 24 hours a day, seven days a week for information or help.

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