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Pomeroy: Medicare 'shopping season' at hand

Seniors participating in the Medicare prescription drug program should take advantage of an upcoming open enrollment period to do some comparison shopping, Rep. Earl Pomeroy, D-N.D., said Tuesday.

Seniors participating in the Medicare prescription drug program should take advantage of an upcoming open enrollment period to do some comparison shopping, Rep. Earl Pomeroy, D-N.D., said Tuesday.

Now until Dec. 31, participants can switch to another plan without penalty during open enrollment - a good time to check whether any changes in coverage match or mismatch a patient's needs, the congressman said in a Fargo news conference.

"This is a very important six weeks for seniors," Pomeroy said. More than 100,000 seniors - a sign-up of 94 percent of those eligible - decided to participate in the prescription drug coverage, at an average savings of $1,100 per person, he said.

But the program is notoriously complicated and fraught with pitfalls, the most common being the so-called "doughnut hole," a gap in coverage triggered once a payment limit is reached. The doughnut hole enlarges a bit - beginning at $2,510 in prescription costs - next year.

A dizzying assortment of 52 coverage plans are available in North Dakota, making comparison shopping difficult. Many insurance companies also changed terms after coverage began two years ago.


Even seniors who are comfortable with their coverage should look again to see if changes in the plan's terms or their health status mean they should switch plans, said Vern Hedland, a Valley City volunteer under the North Dakota Insurance Department's Senior Health Insurance Counseling program.

Three pieces of information are crucial in determining which plan is best, and seniors should bring the following with them when seeking help in choosing coverage, Hedland said:

- Name of the prescription medication.

- Strength or dosage.

- Frequency - the number of times a day, for instance, the medication must be taken.

When that information is uploaded into a computer program, a list of options in order of favorability becomes available, Hedland said.

The Medicare prescription drug program, called Part D, has led more seniors to use lower-cost, generic equivalents, which helps to save money, Pomeroy said.

But he said the program remains too complicated, and should allow Medicare to use its market clout to negotiate discounts with pharmaceutical companies, as private insurers and the Veterans Affairs medical program do.


Dave Olig, a Fargo pharmacist, said the cost savings in the Medicare prescription drug program have come from druggists, not the pharmaceutical companies.

Giving Medicare the ability to negotiate discounts with drug companies would eliminate the "doughnut hole" and lower premiums, he said.

Significant changes in the program, however, probably won't come until after President Bush leaves office, because the president likes the program as it is, Pomeroy said.

Several toll-free hot lines are available, including Medicare and North Dakota's Senior Health Insurance Counseling program, Pomeroy said.

"So there's help out there," he said. But, he added, "The clock is running."

If you go

- What: Medicare drug coverage assistance for seniors

- When: 9 a.m. to 5 p.m. Thursday


- Where: J.C. Penney wing, West Acres

Telephone assistance

- Dial 2-1-1 for free assistance 24 hours a day, seven days a week.

- Visit Medicare's Web site or call (800) 633-4227.

- Call SHIC toll-free at (888) 575-6611.

- Call RSVP at (701) 258-5436 on a Monday, Wednesday or Friday from 12:30 a.m. to 3:30 p.m. only.

- Call Fargo Senior Services at (701) 293-1440.

Readers can reach Forum reporter Patrick Springer at (701) 241-5522

Pomeroy: Medicare 'shopping season' at hand Patrick Springer 20071128

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