News Column

Seniors Advised to Study Up Before Picking Medicare Plan

Oct. 29, 2012

Stephanie Innes


Anyone who is new to Medicare or wants to switch Medicare plans has until Dec. 7 to enroll, and experts say enrollees must do their homework to avoid hidden costs.

About 10,000 baby boomers -- people born between 1946 and 1964 -- become eligible for Medicare each day, and the process can be overwhelming to those who are unprepared. There are more than 50 different Medicare plan options for Pima County consumers, for example.

And some of the top Medicare plans will have double-digit increases in 2012, says a new analysis by Washington, D.C.-based Avalere Health. Overall, Part D premiums for current plans are increasing by 6 percent in 2013, the analysis says.

Humana Walmart's Preferred Rx Plan raised the premium on its popular low-cost plan by 23 percent to $18.50 per month, for example. Overall, seven of the current top 10 prescription drug plans have double-digit increases in premiums, says Avalere, a private health-care advisory services company.

"Some of the Part D premiums have increased, and some have decreased," said Pima Council on Aging Medicare coordinator Lynn Heskett. "It's important to look at the whole picture as far as annual costs when reviewing Part D plans, not just the premium."

Indeed, Avalere notes there are alternatives, and seniors will not necessarily be paying more. The company cites UnitedHealth's new Medicare Rx Saver Plus prescription drug plan, which is offering premiums that average $15 per month -- the lowest available in many markets.

"Seniors need to carefully assess their options going into this open season to ensure that they have a plan that meets their needs," Bonnie Washington, senior vice president of Avalere Health, said in a written statement.

Medicare enrollment began Oct. 15. Anyone who is already enrolled in the program and is happy with their plan does not need to do anything -- their coverage will roll over to 2013. But people who want a new plan or who are new to Medicare need to sign up before Dec. 7.

Medicare is a national health-insurance plan for people 65 and older, people under 65 with certain disabilities and people with end-stage renal disease.

The Pima Council on Aging can offer local residents an overview of Medicare Parts A and B, Medicare Part D Prescription Drug benefits and an overview of how the new federal health law affects seniors. The nonprofit agency is offering several upcoming seminars to give residents objective information about choosing a plan.

On the upside, beneficiaries will see an increase in discounts offered during the Medicare prescription coverage gap -- also known as the doughnut hole -- to 52.5 percent for brand-name medications and 21 percent for generics.

Heskett said about 110 people attended the agency's first Medicare seminar last week and that the most common questions revolved around Medicare Advantage replacement plans. The biggest change for 2013 is the introduction of competitive bidding for durable medical equipment, prosthetics, orthotics and supplies.

Beneficiaries who have original Medicare and live in or are visiting a so-called "competitive bidding area" must use Medicare's contracted suppliers for certain items. Tucson, Phoenix and surrounding areas will become competitive bidding areas in July 2013, Heskett said.

"People new to Medicare need to know what their options are so that they can make educated decisions," Heskett said. "They need to verify that their medical providers are covered by the plan they are thinking of enrolling in and also need to make sure their medications are covered by the formularies.

"Beneficiaries can make mistakes when they enroll in plans without doing their homework. It is important to make sure their medications and providers are covered by any plan they enroll in."

On StarNet: Stephanie Innes brings you the latest health information in her blog, Tucson Health and Wellness, at

If you go

The Pima Council on Aging, along with four community partner agencies, will host a Medicare enrollment seminar from 8 to 11:30 a.m. on Tuesday at Sun City Rancho Vistoso Social Hall, 1495 E. Rancho Vistoso Blvd., in Oro Valley.

Other information sessions are scheduled for Saturday at Tucson Medical Center and Nov. 14 in Green Valley.

Registration is required and the cost is $10 per person, including registration and a resource guide.

Register online at or download a conference brochure to complete and mail to PCOA with payment.

For details or questions, call 324-3745.

The Pima Council on Aging Medicare Helpline is 546-2011. Hours are 8:30 a.m. to 5 p.m. Monday through Friday for appointments and information.

Contacting Medicare

Call 1-800-Medicare. Its phone lines are available 24/7. Or visit and compare available plans and costs for 2013.

People new to Medicare "need to verify that their medical providers are covered by the plan they are thinking of enrolling in and also need to make sure their medications are covered by the formularies."

Lynn Heskett, Pima Council on Aging Medicare coordinator

Source: (c)2012 The Arizona Daily Star (Tucson, Ariz.). Distributed by MCT Information Services.

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