Medicare’s changing, so shop around

Those who don’t may see drug costs rise sharply

By Ricardo Alonso-Aaldivar
Associated Press / September 24, 2010

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WASHINGTON — Millions of seniors face double-digit increases in Medicare prescription premiums next year unless they shop for less expensive coverage.

A new analysis of government data finds that premiums will go up an average of 10 percent among the top plans, which have enrolled about 70 percent of participating seniors. That’s according to Avalere Health, a private research firm.

Marketing for next year’s drug plans gets underway Oct. 1, and seniors will see some of the biggest changes since the Medicare prescription benefit became available in 2006. More than 17 million are enrolled in these private drug plans offered through Medicare.

“People are just going to have to get on top of this and shop around,’’ said Dan Mendelson, president of Avalere.

On the plus side: a new 50 percent discount on brand-name drugs for those who land in the program’s coverage gap, the dreaded “doughnut hole.’’ It’s a major step toward phasing out the gap by 2020, required under the new health care law. Seniors don’t have to take any action to qualify.

But changes decreed by Medicare to force insurers to winnow down duplicative plans could cause some head-scratching.

More than 3 million seniors will see their plans discontinued, according to Avalere. Medicare says all but 300,000 will be seamlessly switched to another plan, but the Avalere data suggest it may not be that simple.

Medicare “is really reshaping the market,’’ Mendelson said. “There are a lot of plans that are shutting down.’’

Among them is the second-largest, the AARP MedicareRx Saver plan. Seniors in that plan are expected to be switched to AARP MedicareRx Preferred, the leading national plan. Both are offered by UnitedHealthcare. But the switch will raise premiums by close to 15 percent, on average, for seniors in the Saver plan.

And there’s another wrinkle: Seniors already in the AARP Preferred plan will see premiums fall 11 percent, on average.

The study found the biggest percentage increase in premiums, nearly 43 percent, will be for the First Health Part D Premier Plus plan, offered by Coventry Health Care. Average monthly premiums will rise from under $64 to nearly $91.

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