Open enrollment begins today for thousands of older area residents who rely on Medicare prescription drug or managed-care plans to help pay for their medications and medical care.Consumers need to start — and finish — their annual comparison shopping for coverage earlier than in previous years. The enrollment period is starting a month sooner and ending Dec. 7 rather than Dec. 31.Changes are effective Jan. 1.The 1.8 million Ohio residents covered by Medicare can select from among 33 Medicare prescription drug plans, also known as Medicare Part D plans.Dozens of Medicare Advantage managed-care plans also are available that provide help paying for doctor visits, hospital stays and other medical services.Both types of plans are available — but not required — for everyone covered by Medicare, the federal health insurance program for people 65 and older and some younger disabled Americans.Enrollees already should have been notified by mail about any changes in benefits for 2012, said Francine Chuchanis, ombudsman supervisor for the Greater Akron/Canton Area Agency on Aging.To avoid surprises at the drugstore come Jan. 1, consumers should review plan details to determine whether co-pays, co-insurance, covered drugs (known as the formulary) and the list of participating pharmacies are changing.The vast majority of Medicare prescription drug plans in Ohio are making at least some minor adjustments to the amount enrollees will pay when they fill a prescription in 2012.“We always point out that the plans can change, not only their premiums but their benefits, their networks and formularies,” said Gretchen Lopez, program director of the Ohio Department of Insurance’s Ohio Senior Health Insurance Information Program
(OSHIIP). “What works this year might not be the best solution for next year.”Enrollees in Medicare managed-care plans also should check whether deductibles are being added next year before coverage begins, Chuchanis said. Plans also must share the annual limit on out-of-pocket charges.“If you’re a person who has high medical costs, you want to pay attention to this,” she said.Starting in 2012, the federal government is allowing consumers to switch to a plan with a 5-star quality rating at any time during the year. The rating measures patient satisfaction and other quality indicators.None of the Medicare Part D prescription drug plans in Ohio have the top rating for 2012. Plans from Medco earned the highest rating in the state with four stars.The highest-rated Medicare managed-care plans in Summit County next year are 4.5-star offerings from SummaCare and Kaiser Permanente.The federal government contracts with private insurance companies to provide drug coverage to Medicare recipients who sign up for the plans. Everyone but the poorest enrollees pay a portion of the monthly premium; the government picks up the rest.‘Doughnut hole’Enrollees in a majority of plans next year will face a gap in coverage that will potentially force them to pay for as much as $4,700 worth of prescription drugs on their own before more comprehensive, catastrophic coverage begins.Next year, enrollees who reach this so-called “doughnut hole” will get a 14 percent discount off the price of generic medications and 50 percent off brand-name drugs.Retirees who get their coverage from a former employer or union should have received a notice indicating whether their plan is considered “creditable coverage,” or at least as good as Medicare Part D plans. Anyone who loses creditable coverage can sign up for a Medicare prescription drug plan within 63 days after losing coverage without paying a late-enrollment penalty.Regardless of their situation, the Area Agency on Aging’s Chuchanis recommends people get advice and help reviewing the available options from an independent source, such as her agency, the Ohio Senior Health Insurance Information Program or Medicare’s toll-free number or website.“We recommend that people check with an impartial adviser who is not paid by an insurer,” she said.Cheryl Powell can be reached at 330-996-3902 or chpowell@thebeaconjournal.com. Follow Powell on Twitter at twitter.com/abjcherylpowell.