Since it was enacted Part D Medicare undergoes changes every year. No, we don’t mean changes in the basic structure of the Medicare Part D program. What we mean by yearly changes are changes in the formularies of drug plans, although this varies from one Part D plan to another.

By yearly changes we also mean changes in the minimum amounts allowed in a Part D Standard Benefit Plan. (Plan providers can add more to the standard benefits.)

 

 

 

The year 2009 will not be different. There are going to be changes in the Part D Standard Benefit Plan. So what can you expect from Medicare Part D 2009? These are the figures that are set for 2009 Part D Medicare:

• Initial Deductible:                       $295
• Initial Coverage Limit:                $2,700
• Out-of-Pocket Threshold:           $4,350
• Minimum Cost-sharing in Catastrophic Coverage:
  $2.40 (generic drugs)
  $6.00 (all others)

If you have a Medicare Part D plan for 2008, then it’s time to re-evaluate your plan, i.e., if it still fits your needs. You can begin to review the terms of the 2009 Part D plans starting on October 1, 2008. That day marks the beginning of marketing activities for the Part D plans that are going to be made available in 2009. The enrolment period or the annual coordinated election period for Medicare Part D 2009 begins November 15, 2008 and ends on December 31, 2008.

During the election period, you can opt to stick to your old Part D plan or take out a new Part D plan. If your decision is not to make a decision, you will be covered under the terms of Part D plan 2008.

The effective date of all 2009 Part D plans is January 1, 2009. However, for Part D recipients who want to switch their 2009 Medicare Advantage Plan with prescription drugs coverage (MA-PD) to a Prescription Drug Plan (PDP), there is a Special Enrolment Period within which they can make a switch. The Special Enrolment Period I s from January 1 to March 31, 2009. The Centers for Medicare & Medicaid Services (CMS) has guidelines requiring PDP providers to accept MA-PD enrollees.

First-time enrollees in the Medicare Part D plan can avoid penalties in enrollment if they enroll within the designated enrollment period. They can still enroll late in a Part D plan without the penalties if they prove to have creditable coverage prior to their enrollment.

Employers offering health care benefits are required by law to provide Disclosure Notices to their (active and retired) employees as well as their beneficiaries indicating if their healthcare plan is “creditable” for Part D. Determining whether or not a particular plan is creditable is determined either through actuarial variation or through an alternative valuation method that is not as expensive.

If you enroll in Medicare Part D beyond the designated election period, you will pay the enrolment penalty, which is equivalent to 1% of the premium of each month in 2009 that you did not have creditable coverage.