Question: Can I be penalized for not joining a Medicare prescription drug plan when I’m first eligible?
Answer: Yes. If you don’t join a Medicare prescription drug plan when you’re first eligible or go without prescription drug coverage for a period of 63 or more days in a row after you qualify, you may have to pay a late-enrollment penalty.
Seniors get to choose a new Medicare Part D prescription drug plan each year during an annual enrollment period from Oct. 15 to Dec. 7. About 22.7 million people, or 43 percent of Medicare’s 52 million beneficiaries, are enrolled in these drug policies.
Medicare officials recommend seniors shop around for a new plan even if they are happy with their current coverage because premiums, covered medications, out-of-pocket costs and the plans offered change each year.
Some tips to keep in mind:
* If you don’t join a Medicare prescription drug plan when you’re first eligible or go without prescription drug coverage for a period of 63 or more days in a row after you qualify, you may have to pay a late-enrollment penalty.
* There’s a coverage gap in many Medicare Part D plans, often called the “donut hole,” that is scheduled to be gradually eliminated by 2020. The donut hole is the temporary limit on what Medicare drug plans pay after certain dollar thresholds for drugs have been met. For 2014, drug coverage stops when the insurer and member together have spent $2,850 and resumes when the member has spent $4,550. Also for 2014, the deductible is $310 instead of $325.
* Among the top 10 most popular drug policies, monthly premiums for 2014 are changing dramatically — up 55 percent for one AARP UnitedHealth plan and down 38 percent for another from Wellcare, according to a recent study by Avalere Health, a Washington, D.C., health research firm (as reported by Kaiser Health News).
* Policies can change from year to year, so Medicare officials encourage seniors to review their current coverage to make sure their drugs are still covered and at the best price. They should also check to see if they can get to the plan’s preferred pharmacies, which offer lower prescription prices than others in the plan’s network.
* For assistance, check out the government’s Part D drug plan finder or call 1-800-MEDICARE (800-633-4227).