Helpful aids to navigate you through D-Day


Today is Oct. 14, 2012. As noted last Sunday, which was Oct. 7 of 2012, “open enrollment” for Medicare Part D and Advantage Plans starts tomorrow, which is Oct. 15 – Monday. If you’re NOT retired, it makes perfect sense that “open enrollment” would begin on a Monday. If you ARE retired, Monday is simply the day that keeps Sunday and Tuesday from bumping into one another; either way, Monday is (literally) “D-Day.”

This column is going to be all about the intricacies of this process. If Part D is not part of your life and you couldn’t care less, bail out now and go shopping for Halloween candy, and remember who loves you…

OK, Oct. 15 through Dec. 7! There is no practical way to make a quasi-intelligent decision about these Part D and Advantage Plans without using Medicare’s “Plan Finder,” which you can find at www.medicare.gov/find-a-plan or just go to www.medicare.gov and it will be obvious. You could also call 1-800-MEDICARE (1-800-633-4227) 24/7 for help (TTY = 1-877-486-2048).

And there is free, local, face-to-face help available – stay tuned.

All the Plans are now in the “Plan Finder,” so you could go into it, enter your drugs and what-not and get some extra time to think, but remember that you can’t actually enroll/change Plans until Monday.

If you have a Part D plan now that you’re just as happy-as-a-happy-clam with, and you’re totally confident that you’ll be clam-happy with it again next year (without even looking at premiums or formularies or whatever), then feel free to do absolutely nothing, and your current plan will continue, unabated and unperturbed, into 2013. Whatever you do (or don’t do) will kick-in on Jan. 1, 2013 – Happy New Year!

Last week I referenced the “donut hole” (i.e. “coverage gap”), in which the Part D plan pays nothing and we pay everything, assuming that you have a plan that has a “donut hole” – That’s true; however, if you hit the donut hole in 2013 you will at least get a 52.5% discount on all brand-name drugs covered by the Plan (which will still count toward getting you OUT of the donut hole) and/or a 21% discount on generics covered by the Plan, courtesy of the Affordable Care Act.

So, let’s talk about money. You may have heard “extra help” or “L.I.S.,” both of which refer to the Part D “Low Income Subsidy,” for which many of us qualify and don’t know it. If you’re single and your income is at or below $1,397 per month ($16,764 per year) AND your assets are less than $13,070, you qualify. “Assets” means, for most of us, money in the bank (plus stocks, bonds, contracts, etc) – It does NOT mean your house, your car or your stuff. For a couple, your income has to be at or below $1,892 per month and your assets below $26, 120; FYI, these numbers will probably increase in April of next year.

If you do qualify, you’ll be able to enroll in one of the “benchmark” Part D plans with little or no monthly premium, drastically reduced deductibles and NO “donut hole!” If this sounds even vaguely like you to you, you can apply by calling Social Security at 1-800-772-1213 (TTY = 1-800-325-0778) or going online to www.socialsecurity.gov/prescriptionhelp (where you see a photo of Chubby Checker) and you want to do this RIGHT NOW! If you call, will you have a wait on the phone? Probably, so take the opportunity to cruise through your checkbook while you’re waiting, in order to remember why you’re waiting.

Now, I told you that there was free, local, face-to-face help available. There is. These folks know what they’re doing and will not try to sell you anything because they don’t have anything to sell – I know this to be true because they’re “us” – I also know them to be good and decent people. So, beginning tomorrow:

1. In Aberdeen, you can call 532-0520 (1-800-801-0060), Monday through Friday, or stop by 2700 Simpson Avenue, Suite 205, but remember that other folks may have had the same idea. These folks also bring help and simple human decency to the North Beach Resource Center, the Oakville congregate nutrition site and the Aberdeen, Elma, Hoquiam and Westport Senior Centers. For dates and times, call either of those numbers above or check our FACEBOOK page at “Olympic Area Agency on Aging-Information & Assistance;”

2. In or around Raymond? OK, call 942-2177 (1-888-571-6557), 430 3rd Street, in Raymond;

3. South Pacific County? OK, call 642-3634 (1-888-571-6558), 1715-A N. Pacific Highway.

Bring your Medicare card or Medicare number, any/all insurance cards/prescription drug cards/benefit booklets, any letters you’ve gotten from your insurance company on the subject, an estimate of your monthly/annual income and assets, a list of your medications, dosages and what you’re paying for them now and anything else that you think might be a good idea or that you have questions about.

These are first come, first served affairs, so remember to be as cheerful and patient as possible, because everybody else is doing the same thing that you’re doing and are equally thrilled at the prospect.

Last one today: Remember that part above about “extra help?” Well, if you’d like to see if you’re eligible and (if you are) actually apply online AS WELL AS finding out if you might be eligible for any number of other programs, go to www.benefitscheckup.org and work through it. It goes surprisingly quickly, is very straightforward and you might be amazed by what you discover.

I’d hoped to get into Medicare Savings Programs today, but I suspect that this is MORE than enough for now, so let’s call it “good;” remember, you have until Dec. 7 to pull this off; personally, I’m shooting for having it done before Nov. 24, to put the “Thank you!” back into Thanksgiving!

Mark Harvey is the director of Senior Information and Assistance for Olympic Area Agency on Aging. He can be reached at harvemb@dshs.wa.gov or 532-0520 in Aberdeen, (360) 942-2177 in Raymond or (360) 642-3634. FACEBOOK: Olympic Area Agency on Aging-Information & Assistance.