Medicare Drug Plan Changes Not For Connecticut

By Nancy K. Crevier

Medicare Prescription Drug Plan Part D has had its ups and downs since its inception in January of 2006, but as educational efforts from various state agencies stepped up accessible information and governmental glitches were unsnarled, drug plan participants found that in most instances they were saving money and finding the new drug plan a workable solution to the high costs of prescriptions.

A recent Associated Press report, however, may have found some residents with their hearts in their throats, anticipating yet another round of confusing plan switches. The reassignment of millions of low-income Medicare beneficiaries to new prescription drug plans reported by the AP story, however, does not apply to Connecticut Medicaid clients who are in a full Medicaid plan without a spend-down or who are in a Medicaid Savings Program, or to ConnPACE (Connecticut Pharmaceutical Assistance Contract to the Elderly and Disabled, a state program the helps seniors and the disabled pay for certain drugs, insulin, and insulin syringes) clients, said Dawn Macary of Western Connecticut Area Agency on Aging (WCAAA) CHOICES program.

Even though the prescription drug plan switch affecting nearly two million of the poorer Medicare customers does not affect Connecticut residents, both Ms Macary and Joanne Klopfenstein of Newtown Social Services want to stress that private pay citizens should take the time to look at the drug plan they have and determine if it is still the best one for their needs.

“We are trying to figure out a way to get seniors to come in and make sure they are in the right plan,” said Ms Klopfenstein. “This is important. People need to check their plan, they need to look not just at the premium they are paying, but at the overall drug costs for the year,” she said.

A handful of residents have already taken the time to come in to the Social Services office on South Main Street, said Ms Klopfenstein, including one woman who discovered her plan was going up $600 a year when the premium, deductible, and pharmacy co-pay were taken into consideration. By running her personal information through the computer, they were able to find a lower-cost plan that better suited her needs.

“If you are with any Medicaid plan or with ConnPACE, your plan won’t be changed,” said Ms Macary. “We are very lucky here in Connecticut.”

 Senior citizens who have a prescription drug plan through a private company may be affected by premium changes this year, though, some of which, according to the Associated Press release, could jump from 16 to 71 percent.

The other thing private pay plan clients need to be aware of as they look over their drug plans, said Ms Macary, is the difference in generic drugs this year. “There are now four categories of generic drugs. There are value generics, preferred generics, nonpreferred generics, and specialty generics.” Seniors with payments that cover drugs in the “gap,” that area between drugs cost of $2,510 and $4,050 in which they must pick up costs out of pocket, want to make sure what kind of generic drugs that plan is covering in that gap, she said.

“Look at your plan,” urged Ms Macary. “I’ve had about eight to ten calls a day already and that is great. If people call, we will get a personal information form out to them, run it through the computer, and come up with the three best plans best for them.”

“Medicare Prescription Drug Plan Part D only allows plan changes between November 15 and December 31 this year, so people should not wait,” reminded Ms Klopfenstein.

For assistance with selecting the prescription drug plan best suited to one’s needs, or for any questions concerning the plans, call Newtown Social Services at 270-4330 to set up an appointment, or call WCAAA CHOICES at 800-994-9422.