(Centers for Medicare and Medicaid Services: Washington, D.C.) -- As the beginning of the annual election period for the Medicare Prescription Drug Program nears, many seniors and their caregivers are in the dark about how the program works and how to make the most of it. This is something Esther Koch, gerontologist and eldercare expert, sees every year and she says that it's costing seniors and their families. “Many seniors in the U.S. are spending more money on prescriptions drugs than they have to because they're confused about the basics of the Medicare Prescription Drug Program,” she says. “And in the current economic downturn this can really have an impact.”
 
When it comes to prescription drug coverage, seniors fall into four groups: seniors with employee or retiree drug coverage; those in Medicare Advantage Plans with drug coverage; those in low income subsidy programs; and seniors who are in stand-alone Medicare Prescription Drug Plans or have no prescription drug coverage.

Guidance for those with stand-alone or no prescription drug plans:

• Seniors must review their drug plans every year. Why? Because even if their medications haven't changed, it's almost certain that their plan's formulary of drugs covered and pricing have. “Medicare contracts with a variety of insurance companies to cover drug costs. What few seniors or caregivers know is that these insurance companies submit new plans to Medicare each year,” says Koch. “Last year's plan is not this year's plan and that means that it's unlikely that the best plan for you last year is the best plan for you this year.” In fact, Koch says that she has yet to have a client whose optimum plan choice remained the same each year.
• A higher premium plan doesn’t mean more or better coverage. It seems logical that choosing a drug plan with a higher premium is going to give you more benefits, but when it comes to Medicare Prescription Drug Plans this simply isn't true. “What you need to focus on is total estimated annual cost,”  notes Koch. This takes into consideration all the variables including the plan's formulary of drugs, individual drug classifications and pricing, monthly premiums, deductible amount, whether “doughnut hole” coverage is provided; and when catastrophic coverage is triggered. She likens the process of choosing a Medicare Prescription Drug Plan to comparison shopping for holiday gifts. “If you can buy the same gifts at Store A for 50 percent cheaper than at Store B, you'd buy them at Store A. The same principle applies here,” says Koch. “You need to compare the total estimated annual cost of your parents' specific drugs by plan and then choose from among the least expensive plans.”  
• Use online tools to help sort out prescription plans. If choosing the right plan sounds like it requires sifting through a lot of information, it does. Luckily, the government offers the online Medicare Prescription Drug Care Plan. By entering a patients ZIP code, drug names, dosage information, and 30-day supply amounts, users can obtain a prioritized list of prescription drug plan options sorted from the least expensive to the most expensive plan based on total estimated annual cost. An added benefit of this is that caretakers can be informed of all of the medications an elder is taking, enhancing knowledge of health conditions and insurance coverage.

The annual election period for the Medicare Prescription Drug Program runs from Nov. 15 to Dec. 31.

For further information, visit www.medicare.gov, or www.ssa.gov/prescriptionhelp, or www.ENCOREmgmt.com.