Phil Castell
Castell Insurance
426 E. Washington St., Sequim, WA 98382
Phone: 360-683-9284 • Fax: 360-683-9026
Phil@CastellInsurance.com
www.CastellInsurance.com  

 

I don't know about you but I am scratching my head wondering, "Where the heck did January disappear to?" The month is over and we are approaching Valentine's Day.

I have titled this month's column "Am I too late?" and, in a perfect world, I always would be able to give a definitive answer. However, as you may be aware, we do not live in a perfect world and so the answer is, yes, no or maybe."

It all depends on the question you ask as well as your personal situation. Of course, we are talking insurance and all things insurance related in the column, with a strong focus on things concerning Medicare.

As of Dec. 31, we finished the Annual Enrollment Period for Medicare Part D, prescription drug coverage. But as soon as that finished, we started with the Open Enrollment Period, which runs from Jan. 1 to March 31 each year.

To keep things simple, if that is possible, I shall explain the difference between the two enrollment periods.

During the AEP of Nov. 15-Dec. 31, people on Medicare may add, drop or change their medical and Part D drug coverage.

During the OEP of Jan. 1 -

March 31, people may make certain changes but may not add or drop their Part D coverage. In addition, they cannot change from one PDP drug plan to another unless they also changed their medical to a Medicare Advantage Plan with drugs included.

Already this month we have had phone calls from people who never reviewed how their drug plans were going to be changed for 2010 and they had a nasty surprise when either their medications were not going to be covered or the co-pay had increased, sometimes dramatically.

For these people, the only option we had was if they wanted to combine their medical and prescription drug plan into an all-inclusive Medicare Advantage plan, otherwise they would be stuck for the balance of the year.

We also have seen a few people learning that their Medicare Advantage plans did not have a limit of what their co-pays would be if they got ill. Those plans were really sneaky in how they altered their benefits and hid the details in mountains of fine print.

Here are a couple of updates on subjects from prior months.

_ Pacific Primary Care here in Sequim has chosen to contract with Group Health and will be accepting the Clear Care PPO Medicare Advantage plan. Many personal thanks to Dr. Asma Weber for making this happen.

_ As more Medicare Advantage plans will be converting to the Preferred Provider Organization model in the next year, I will keep you up to date on what I learn.

_ With the Obama administration health care plans in limbo, it appears that removal of the coverage gap or "doughnut hole" from the Part D plans also is in limbo.

I have tried to do some research and nowhere can I find any mention of this provision. It is a shame as this is the one hot button for many seniors who are unfortunate enough to find them affected by this.

In next month's column, I hope to have all the latest news about two new individual Medicare supplement plans that will be available starting in March for effective dates of June 2010. Most people are familiar with Plans F, G or J, but soon we also will have Plans M and N available.

As always, if you ever have questions, those hard-

working folks at SHIBA are available each Tuesday between 10 a.m.-noon at the

Sequim Senior Activity Center or call your local insurance agent.

Phil Castell is an independent insurance agent in Sequim. He can be reached at 683-9284 or PhilCastell@msn.com.