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Gerri Willis Commentary:
Top Tips by Gerri Willis Column archive
Medicare confusion
5 Tips: How to get your Medicare needs organized in time for the deadline.
By Gerri Willis, CNNMoney.com contributing columnist

NEW YORK (CNNMoney.com) - The deadline to enroll in a Medicare plan is just a week away...May 15. In today's Five Tips, we'll help you figure out everything you need to know - before next week.

1. Know your deadline

May 15 is coming soon, and if you qualify for Medicare and miss this deadline, you'll pay a nasty penalty: One percent of the premium every month for the life of your plan. The next opportunity to enroll is Nov. 15 and then your coverage will begin in January 2007. That means you you'll automatically be paying 7 percent on top of your premium for as long as you have your health plan.

Let's break it down. The average premium for a Medicare Part D plan is about $32. If you sign up in November, you'll be paying about $2.24 each month on top of your regular monthly premiums. And these premiums can go higher. So if you are still relatively healthy, you may still want to enroll in a very low-cost plan just to avoid the penalties.

But keep in mind there are exceptions. Hurricane Katrina victims will have until December 31, 2006 to enroll in a plan without penalty. You can also get an extension if you've moved into or out of a nursing home.

You will also qualify for an extension until the end of the year if you meet income requirements. If your annual income is less than $15,000 ($20,000 for couples) and your resources are less than $11,500 ($23,000 for couples), you'll be able to get some extra assistance from the government.

If you think you might qualify for the extra help, you can complete an online application at www.socialsecurity.gov.

2. Weigh your position

If you have drug expenses that are more than $750 a year, it makes sense to enroll in a plan, according to Consumer Reports. And if you're on Medigap, you'll also want to enroll. Even the most basic Medicare plan is far superior to Medigap offerings.

With the price of drugs increasing at twice the rate of inflation, it's unlikely that Medigap coverage will even exist in the future, according to Steve Hahn of the AARP.

If you're currently getting Medicare, you should have been assigned a plan (which you can change of course) and if you have retiree health coverage through your employer and you've gotten a letter saying your benefits are comparable to the Medicare program, you don't have to sign up. If you have low income, this is a no-brainer.

3. Go national

If you tend to spend your winters in Florida or you have a beach house in California, you'll want to consider investing in a National Medicare plan, rather than one tied to your community. That's because some plans won't cover you outside your home state.

There are about 10 national options that will cover you wherever you go, says Peter Ashkenaz of the Centers for Medicare and Medicaid Services. These national options have a network of pharmacists that work with a national chain.

If you see national pharmacies, like Rite Aid or CVS, you're dealing with a larger national brand. You may also want to find out if your plan provider will mail order your prescriptions.

4. Get your drug rights

Of course, you're going to choose a plan based on the medicines you take. But make sure you know what rights you have as a consumer. This is where you have the most leverage.

In the past insurers could drop coverage of medication after you've signed up. But now they can't drop coverage for a year if you've been using that specific medication.

Make sure you read the fine print. Some plans even have limits on how much medicine you can get, says Dee Mahan of Families USA. If you have a history of a certain disease in the family, you may want to include those medications in your plan. If your medical condition changes, you can't change plans until the enrollment period, which is in November.

5. Send out the SOS

With over 40 Medicare drug choices available to consumers in some areas, navigating the drug plan is no easy feat. You'll want to enlist some help. You can call Medicare at 1-800-633-4227, but be warned, you'll have to be very patient if you want to talk to a real human being.

You may be better off using the Web site at www.medicare.gov. For one-on-one counseling and assistance in person or on the phone, look up your State Health Insurance Assistance Program, or SHIP at www.shiptalk.org. You can also go to your local Area Agency on Aging for more specific information about your state. That Web site is www.eldercare.gov or call 1-800-677-1116.

____________________________

Gerri Willis is a personal finance editor for CNN Business News and the host for Open House. Send your questions, your comments and your own ideas to us at 5tips@cnn.comTop of page

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