The cost for getting drug coverage could go up for Ohio seniors next year if they want a plan without a deductible or potential gap in coverage.
But for those willing to pick more basic benefits, their monthly premiums could go down in 2014.
The nearly 2 million Ohio residents covered by Medicare will be able to select from 37 optional Medicare Part D prescription drug plans in 2014, four more than this year, according to details released Thursday by the Centers for Medicare and Medicaid Services (CMS).
Humana will offer the lowest-cost Medicare Part D option in Ohio in 2014: a plan marketed with Walmart for $12.60 per month.
As is the case with at least 15 other options next year, the low-cost Humana Walmart Rx Plan has a deductible of $310 before coverage begins.
This year’s least expensive plan — the AARP Medicare Rx Saver Plus plan from UnitedHealthcare — is increasing its monthly premium from $15 to $20.50 per month in 2014.
Enrollees in Medicare Part D plans nationwide will pay an average $31 per month for drug coverage, roughly $1 more than this year’s average, according to CMS.
The federal government contracts with private insurance companies to provide drug coverage to Medicare recipients who sign up for the plans. Everyone but the poorest enrollees pay a portion of the monthly premium; the government picks up the rest.
Dozens of Medicare Advantage managed-care plans also are available next year that help cover medical costs and, in most cases, include prescription drug coverage.
Both types of plans are available — but not required — for everyone covered by Medicare, the federal health insurance program for people 65 or older and some younger disabled Americans.
Open enrollment for Medicare Part D drug plans and Medicare Advantage plans starts Oct. 15 and ends Dec. 7. Changes are effective Jan. 1.
The Medicare open-enrollment period is separate from the Oct. 1 launch of the federal Health Insurance Marketplace, created under the federal health-care reform law or “Obamacare.”
All Medicare plan enrollees should carefully review notices they receive in the mail about changes in 2014, said Francine Chuchanis, ombudsman supervisor for the Greater Akron/Canton Area Agency on Aging.
If consumers are unhappy with any changes or if all their prescription drugs won’t be covered next year, “They might want to look at another plan,” she said. “If they’re happy, they can stay where they’re at.”
In Summit County, 45,820 of the more than 98,600 Medicare recipients are enrolled in a Medicare managed-care plan, according to CMS data.
SummaCare, Summit County’s largest Medicare managed-care insurer with more than 15,400 enrollees, will again offer three plans, a “Ruby” plan for $0 per month, a “Sapphire” plan for $65 per month and an “Emerald” option for $165 per month, according to CMS data.
This year, SummaCare is offering a “Core” plan for $0, a “Silver” plan for $43 and a “Gold” plan for $134.
Medicare managed-care plans also will be offered in Summit County next year by Aetna, Anthem, UnitedHealthcare, PrimeTime Health Plan, The Health Plan, Kaiser Permanente, Humana, Gateway Health and WellCare, according to CMS.
Three new companies — Advantage-Plus Meridian, Stonebridge Life Insurance Co. and Symphonix Health — will sell Medicare Part D prescription drug plans in Ohio in 2014, according to CMS.
Information about five plans marketed in Ohio next year by Silverscripts and SmartD Rx was not released Thursday because the companies are under sanctions and unable to enroll members at this time, according to CMS.
At least eight Medicare Part D drug plans will be available in 2014 that pay for at least some medication without a potential gap in coverage, according to the CMS data. These plans will be among the most expensive, with monthly premiums ranging from $54.10 to $119.10 per month.
Enrollees in a majority of plans will face a potential coverage gap that could force them to pay for thousands of dollars worth of drugs on their own before more comprehensive coverage begins. However, the federal health-care reform law is slowly shrinking the so-called “doughnut hole” in the coming years until it disappears in 2020.
Detailed, personal information about Medicare Part D drug plans and Medicare Advantage options for 2014 will be available soon by logging onto Medicare’s website at www.medicare.gov or by calling 800-633-4227.
Cheryl Powell can be reached at 330-996-3902 or email@example.com. Follow Powell on Twitter at twitter.com/abjcherylpowell.