WATERLOO - Switching Medicare prescription drug plans may be worth a look as 2009 brings some significant cost increases and changes.

Part D enrollment begins Saturday and runs through Dec. 31.

"Forty-two out of the 48 plans offered increased their premiums for next year, and we're seeing changes in the drugs covered," said Kris Gross, with Iowa's Senior Health Insurance Information Program.

The average premium for basic coverage has gone up approximately 22 percent for 2009, said Julie Brookhart, public affairs specialist with the Centers for Medicare & Medicaid Services at the Kansas City regional office.

The popular Humana premium was very inexpensive in its first year at less than $2 per month, recalled Ruth Buck, outreach coordinator for the local Retired & Senior Volunteer Program. Beneficiaries paid $14.40 for the cheapest plan in 2008, but it will cost $29.80 in 2009.

"The benefit is still very affordable when comparing these health care costs to private sector health care insurance," Brookhart said.

Brookhart stressed the theme of this year's Medicare campaign: Plans change. You change. Shop and compare.

For example, seven of 52 current plans have been discontinued in Iowa for 2009, although three new plans will be available. Also, individuals may not be taking the same drugs as when they opted for their current plan, so another plan could be more economical, she said.

"Last fall approximately 80 percent of people who compared plans with the help of Iowa's Senior Health Insurance Information Program saved money by changing plans for the next year," Gross said.

That trend was also seen locally, Buck said.

The "doughnut hole," the coverage gap that kicks in partway through the year, will be reached when total drug costs, paid by the beneficiary and the Part D plan, reaches $2,700 in 2009. Once one's out-of-pocket drug costs reach $4,350, Medicare's catastrophic coverage is employed, and the beneficiary pays 5 percent of prescription costs.

Individuals whose income is less than $15,600, or $21,000 per couple, and those with resources below $11,990, or $23,970 per couple, may qualify for help with premium and drug costs. They should call the Social Security Administration at (800) 772-1213 to apply.

"We know statistically there are a lot of people in Black Hawk County that would qualify for that extra help that just haven't done anything yet," Buck said. "If their income is low enough, they may pay as low as $2.40 for a generic (prescription drug) and $6 for a (name) brand."

About 17,000 beneficiaries in Iowa would potentially qualify for extra help but have no known coverage, Brookhart said.

Signing up for a Medicare Part D plan isn't mandatory, but if a person doesn't sign up when they're first eligible - at age 65 - and then decides to enroll, a penalty will make the plan permanently more expensive.

About 84 percent of the approximate 497,873 Medicare beneficiaries in Iowa have prescription drug coverage, Brookhart said. About 35 percent of all Iowans who have Medicare are receiving the low-income subsidy. But about 16 percent have no known coverage.

SHIIP counselors are available by appointment from 9 a.m. to 3 p.m. at the Kimball Ridge Center, 2101 Kimball Ave.

Enrollment help

For help on enrollment or evaluating plans, try one of these resources:

Senior Health Insurance Information Program at RSVP, (319) 272-2250.

Golden Care at Allen Hospital, (319) 235-3590.

View and compare plans online at Medicare's Web site, www.medicare.gov.

Call Medicare's hot line, (800) 633-4227.

Contact Tina Hinz at (319) 291-1484 or tina.hinz@wcfcourier.com.