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Advocates said, Insurers in general held down monthly premiums for 2008. A number of them are raising co-payments and changing the drugs they cover. That is why recipients have to shop, even if they look forward to to keep their present plan.

Judith Stein, executive director of the Center for Medicare Advocacy, a consumer group said, "You can't be sure it will stay the same. [Plans] know people look primarily at the premium. If the premium stays at $25 or goes down to $24.50, it looks good. However, if you look carefully, there is going to be higher co-pay. Those kinds of changes make a big difference and add up in the end."

Drugs-only plans begin at $12.10 a month. At least 70 HMO-style plans charge no premiums. A few will pay the whole or part of your monthly Medicare part B premium. The average South Florida HMO will charge $7.50 a month, the average Preferred Provider Organization $33 and the average drug plan $37.

Nevertheless, there will not be much new help for seniors who need a lot of medicine. Like a year ago, 18 drug plans and 35 health plans offer coverage for drugs during the gap, or "doughnut hole," when government subsidies end. Only a dozen cover brand-name drugs in the gap.

Even light users of medicine have to to shop. With big retailers now selling generics free or $4, an HMO with $7 generics looks less enticing, said Jack Hadley, a health policy analyst at Georgetown University.

Advocates advice making sure your plan covers all the drugs you take, or at least the costly ones, and check if it imposes quantity limits, requires prior approval or makes you try a less expensive drug before getting a pricey one.

This fall, recipients also will observe an explosion of "fee for service" plans: 54 compared to four last year. The plans typically offer about unlimited choice of doctors, but the average premium here tops $83.

 

 

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