Tomorrow marks the beginning of the annual Medicare open enrollment that continues through Dec. 31, the once-a-year period when beneficiaries may switch, modify or drop plans.

Many Medicare Advantage beneficiaries are seeing increases, and sometimes significant increases, while some Part D prescription plans actually will have lower premiums in 2010.

Retired city school teacher Rosalyn Robin, of Squirrel Hill, said her Highmark Security Blue plan monthly premiums would go from $82 to $119 next year, which "was a little bit higher than I anticipated, but they didn't consult me," she said.

Leading up to this open enrollment period, Mrs. Robin said she'd been "bombarded" with mail from other plans trying to get her to switch, but that she appreciated that Security Blue representatives call her every few months to check in on her

As for the increases, she said: "There's not much you can do about it. I think every plan is going up, and it seems everybody is getting an increase no matter which plan you belong to."

The Centers for Medicare and Medicaid Services is encouraging beneficiaries to use the open enrollment period to make sure they have the best coverage for their health needs. Sorting all the plans out, though, can mean navigating a confusing array of changes and variables.

A senior's current plan may be fine for him or her, but changes in health status, medications or the plan's formulary or premium could be cause to reconsider if the plan is the best fit next year.

Most of the attention has gone toward Medicare Advantage plans because of premium boosts that insurers attribute in large part to reduced reimbursements from the Centers for Medicare and Medicaid Services. Medicare Advantage reimbursements in Allegheny County will decrease in 2010 by $4.52, from $820.48 to $815.96 per member per month.

That decrease, noted Highmark spokesman Aaron Bilger, comes "at the same time medical costs continue to rise at a level that far exceeds inflation."

In 2010, 55 separate Medicare prescription plans will be available statewide, and 22 of them offer zero deductibles.

According to the Centers for Medicare and Medicaid Services, the lowest payment among Pennsylvania prescription drug plans that require a monthly premium is $16.70. The lowest monthly premium is $57.40 among plans offering any generic coverage in the coverage gap that falls between the end of standard coverage and the beginning of catastrophic coverage.

Without that coverage, subscribers pay all of their drug costs while in that gap, until they reach the threshold for the catastrophic coverage.

At Highmark, the Blue Rx Value prescription plan will increase $23.10 a month, going from $33.10 to $56.20. Blue Rx Plus premiums are increasing from $49.10 to $51.30, a jump of $2.20, while Blue Rx Complete premiums will go down $14.10, from $108 to $93.90.

Aetna is lowering monthly premiums on two of its three offerings: Aetna Medicare Rx Plus goes from $63.90 to $36.70 and its Medicare Rx Premier Plan drops from $99.90 to $83.70. Premiums for the Aetna Medicare Rx Essentials plan is increasing, from $33.40 to $49.

UPMC Health Plan, the area's second largest insurer, has fewer than 1,000 members in its Part D prescription drug plan and does not actively market the product, said spokesman Jeffrey Nelson.

To look at specific details about local plans, go to www.medicare.gov then click on either the "Compare Health Plans" or "Compare Drug Plans" link, then click on the "Learn More About Plans in Your Area" link, where you can search by state and county.

More information about Medicare Advantage and Part D plan options can be found at www.cms.hhs.gov/center/openenrollment.asp or by calling Medicare's toll-free phone number, 1-800-633-4227.

The number for Pennsylvania's drug assistance program for those with low incomes is 1-800-225-7223.

Apprise, state's free health insurance counseling for Medicare, 1-800-783-7067; services locally provided by Family Services of Western Pennsylvania, 412-661-1670.

Another helpful alternative Web site for comparing plans has been set up by online insurance broker eHealthInsurance at www.eHealthMedicare.com.

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