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Changes are in store for Medicare Part D, set to begin its fourth year on Jan. 1 as the government's prescription drug program for senior citizens.

Open enrollment begins Nov. 15 and gives seniors and other Medicare beneficiaries six weeks to sign up for benefits or make changes to existing coverage.

"It is very important for people to be aware that plans are changing," said Twila Sunden, an advocate at St. Vincent Healthcare. "Just because you're happy with the coverage you have now doesn't mean it's going to continue next year."

Forty-eight plans with monthly premiums ranging from $15.20 to $106.70 will be available from 21 insurance carriers in 2009, said Sue Bailey, program manager for the Yellowstone County Council on Aging Resource Center.

That's four fewer plans than were offered this year, and the average premium has risen $2, from $28 to $30, Bailey said.

Low-income beneficiaries can choose from eight plans with no premiums or pay between $2 and $73 a month for broader coverage.

"I think most people are going to face an increase in cost," Bailey said. "But there might be something cheaper than what you're in."

Trained counselors at The Resource Center and at Billings Clinic can help beneficiaries determine which plan gives them the best deal.

A tool on Medicare's Web site also can evaluate each plan based on the medications a person uses.

Even seniors who do not take any prescription drugs should sign up for the program, said Bobbi Roberts, coordinator of Senior Life Partners at Billings Clinic.

"One doesn't know whether the next doctor's visit might result in medication," Roberts said.

Senior citizens who do not enroll in Part D as soon as they become eligible for Medicare face financial penalties when they do sign up.

But people who have been covered by other insurance, such as from the Veterans Administration or a former employer, usually are not penalized.

As companies react to the nation's financial meltdown by cutting insurance benefits for retirees, more seniors are turning to Medicare for prescription coverage, Bailey said.

"We've had a lot of retirees losing insurance this year," she said.

Beneficiaries who participated in Part D this year should check their plans to ensure that their medications will be covered next year.

Deductibles vary across plans, but the highest amount a beneficiary can pay out-of-pocket next year is $4,350.

Seniors who meet income and asset guidelines can qualify for financial assistance to help pay for coverage.

A single person taking in less than $15,600 a year and who has less than $11,990 in assets qualifies. The cutoff for a couple is $21,000 in income and $23,970 in assets.

Vehicles and homes do not count as assets. The assistance is available through the Social Security Administration.

Contact Diane Cochran at or 657-1287.