Sturm and his team have been closely involved in the enrollment process, because they have been enrolling residents of Erickson-built and –managed communities into Erickson AdvantageSM. This is a Medicare Advantage program available only to these residents and provides a Part D option.

A report published by the American Academy of Family Physicians notes that Part D “will lower medication expenditures for many older patients.” That has been the case for Betty Claus, an Erickson AdvantageSM member.

“My AARP coverage was good, but I am saving quite a bit with Erickson AdvantageSM. Now I pay only $28 a month instead of $100 for one of my medicines, and I get a 3-month supply of another for less than $10,” she says.

Mark McClellan M.D., Ph.D., outgoing director of the Centers of Medicare and Medicaid Services which administers the Part D plan, points out many older people couldn’t afford any prescription coverage before Part D. Many of these people will never reach the donut hole, he says, and if they do they will have saved at least $1,500 first.

That ‘donut hole’ is still a concern among both Part D subscribers and the experts monitoring the program. Right now, once your drug costs reach $2,250 you become responsible for 100 percent of all your costs until they exceed $5,100. At that point, Part D kicks in once again and picks up 95 percent of your drug expenses.

This coverage gap is called the donut hole and is on many older Americans’ minds. A majority in McFadden’s study—88.4 percent—viewed this gap in coverage as a significant drawback in Part D’s structure. Another 90.2 percent were worried about upcoming changes in the drugs covered by their plan, perhaps even pushing them into this coverage gap.

Opinions vary as to how much of a danger this coverage gap actually presents. Some take McClellan’s stance. Others say people with diabetes, heart conditions, high blood pressure, and other chronic conditions— especially those requiring expensive medicines— have already hit the gap. This year there are 7 million people who will pay 100 percent of their drug costs for anywhere from 1.5 to 7.2 months.

According to the “Mind the Gap” report, “Current estimates for the number of people already in this ‘hole’ vary widely, from 3 million up to 15 million. I would guess it is about 7 to 8 million. I think we will see a lot more people hitting that hole this fall,” says Kathleen Stoll, director of health policy for Families USA, a non-profit organization.

Pat Venable, SHIP (Senior Health Insurance Program) Coordinator for the Baltimore County Department of Aging, urges people to look into the many resources available to help you make smarter decision choices as the 2007 enrollment approaches.

“Before May 15th here in Baltimore County, we ran numerous seminars with counselors to help you choose drug plans. There were, via both phone hotline and online, drug comparisons offered by Medicare, and vans from the National Council on Aging went around. Many of these will be available again this fall and winter for the January ’07 enrollment,” she says.

“Simply knowing which, is the ‘preferred drug’ your health plan covers for certain conditions could save you money. Ask your doctor if you can take what your plan covers—or save even more by switching to a generic,” she adds.

If you are already saving money, McFadden suggests pretending you didn’t—and save what you would have spent. “By the time you reach $2,500 in drug costs, Medicare will have paid about $1,500. If you saved the other $1,000, it will help to offset some of your gap expenses,” he says.

Many experts agree relatively simple steps could enhance Part D’s effectiveness.

“The U.S. government has the best purchasing power. The Veterans Administration buys medications in bulk for its patients and so gets good prices. If CMS uses the same purchasing power, the government can save some money and maybe we can patch that donut hole,” says Stoll.

Other advice for enhancing Part D’s effectiveness:

• Simplify the enrollment process

• Increase efforts to reach the 1.5 million nonenrolled unhealthy people who should be in the program

• Require insurers to present information on features and costs in an easily understood format

• Encourage people to choose enhanced plans that offer gap coverage.

Fall’s open enrollment for 2007 is a good time for a re-evaluation. Changing plans might help you avoid the donut hole by saving on drug costs, like Claus did. Ask your doctor or pharmacist about changing some of your brand-name medications to generics. In 2006, a number of generics have become available, offering estimated savings of $24.7 billion to consumers.

Insurers are looking for ways to keep costs down. And if you don’t find that is the case for your program? “In addition to your drug card, have a voter registration card in your wallet,” says Stoll.