The time to shop for a Medicare prescription drug plan is right around the corner.

The Medicare prescription drug program is gearing up for its annual open enrollment period, Nov. 15 through Dec. 31.

During that time, Medicare beneficiaries will be able to pick from among a number of plans that will help pay for their prescription drugs next year.

Broadly speaking, the program for next year will be the same as it was for this, its initial year, said Larry V. Grimaldi, chief of program development for the Rhode Island Department of Elderly Affairs.

But there are some key changes. For example, there will be more companies offering more plans to Rhode Island beneficiaries.

The average monthly premium for standalone plans will be lower. But certain costs — for deductibles and such — will be higher for some plans.

There are about 176,000 Medicare beneficiaries in Rhode Island. Many of them won't have to act during the open enrollment period, but some will, said Roseanne Pawelec, spokeswoman for the federal Centers for Medicare & Medicaid Services.

In general, the open enrollment period is for you if you fall into one of the following categories, Grimaldi and Pawelec said:

• You're enrolled in a Medicare Part D prescription drug plan now, but you're thinking about switching to another plan for next year.

• You didn't sign up for a plan when you were eligible last time around, but you're thinking of enrolling now.

• You're enrolled in a Medicare Advantage plan or a Medigap supplemental insurance plan, but you want to add or change your drug coverage.

If you already have a plan and it suits your needs, you needn't bother with open enrollment; you won't have to re-enroll. (Nearly all the plans that were available for this year will be back again for next year.)

"For people who are happy with their current Part D plans, they don't have to do anything," said Grimaldi, who coordinates Medicare education and outreach efforts for the Department of Elderly Affairs.

Still, you may want to at least look at the offerings this time around to see how your plan compares. And if the plan you're in now will have changes for next year, you may want to shop around now. (Your plan will send you a notice by the end of this month if there are any changes in coverage, Pawelec said.)

Medicare is a federal health insurance program covering many people who are 65 and older or disabled.

The prescription drug plans fall under a section of Medicare called Medicare Part D. But they're not offered by Medicare. Instead, they're generally sold by insurance companies directly to beneficiaries, under Medicare's umbrella. (Medicare pays the companies a subsidy.)

What can you expect to find during the coming enrollment period? Here are some highlights:

• More Plans: A total of 21 companies will offer standalone prescription drug plans for next year, up from 18 for this year. They'll be offering a total of 51 standalone plans this time, up from 44 last time, Grimaldi said.

The list includes plans that were among the most popular for Rhode Island beneficiaries last time around: Blue Cross & Blue Shield of Rhode Island (Blue MedicareRx plans); Humana Insurance Co. (Humana PDP plans); and UnitedHealthcare (whose offerings include the AARP MedicareRx plans).

• Lower Premiums: The average Rhode Island plan premium will range from about $24 to $27 a month this time around, compared with an average of about $30 a month last time, Grimaldi said. (A "premium" is the amount you must pay each month to be covered under a plan.)

Among those with the lowest monthly premiums are a WellCare plan, for $13.40; a Humana plan, for $16.90; and a UnitedHealthcare AARP plan, for $18.50.

Among those with the highest monthly premiums are a Humana plan, for $87.40, and an Aetna Medicare Rx plan, for $71.80. (In general, the higher the premium, the broader the coverage.)

Fifteen of the plans come with no premium and a full subsidy for beneficiaries who qualify under the Social Security Administration's "extra help" program. In essence, these are people with low income and limited resources. To see whether you may be eligible, call the Social Security program toll-free at 1-800-772-1213, or use this Web site: www.socialsecurity.gov.

• Higher Deductible: A standard, bare-bones prescription drug plan has a "deductible." That's the amount you must pay, initially, for prescription drugs before insurance coverage kicks in. For next year, the deductible will be $265, up from $250 for this year.

Altogether, 16 of the Rhode Island plans will charge a $265 deductible; 31 will have no deductible; others will be somewhere in between.

• Coverage Gap: Because of the way the Medicare drug feature was designed, standard plans typically have a gap in coverage. Once you fall into the gap, you must pay the entire cost of drugs; the plan pays nothing.

For next year, the coverage gap — also known as the doughnut hole — will generally work like this, Grimaldi said:

After you've bought drugs worth $2,400, the insurance coverage stops. At that point, you must pay 100 percent of your drug costs. Insurance coverage will resume once you've spent $3,800 in out-of-pocket expenses (for such things as deductibles, co-payments and co-insurance), and your drug purchases total $5,451.

Most of the Rhode Island plans will provide no coverage for the gap. However, 15 plans will provide at least some gap coverage, mostly for generic drugs.

"That's a major difference [from the plan offerings for 2006], and will go a long way to help the small percentage of beneficiaries who found themselves in the gap this year," Pawelec said.

One caveat: If you're looking for a plan that offers full coverage through the doughnut hole, forget it: No such plan will be offered in any of the New England states for next year, according to a study by the Medicare Rights Center, a nonprofit consumer group based in New York: www.medicarerights.org.

• Medicare Advantage: These plans, which are popular in Rhode Island, essentially offer one-stop shopping: You get health insurance coverage — including preventive care — plus prescription drug coverage in a single plan. In exchange, you typically must use a certain network of doctors, hospitals and pharmacies.

If you're looking for a Medicare Advantage or similar such plan in Rhode Island (the government groups them under the "Medicare Health Plans" banner), you'll have a bit more choice this time around.

Five companies will offer plans: two newcomers — Humana and Unicare Life & Health — as well as three that are already in the market — Blue Cross, UnitedHealthcare and SecureHorizons.

Altogether, the companies will offer 11 Medicare health plans (some may be available only in certain counties). The total monthly premiums, including any drug premium, will range from zero — the AARP Medicare Complete Rx plan, from UnitedHealthcare — to $172 — the BlueCHiP for Medicare Preferred plan, from Blue Cross. Of the 11 plans, two will provide coverage for the gap; nine will not.

Also, two companies — Blue Cross and UnitedHealthcare — will offer "Medicare Special Needs Plans" for next year. These plans are generally geared toward specialized groups of beneficiaries.

Some other points:

• Technically, you may sign up for a plan at any time during the six-week enrollment period that ends Dec. 31. But Medicare is urging beneficiaries to sign up before Dec. 8, to ensure they'll have new prescription drug cards in hand to fill prescriptions in early January.

• If you already have a Medicare Advantage plan, and you want to add drug coverage, you must obtain it through your Medicare Advantage provider. If you obtain an independent, standalone drug plan instead, your health coverage under the Medicare Advantage plan will stop, Grimaldi said.

• If you're turning 65, you can use this open enrollment period to shop around for a Part D plan, Pawelec said. Keep in mind, though, that a separate — longer — enrollment period applies to you for picking a plan. (If you choose not to sign up for a Medicare drug plan when you first become eligible, you'll have to pay a penalty if you sign up later on.)

• Check out the Rhode Island Pharmaceutical Assistance to the Elderly program, known as RIPAE. If you're eligible, it can help pay for prescription drugs that you'd otherwise have to cover all yourself (for example, when you're trying to meet your annual deductible amount).

In certain circumstances, RIPAE will pay up to 60 percent of the cost of prescriptions; you pay the rest.

About 18,000 people are enrolled in RIPAE, Grimaldi said. It's for people 65 or older, and for people from 55 to 64 who are disabled and receiving Social Security disability benefits.

In general, you're eligible if your income is less than $41,136 if you're single, or $47,012 if you're married. (To obtain more information, about RIPAE, please see below.)

TODAY'S TIP: There are many factors to consider when choosing a plan, such as how much a plan costs, what drugs it covers and whether it covers pharmacies you use.

Fortunately, there'll be lots of places to turn for help in the weeks ahead. For example:

• Medicare will soon mail its annual "Medicare & You" booklet. It's a plain-language guide to Medicare, including details about standalone prescription drug plans and Medicare Advantage plans. You'll also be able to get more information directly from Medicare by calling toll-free at 1-800-633-4227, or using its Web site: www.medicare.gov.

• The state Department of Elderly Affairs plans to hold a series of workshops throughout the state to answer your questions and help you choose a plan. Tomorrow, the agency is scheduled to post a list of its first round of workshops.

The agency's Senior Health Insurance Program (SHIP) volunteers will be available at many locations statewide, including local senior centers.

For more information — including details about qualifying for RIPAE — call the agency at (401) 462-4000 from 8:30 a.m. to 4 p.m. business days. You may also call "The Point," the state's call resource center, at (401) 462-4444 from 8:30 a.m. to 4 p.m. Mondays, Wednesdays and Fridays; 8:30 a.m. to 8 p.m. Tuesdays and Thursdays; and 8:30 a.m. to noon Saturdays.

Or use these Web sites: www.dea.state.ri.us and www.ThePointRI.org.

• To preview details of plans that'll be offered in Rhode Island, use the Medicare Web site: www.medicare.gov. (In the middle of the screen, click on the link titled: "Medicare Prescription Drug Plans by State for 2007.")

MoneyLine correspondent Neil Downing is a staff writer for The Providence Journal in Rhode Island and author of "The New IRAs and How to Make Them Work for You." Do you have questions about your money matters? Call us at 1-401-277-7484 and leave a message, or e-mail moneyline@projo.com.

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