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Nov. 15 will mark the start of a 45-day period known as the “Medicare Open Enrollment Period,” or “OEP.” Open Enrollment became part of the Medicare platform with the introduction of the Medicare Part D drug program in January of 2005.

In simple terms this period is the time for Medicare Beneficiaries that enrolled in a Medicare Advantage Program, Part D drug program, or original Medicare to make changes to their existing coverage.

During this 45-day period, Medicare beneficiaries may change to any other plan that they wish to or add drug coverage to their existing plan.

Once this period passes, beneficiaries will only be allowed to change from a “like plan” to a “like plan.”

This means that if a beneficiary chooses not to enroll in a part D drug plan during open enrollment, then they will be unable to add drug coverage for the remainder of the year.

Likewise, if they do select a drug plan during open enrollment, they must keep a drug plan for the remainder of the year.

There is also a period from Jan. 1 to March 31 known as the “Annual Enrollment Period” or “AEP.” During these months a beneficiary may only change to a like plan.

Thus if they select a plan during open enrollment that covers drugs, then they may only switch, during the AEP to another plan that also covers drugs.

It is critical that seniors get good advice with regards to the part D drug program and make their selection in a timely fashion, as there are penalties for enrolling as a late enrollee.

In order to be considered a timely enrollee, a senior must enroll in a part D drug program in the seven month period that includes the three months prior to beneficiary turning 65, the month they turn 65 and the three months following the month they turn 65.

Any enrollment in the drug program after that time and the beneficiary is considered to be a “late enrollee” and a 1 percent per month penalty will apply. For example: A senior turns 65 in May of 2007 and chooses not to enroll in a drug program until January of 2008.

Beginning in August of 2007 they would be considered a late enrollee. Counting forward to January that would be five months and Medicare would apply a 5 percent penalty per month for the rest of this beneficiaries' life.

The new Medicare rules are quite complex and confusing for many seniors.

In addition, every year there are changes to the Medicare program that further compound the complexity of the program.

Overall, the drug program has been a tremendous benefit for many seniors. Several of my clients have told me that prior to the program they had to make the decision between food and medication.

Understanding the program and how it can benefit you is imperative in today's high cost prescription environment.

Seek the advice of a competent independent insurance agent that has significant experience in the Medicare arena.

Do not be fooled by the many new agents that have entered the industry recently to take advantage of the “Part D” surge of enrollees.

Many of these unscrupulous agents are targeting the “turning 65” crowd and scaring them into making a decision.

Or they are enrolling them in a Medicare Advantage program under the premise that they can get a “free” drug card just by completing an application.

The Centers for Medicare and Medicaid (CMS) require that any presentation of the part D drug program include a summary of benefits, a formulary of covered drugs, and a list of participating pharmacies.

If you are approached by anyone promoting a drug plan and they do not include these documents in their presentation, you should decline their offer and report them to CMS.

Some great information about the drug program as well as Medicare Supplements and Medicare Advantage plans can be found on the Medicare Web site medicare.gov.

On that Web site you can compare plans in your area and even enter your current medications to find the best plans for your situation. I will advise you that the information can be overwhelming and the help of a competent agent is invaluable.

Due to the limited space of this column I have not been able to cover all of the enrollment periods or the conditions for enrollment. “Special Enrollment Periods” or “SEPs” are numerous and apply to certain individuals at specific times of the year.

Medicare has several programs to assist low-income seniors with the cost of their drug program.

Talk to your independent insurance agent to see if you qualify for these enrollment periods or special assistance programs.

George Harris is an independent insurance agent and financial advisor with 20 years experience. He can be reached at his office in Gulf Shores at 1-866-346-GULF or you can email him at george@georgeharrisfinancial.com with any questions or comments.