Uh-oh. If you have a Medicare Advantage plan

Beacon Journal medical writer Cheryl Powell warns in today's BJ that Medicare Advantage plans, such as the one the BJ nudged its retirees to sign up for, will increase premiums in 2010. Currently the BJ pays its retirees' premium, but BJ owner Canadian Press is the same outfit that dropped the $2 to $5 co-pay for prescriptions and installed one that makes retirees pay $5 to $80 per 90-day prescription.

The changes in retirees' medical coverage is at the heart of the lawsuit against the BJ by retired Beacon printers. The first hearing on that lawsuit will be Oct. 26 in Federal District Court in Akron.

Some BJ retirees have opted to get their medical and prescription coverage elsewhere, even though they have to pay their own premiums, because they prefer the overall package of benefits compared to the Aetna Medicare plan supported by Black Press.

Cheryl's story says that Medicare Advantage premiums will rise from $16.90 to $97.50 in 2009 to $22.60 to $102.20 in 2010. Of charges on the 19 plans listed in the BJ today, Aetna Medicare's premiums range from $25.40 to $78. Only two of the 19 plans have higher premiums than Aetna. The plans have different benefits so it's like comparing apples and oranges.

One of the constants is that the "donut hole," the point where you begin paying 100% of your brand-name prescriptions' costs, will rise from $2,700 in 2009 to $2,830 in 2010 for the "actual costs" of the prescriptions. Generics generally don't cost any more in or out of the "donut hole."

And you won't escape the "donut hole" until you spend $4,550 of your own money for prescription drugs.

The calculations switch from the "actual total cost" of the drugs, used to determine when you hit the "donut hole," to the amount that you spend for your drugs, as co-pay or otherwise. In my case, when the "actual total costs" of my prescriptions hit $2,700, my out-of-pocket drug costs were about $400.

That meant I would have to spend more than another $4,000 for the rest of the year before I got out of the "donut hole." Few people escape the "donut hole" so, in reality, you lose the cheaper co-pay for brand-names once you hit the "donut hole."

Also Aetna Medicare Advantage has another trick to get you to the "donut hole" faster, and get Aetna out of paying as much of your prescription costs. It over-values the "actual cost." Examples, all for 90-day prescriptions for a drug: Aetna says Carvedilol costs $54, but Giant Eagle and Wal-Mart charge $10 for the same drug. Aetna says Terazosin's "actual cost" is $29.70, but Giant Eagle and Wal-Mart charge $10. Aetna lists Celebrex at $316.49 with no U.S. generic available, but the generic Celecoxib in Canada costs $68.15.

I save almost $700 a year by getting my brand-name prescriptions from Canada once I hit the "donut hole." I get my generics through Aetna for the entire year because my co-pay doesn't change on generics, even if I'm in the "donut hole."

In addition, deductibles for many plans will rise from $295 to $310.

Starting Oct. 15 you can get detailed, personal information about Medicare Part D drug plans and Medicare Advantage options for 2010 by logging onto Medicare's Web site at http://www.medicare.gov or calling 800-633-4227.

Click on the headline to read Cheryl's story.