Medicare, an insurance plan for seniors over 65 and the disabled, was originally was geared to cover emergencies and doctor visits, however prescription drug coverage, called part D, was added by a law that went into effect Jan. 1. The federal government is contracting with dozens of private companies to provide drug coverage under Medicare, each offering plans catering to different needs. Supporters say the program has helped millions of people by providing assistance for drug costs but critics say Part D is just too complicated and point to the mass confusion and chaos following its launch as evidence. As this year progressed, though, people settled into their plans and the turmoil calmed. Some senior experts are now worried that at least some of the confusion could rise again during the upcoming enrollment period with changes to co-payments, formularies, prior authorization requirements and deductibles. Nine insurance plans dropped out of the Medicare program, and 14 were added. The basic plan's deductible, coverage limit and coverage gap costs have increased. And some plans are no longer paying for previously covered drugs or have added new drugs to their coverage. If beneficiaries don't recheck their prescriptions online or with an insurance counselor, they could get an expensive bill from a pharmacy after January for drugs that were inexpensive before on the plan. People considered “dual eligibles” — those on both Medicare and Medi-Cal — don't have to change plans and can rest easy. Experts say that the revisions to the Part D program could be good for some of its users. Many plans are now offering coverage for generic drugs during the coverage gap, called the "dough nut hole."  The dough nut hole is a dollar amount where coverage abruptly stops. A customer must pay out of pocket until "catastrophic coverage" begins thousands of dollars later. Six more plans are offering relief from these costs this year, said Jack Cheevers, a regional Medicare spokesman. "I think the plans really got the message that people are really unhappy with the doughnut hole, so some of them are offering more coverage in the dough nut hole," he said. To avoid the backlogs of last year, Medicare officials are asking people to sign up by Dec. 8. That will give the program time to process applications and get clients their insurance cards before the New Year begins. "We did have problems last year with a lot of people signing up very late very close to the deadline, and that overwhelms us," he said. "And, as a result, there were delays."  Since more than 38 million people are already enrolled nationwide, Cheevers said most of the issues of last year’s sign ups will not arise.  "We don't expect to have a tsunami of people switching or signing up," he said. "But there will be people switching, there will be people signing up, and that's why we just want to make that transition as seamless as possible."  Medicare has a new online tool at MyMedicare.gov that people can personalize to help track spending, deductibles, screenings and bills, he added. For help on this issue contact the Amador Senior Center @ 223-0442. They have Counselors available weekly. Walk-in Consultations Wednesdays from 1 pm to 3 pm to provide free, unbiased assistance with insurance programs through HICAP---Health Insurance Counseling and Advocacy Program.

 The Union Democrat contributed to this story