A certain person I know got a big packet, maybe 300 pages or more, from AdvantraRx, a Medicare Part D insurer, the other day.

Most of the news was on one page. It said the monthly fee was going up by 68.98 percent in 2010. It didn’t say it in so many words; we had to figure out the percentages on our own. But that was easy. The increase was from $24.50 a month to $41.40 a month.

The annual increase is even higher – it’s more than 100 percent. That’s because AdvantraRx added a $100 annual deductible to the policy, where there was no deductible in 2009. (The arithmetic: 2009 annually, $294. 2010 annually, $496.80 plus $100=$596.80, or an increase of 102.99 percent.)

Now I know there are people who would love to have a Part D bill that size. Many Americans need multiple, expensive medications and crash into doughnut hole expenses. Their health stories are a lot worse and their fees much steeper. From my perspective, this increase is an annoying bite but not much more.

But look at it from the insurers’ point of view: Is this a breakthrough achievement for AdvantraRx or what?! All or almost all the major firms must be raising rates a lot for 2010. They always raise rates and now they’ve got an extra incentive – positioning themselves to be ready for health care reform. But still, a 102.99 percent increase from one year to the next, that’s something special. AdvantraRx must be proud. They’re so gutsy, they won’t even slow down when everybody is looking at them.

There’s one more thing. Somewhere in the packet it states that Medicare has approved this rate increase.