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Medicare Drug Program News
Senior Citizens Get More Encouragement to Reconsider
Medicare Drug Options
Time to make changes in Medicare begins Thursday,
open until end of year
 Nov. 13, 2007 If you are reading this at
SeniorJournal.com, you are most likely a senior citizen or someone
carrying for an older adult. This means you should be getting your focus
on the Medicare open enrollment period that opens Thursday. Increasingly
senior advocates and the media are finding significant changes,
particularly in many drug plans, and urging all seniors to look closely
at what they have now and what alternatives are available.
KaiserNetwork.org notes such a report from the Wall Street Journal, and
highlights a "must-read" special section on the drug benefits in the
Miami Herald.
Medicare Part D Beneficiaries Consider Options
as Coverage, Costs Shift in 2008
With the Medicare Part D prescription drug benefit
entering its third year and insurers making changes to their offerings,
beneficiaries might "have more reasons than ever" during the six-week
open enrollment period starting on Thursday "to revisit their
prescription drug coverage and consider a change," the Wall Street
Journal reports.
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Last year, only a small number of beneficiaries
switched plans, even though there was a "flurry of new offerings,
especially in Medicare Advantage," the Journal reports. According
to the Journal, some insurers are "testing the loyalty" of
beneficiaries by raising premiums and increasing out-of-pocket costs.
In the top three plans in the U.S., the average
premium is set to increase 27% in 2008, according to an analysis of data
from the government and private insurers. According to
analysis from the
Kaiser Family Foundation, about one in five beneficiaries in
stand-alone plans will see an increase of more than $10 per month if
they do not switch plans for 2008.
Among those who have remained in the same plan
since the beginning of the drug benefit in 2006, about one-fourth will
see their premiums rise 50% or more above their original rates. Dan
Mendelson, president of consulting firm
Avalere Health, said, "If you went to the market to look for the
least-expensive plan, you need to look again."
In addition, many plans are reducing coverage
during the so-called "doughnut hole" coverage gap. According to the
Kaiser Family Foundation, almost one-third of stand-alone drug plans and
about half of MA plans had some coverage during the gap this year. Most
plans with gap coverage in 2007 included all generic drugs during the
doughnut hole.
In 2008, about half of plans with gap coverage will
cover only certain generic drugs during the gap.
CMS this week is offering new tools on its Plan Finder Web site,
including report cards (Zhang, Wall Street Journal, 11/13).
Miami Herald Features Section on Open
Enrollment for Medicare Prescription Drug Benefit
The Miami Herald on Sunday featured a
special section on topics related to the open enrollment period for the
Medicare prescription drug benefit, which begins on Thursday. Summaries
appear below.
● "Don't
Ignore Medicare 'Doughnut Hole'": The so-called "doughnut hole" in
Medicare prescription drug coverage "continues to be a potential
problem" for many beneficiaries, the Herald reports. Medicare
beneficiaries who fall into this gap have several options, including
choosing a plan that will provide partial coverage for prescription
drugs during the gap, purchasing supplemental drug coverage to pay for
drugs during the gap or avoiding the gap by spending less on
prescription drugs throughout the year (Gilpatrick [1], Miami Herald,
11/11).
● "How
To Use Medicare's Online Prescription Drug Finder": The Herald
featured instructions on how to use Medicare's online prescription drug
finder, available at
http://www.medicare.gov (Gilpatrick [2], Miami Herald,
11/11).
● "Private
Insurers Offer Plans With Perks": Preventive health care "has been
an increasingly large part of the nationwide debate" and will continue
"to play a bigger role in Medicare coverage through expanded Medicare
Advantage plans," the Herald reports. According to the Herald,
MA plans have added "more perks designed to promote better health," such
as smoking cessation and healthy eating programs, which in turn reduce
health care costs for the insurer, industry experts say (Gilpatrick [3],
Miami Herald, 11/11).
● "Selecting
a Medicare Plan May Get Easier": Health care advisers are hopeful
that increased familiarity with the prescription drug coverage and
better tools for evaluating available plans will help seniors choose the
most appropriate plan for 2008, the Herald reports.
However, "with a multitude of plans all with
different premiums, medications, copayments and fine print, finding the
right choice still can be daunting, especially for seniors who don't
have Internet access or aren't Web savvy," according to the Herald.
Health care advocates say that seniors should examine their plans to
determine how they will change in 2008 and whether it would be less
expensive to switch to a different plan (Gilpatrick [4], Miami Herald,
11/11).
● "Tool
Aims To Ease, But Can Seniors Swing It?":
CMS improved the online Medicare plan finder for this year's open
enrollment period in hopes of making it "easier to sift through the
dozens of prescription drug plans, health plans and Medicare Advantage
plans," but for seniors who "aren't computer savvy, let alone Web savvy,
the tools can provide more confusion than guidance," according to the
Herald.
The Medicare Web site allows users to fill out an
online form with their personal information, including location and
current prescriptions, and ranks prescription drug plans in the state.
It also estimates their monthly costs based on the information. The
online tool this year will provide customer service information about
each plan and alert individuals if they can save money by switching to
another plan (Gilpatrick [5], Miami Herald, 11/11).
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