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Medicare Drug Program News
New Medicare Drug Plan Offerings for 2007 Get
Positive Reviews
More plans, lower prices, more drugs, even more
coverage in doughnut hole
October 2, 2006 – The new line-up of Medicare drug
plans released on Friday received positive responses from most with
critics focusing on the confusion of too many choices. What was grabbing
the most attention were the increased number of national plans, lower
premiums in many cases, more plans offering some coverage in the
"doughnut hole," and more drugs added to the formularies.
 17 Insurers Will Offer National Medicare
Prescription Drug Plans in 2007; 83% of Seniors Nationwide Will Have
Access to Lower Premium Plans
Private health insurers that market Medicare
prescription drug plans in 2007 will offer more plans, several of which
will have lower premiums and more of which will provide coverage during
the so-called "doughnut hole," Bush administration officials said on
Friday, the
New York Times reports.
Health insurers on Sunday began to market 2007
Medicare prescription drug plans, and the six-week open enrollment
period for the 2007 plan year begins on Nov. 15.
In 2007, all states except Alaska and Hawaii will
have more than 50 Medicare prescription drug plans available, and 23
states will have at least 55 plans available. Most states in 2006 had 40
Medicare prescription drug plans available (Pear, New York Times, 10/1).
Seventeen health insurers will market nationwide
Medicare prescription drug plans in 2007, compared with nine in 2006,
administration officials said (Zhang/Fuhrmans, Wall Street Journal,
9/30).
Almost none of the health insurers that marketed
Medicare prescription drug plans in 2006 will end participation in the
program in 2007 (Lopes,
Washington Times, 9/30).
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Medicare Releases 2007 Drug Plans Available in Each
State
 Links below will take
readers to their state plans available for enrollment Nov. 15
September 29, 2006 – The Medicare drug programs
available for 2007 in each state were released today by the Centers for
Medicare and Medicaid Services. Check
the link in the sidebar on this
page to find the information for your state. Open enrollment begins
November 15. Those satisfied with their current plans do not have to
take any action but CMS says in 2007 there are new options with lowers
costs and more comprehensive coverage.
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more...
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Premiums
The Medicare prescription drug plans in 2007 will
have an average monthly premium of $24, the same as in 2006, which is
40% less than first estimated for 2007 (New York Times, 10/1).
Medicare beneficiaries who are satisfied with their
current prescription drug plans will not have to take action to remain
in their plans in 2007, administration officials said. However, Medicare
beneficiaries who do not switch prescription drug plans might experience
changes in their plan premiums, copayments or formularies (Wall Street
Journal, 9/30).
CMS Administrator Mark
McClellan said that 83% of Medicare beneficiaries currently enrolled in
prescription drug plans will have the ability to switch to a
lower-priced plan in 2007 (Washington Times, 9/30).
In 2007, the lowest-priced Medicare prescription
drug plan will have a monthly premium of about $10, compared with
about $2 in 2006, according to administration officials (Wall Street
Journal, 9/30).
The highest-priced Medicare prescription drug
plan in 2007 will have a monthly premium of more than $110 (New York
Times, 10/1).
According to the Wall Street Journal, many of the
"more expensive plans in 2006 have come down in price to compete with
the low-cost options" that proved popular with Medicare beneficiaries.
Aetna in 2007 will reduce
monthly premiums for Medicare prescription drug plans by 5% to 13%, and
Cigna will reduce monthly
premiums by 10% to 30%.
Humana, which had the
second-highest Medicare prescription drug plan enrollment in 2006 --
will increase monthly premiums for some plans in 2007, but plans
marketed by the company will remain the lowest-priced in 38 states (Wall
Street Journal, 9/30).
Medicare prescription drug plans will have a median
monthly premium of $33.40 in 2007, compared with $36.01 in 2006,
according to
Avalere Health (Salganik,
Baltimore Sun, 9/30).
Coverage
Medicare prescription drug plans in 2007 will cover
an average of 4,390 medications, an increase of 13% from 2006 (New York
Times, 10/1).
In addition, fewer Medicare prescription drugs
plans will use prior authorization requirements or other utilization
techniques,
CQ HealthBeat reports (Carey,
CQ HealthBeat, 9/29).
In most states, about 15 or 16 Medicare
prescription drug plans will offer coverage during the doughnut hole, in
most cases only for generic medications, according to Avalere (Wall
Street Journal, 9/30).
Under the doughnut hole, Medicare beneficiaries are
responsible for 100% of annual prescription drug costs between $2,250
and $5,100. Medicare covers 95% of annual prescription drug costs that
exceed $5,100 (Kaiser
Daily Health Policy Report, 9/25).
CMS will release more detailed information on
Medicare prescription drug plan formularies and copays in mid-October
(Baltimore Sun, 9/30).
According to the Times, the "existence of so many
plans provides some evidence to support the theory that the federal
government can stimulate fierce competition among private insurers --
regulated and subsidized by the government -- to help control health
costs for beneficiaries and taxpayers" (New York Times, 10/1).
Comments
McClellan said, "As a result of robust competition
and smart choices by seniors, plans are adding drugs, removing options
that were not popular and providing more options with enhanced coverage"
(Wall Street Journal, 9/30).
McClellan said that the increased number of
Medicare prescription drugs plans in 2007 will not lead to confusion for
beneficiaries because they are not required to switch plans and because
CMS has improved the "plan finder" tool on the Medicare Web site.
"What we were looking for and got was a shift in
the options available," McClellan said, adding, "There are still a lot
of plans, but there are now a range of options with increased enhanced
plans and coverage options" (Washington Times, 9/30).
Ron Pollack, executive director of
Families USA, said, "The
incredible confusion that persisted in the past year about the Medicare
drug program is about to get worse" (CQ HealthBeat, 9/30).
He added, "There will be more plans to choose from
-- and those plan will continue to be different from one another. And,
instead of a six-month enrollment period, there will only be a
one-and-a-half-month period this year."
Karen Ignagni, president and CEO of
America's Health Insurance Plans,
said, "Private plans are exceeding expectations by offering low premiums
and expanding benefits" (Baltimore Sun, 9/30).
House Ways and Means Committee
Chair Bill Thomas (R-Calif.) said, "The announcement today ... shows
once again that when competition is injected into Medicare, seniors win"
(CQ HealthBeat, 9/30).
Deane Beebe, a spokesperson for the
Medicare Rights Center, said
that beneficiaries "don't want dozens of choices." She added, "They want
one affordable drug benefit they can count on when it comes time to fill
their prescription" (Freking,
AP/Philadelphia Inquirer,
9/30).
Broadcast Coverage
APM's "Marketplace"
on Friday reported on details of Medicare prescription drug plans for
2007. The segment includes comments from Stuart Altman, dean of the
Heller School for Social Policy and
Management at Brandeis University; Beebe; and Leslie Norwalk,
deputy administrator for CMS (Palmer, "Marketplace," APM, 9/29).
The complete transcript and audio of the segment in
RealPlayer are available
online. In addition, C-SPAN's
"Q&A"
on Sunday included an interview with McClellan about the Medicare
prescription drug benefit, the U.S. health care system, his future plans
and other issues (Lamb, "Q&A," C-SPAN, 10/1). The complete transcript is
available
online. The complete segment
is available
online in RealPlayer.
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