CMS informs some low-income Medicare drug plan beneficiaries that their coverage could change

Nov 6 2007

About two million low-income beneficiaries enrolled in Medicare prescription drug plans could be moved to new plans in 2008, and millions of other beneficiaries will have to change plans if they want to avoid double-digit premium increases, the AP/Houston Chronicle reports.

CMS last week sent letters to about a quarter of the lowest-income Medicare drug plan beneficiaries, who currently pay no premiums, informing them that that their coverage will change. Those beneficiaries must be enrolled in plans that meet the agency's requirements for covering low-income people.

The beneficiaries could retain their current coverage, but they would have to start paying premiums, CMS Administrator Kerry Weems said. Weems added that as the benefit continues there likely will be changes made to help reduce the number of people having to switch plans every year.

Most of the beneficiaries who will be required to switch coverage currently are enrolled in plans administered by United Healthcare and Humana, according to consulting firm Avalere Health. SilverScript and Medco likely will provide coverage for most of the beneficiaries who will be reassigned, according to the AP/Chronicle.

Advocacy groups said all Medicare Part D beneficiaries should review their coverage, even if they are satisfied with their current plan, because many drug plans are changing and some plans are increasing premiums. The premiums for plan with the largest number of beneficiaries, AARP Medicare RX Preferred Plan, will increase by 16% in 2008, while Humana's standard plan will increase by 71% and the AARP Medicare RX Save Plan will increase by 65%, according to Avalere. The average monthly premium in 2008 will be $28. The open enrollment season for 2008 Part D plans beings on Nov. 15 and ends on Dec. 31 (Freking, AP/Houston Chronicle, 11/3).

First-Person Account
Choosing a Medicare plan "wasn't quick or easy, and the more I studied the options, the more concerned I became that making a mistake could have serious consequences," journalist Charles Ornstein writes in a Los Angeles Times first-person account about choosing a Medicare plan for his mother who turned 65 this year. Ornstein continues, "It can take days to pick a plan that seems like the best fit," and the "number of options and their costs vary by region," adding, "In short order, I was drowning in choices."

In addition, for Medigap plans, Medicare's Web site "doesn't tell you how much each insurer charges," and some state regulators do not keep tabs either, so "you have to call each company individually," he writes. "In the end, we selected a plan for Mom that her friends had and her doctors liked -- much the same way as how most active workers pick their health plans" (Ornstein, Los Angeles Times, 11/4).