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Caution Urged During Medicare Open Enrollment
By
Michael A. Piekarz
Staff Writer
The
Centers for Medicare and Medicaid Services (CMS) is using the start
of the 2009 open enrollment period for Medicare and Medicaid — from
November 15 through December 31, 2008 — to remind beneficiaries
to review their available options before making changes to their
health plans or prescription drug coverage.
“This year, because some beneficiaries will see changes in their plans’ costs
and coverage, it’s important that people with Medicare take advantage of
the enhanced tools we have available to review the coverage and costs of their
health or drug plans for next year,” said CMS Acting Administrator Kerry
Weems.
CMS has established an information page on the Medicare Web site and a toll-free
assistance number to help beneficiaries. People making no changes to their plans
are not required to take further action to remain enrolled as is.
For beneficiaries enrolling into Medicare Advantage (MA) plans only, they can
make a one time change in enrollment — enrolling in a new plan, changing
plans or dis-enrolling from a plan — between Jan. 1 and March 31, 2009.
CMS cautions that the MA open enrollment period cannot be used to start or stop
Medicare drug coverage or to enroll or dis-enroll in a Medicare Medical Savings
Account Plan.
Detailed information about the 2009 plans is included in the CMS “Medicare & You” handbook,
available at 1-800-MEDICARE and online at Medicare’s Web site.
At www.medicare.gov, beneficiaries can use the Medicare Prescription Drug Plan
Finder and Medicare Options Compare to enter their Medicare number, age, health
status, local pharmacy and their current prescriptions to receive detailed information
that will help them compare prescription drug plans and Medicare Advantage plans
that serve their area.
The plan finder helps beneficiaries compare drug plans for the best prices and
coverage, including estimated out-of-pocket costs, pharmacy networks and formularies.
CMS encourages beneficiaries to discuss these alternatives with their physicians.
Beneficiaries without Web access can get the same information provided by the
online personalized plan comparison tools by calling 1-800-MEDICARE or by contacting
the HICAP office toll-free at (800) 434-0222.
The “2009 Medicare & You” handbook, mailed to beneficiaries in
October, includes tips on selecting a plan and an overview of plan options. Beneficiaries
already enrolled in a prescription drug plan should have received an Annual Notice
of Change from their health or drug plan describing any changes in the costs
and benefits of their current drug plan from this year to next year.
CMS is also providing information about local open enrollment events as well
as increasing its low income subsidy outreach and education activities in order
to give beneficiaries the opportunity to select the plan choice that best suits
their needs.
“Medicare’s prescription drug benefit and the Medicare Advantage
program for health coverage are critical to preserving a better quality of life
for beneficiaries,” said Weems. “The extensive information and enhanced
online comparison tools we’ve developed, along with CMS’ strong oversight
of marketing activities, will ensure a positive enrollment experience for people
with Medicare.”
Senior Medicare advocates are issuing warnings to low income plan beneficiaries
to be extra careful when reviewing their current plan coverage.
According to a report released last week by the National Senior Citizens Law
Center (NSCLC), changes to the 2009 Medicare Part D plans will force low income
beneficiaries to switch to new plans, face premiums they cannot afford or limit
access to the medicines prescribed by their doctors.
“We are trying to get the word out now to help beneficiaries avoid a disruption
in access to their medications,” said Kevin Prindiville, staff attorney
at NSCLC.
“Everyone who receives premium assistance from Medicare for their Part
D benefit should make sure the subsidy will continue to cover their plan premiums
and that their plan will continue to cover their prescriptions,” said Prindiville.
According to information from NSCLC, plan choices under the Part D program are
shrinking, particularly for those who benefit from the Low Income Subsidy that
assists with premium, deductible and co-pay costs.
Advocates fear that Low Income Subsidy recipients will be unable to find plans
they can afford that cover the medications they need as a result of the lower
number of choices available to them.
“Depending on a variety of factors, low income Part D beneficiaries may
find themselves unable to access their prescription medication, paying a monthly
premium that they cannot afford, or both,” said Hector Javier Preciado,
Health Policy Director at the Greenlining Institute.
The NSCLC report recommends a number of changes to the Medicare Part D system
that would reduce annual disruption to low income beneficiaries.
“The current Part D system and its lack of stability places too heavy a
burden on beneficiaries, many of whom are ill, do not speak English as a first
language, or are simply overwhelmed by the complexity of the choices before them,” Preciado
concluded.
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Metropolitan News Company, Inc.
