Medicare Prescription Drug Enrollment Starts On November 15

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Medicare encourages beneficiaries to review and compare their current health insurance coverage using enhanced online tools.

The Centers for Medicare & Medicaid Services (CMS) today is reminding people with Medicare that, starting November 15th, they will be able to make changes in their health insurance and prescription drug coverage for 2009. The Medicare annual coordinated election period for Medicare Advantage and Medicare prescription drug plans runs from November 15 through December 31, 2008.

“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. “And beginning on November 15, beneficiaries can go to www.medicare.gov or call 1-800-MEDICARE to enroll in a Medicare Advantage plan, with our without drug coverage, or a Medicare prescription drug plan. Those beneficiaries who are satisfied with their current plan do not need to do anything to remain in that plan in 2009.”

For beneficiaries enrolling into Medicare Advantage (MA) plans only, they can make one change in enrollment -- enrolling in a new plan, changing plans or disenrolling from a plan -- between Jan. 1 and March 31, 2009. However, the Medicare Advantage open enrollment period cannot be used to start or stop Medicare drug coverage, or to enroll or disenroll in a Medicare Medical Savings Account Plan.

Where Beneficiaries Can Get Information About the 2009 Plans

Detailed information about the 2009 plans is available in the Medicare and You handbooks, at 1-800-MEDICARE, and online. 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. At the Web site, users can find one overall summary score for the five-star ratings of the quality and performance of plans. Plan ratings are intended to help people with Medicare choose a Medicare Advantage health plan, a Medicare Advantage Prescription Drug Plan, or a stand-alone Prescription Drug Plan by combining cost and coverage information with quality and performance information. CMS also uses plan ratings for oversight and monitoring purposes to ensure plan quality. Medicare Advantage plans are rated on criteria such as providing timely information and care and management of chronic conditions. Prescription drug plans are rated on criteria such as customer service and providing drug pricing information.

The enhanced plan finder helps beneficiaries compare drug plans for the best price and coverage, including estimated out-of-pocket costs, pharmacy networks, and formularies. A new feature allows beneficiaries to view estimated monthly mail order drug costs in a bar chart which can be compared to retail drug costs. Beneficiaries can also find ways to further reduce costs based on the substitution of drugs which are lower cost but within the same therapeutic class. This goes beyond just generic products to include a choice of all less expensive drugs available with similar functions. CMS encourages beneficiaries to discuss these alternatives with their physicians

Personalized Assistance Available

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Beneficiaries without Web access can get the same information provided by the online personalized plan comparison tools by calling 1-800-MEDICARE, visiting their local State Health Insurance Assistance Program (SHIP) office for free personalized counseling, or by attending one of the local enrollment events taking place across the country now through Dec. 31, 2008. 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.

Information About Local Open Enrollment Events

This fall, CMS will host over 100 Medicare Open Enrollment events in major cities that will be attended by HHS and CMS leaders. In addition to helping new enrollees select a plan, these events will emphasize the availability of local resources to help beneficiaries review their current health plans and compare them to 2009 plan options.

Additional CMS-sponsored events will be held in communities nationwide throughout the Open Enrollment period. Partner organizations also will sponsor activities, and CMS estimates that a total of 10,000 community-based events will be conducted that will provide direct one-on-one counseling and support to beneficiaries and their caregivers during the Open Enrollment Period. More information on events is available at: http://www.cms.hhs.gov/center/openenrollment.asp.

Low Income Subsidy Outreach and Education Activities

CMS is also continuing in its efforts to educate and inform beneficiaries with limited income and resources about any plan changes they may experience in 2009. This fall, beneficiaries who receive the low-income subsidy (LIS), but who no longer qualify in 2009, received a letter from CMS about their loss of LIS coverage, along with a Social Security Administration application to re-apply if they choose. CMS also mailed letters to beneficiaries receiving the full low-income subsidy who currently pay no premium, and who would have to begin paying a premium if they stay in their current plan for 2009. This notice lets people know the cost for their drug plan premiums in 2009 and their options to stay in their plan or join another plan, including plans for which they will pay no monthly premium.

Many Low-Premium Plan Choices Available to Beneficiaries

The vast majority of beneficiaries enrolled in a stand-alone prescription drug plan will have access to Medicare drug and health plans in 2009 whose premiums would be the same or less than the premium they pay for their coverage in 2008. In every State, beneficiaries will have access to at least one prescription drug plan with a premium of less than $20 a month, except for those beneficiaries living in Alaska who will have access to a prescription drug plan with a premium of $23 a month. Those who qualify for the full Medicare subsidy will pay no premiums or deductibles in these plans. The national average monthly premium for the basic Medicare drug benefit in 2009 is projected to average approximately $28.

“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 - and CMS’ strong oversight of marketing activities - will ensure a positive enrollment experience for people with Medicare.”

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