Press Release             

FOR IMMEDIATE RELEASE
Contact: Deane Beebe
Public Affairs Director Medicare Rights Center
212-204-6219
E-mail
Akiko Takano
212-204-6214

November 9, 2007

Consumers Should Review Their Current Medicare Private Drug Plans' Costs and Benefits and Compare All Their Drug Plan Options for 2008

Free Resources Are Available to Help Consumers Through the Selection Process

New York, NY - Anyone who gets drug coverage through a Medicare private drug plan (Part D) should review all of their drug plan choices for 2008-even if they are satisfied with their current plan-because most drug plans will change their costs and benefits.

People with Medicare have the right to change their Medicare private drug plans, or enroll in one for the first time, from November 15 through December 31. It is important for people to review their Medicare private drug plan choices now and choose the plan that best suits their needs, because after January 1, most people will be locked into the plan they chose for the rest of the year.

"Medicare private drug plans are a moving target for Americans with Medicare," said Robert M. Hayes, president of the Medicare Rights Center, a national consumer group. "A plan that worked well for someone this year may be more expensive, cover different medications and have different restrictions on their covered drugs in 2008. No one should assume that their drug coverage will remain the same if they stay in their current plan."

Medicare drug coverage is available only through private insurance companies. People who have Original Medicare can purchase a "stand-alone" plan (drug coverage only). Most people who get their Medicare benefits through a Medicare private health plan-such as an HMO or PPO-must get their drug coverage as part of the health plan's benefit package.

Annual deductibles, copayments, covered drugs (formulary) and participating pharmacies vary from plan to plan. In 2008 the annual deductible can never be more than $275. People who are currently enrolled in a Medicare private drug plan should have received a letter from their plan that informs them of changes for 2008. They should call their plan if they have not received a letter.

Medicare private drug plans have a gap in coverage known as the "doughnut hole," during which people must pay the full cost of their prescriptions. In 2008, the gap for many plans begins when total drug costs (what the consumer pays plus what the plan pays) reach $2,510. The coverage gap ends and catastrophic coverage begins after the consumer has spent $4,050 out of pocket. People with catastrophic coverage will then pay 5 percent of the cost of each drug or a copayment of $2.25 for covered generics and $5.60 for covered brand-name drugs, whichever is greater. There are plans in most states that offer some coverage through the gap, but they generally have higher monthly premiums and most cover only generic drugs in the gap.

People with low incomes (monthly income of $1,276 for singles, $1,711 for couples) and few assets (below $11,710 for singles, $23,410 for couples) may be eligible for Extra Help, a federal program that helps pay for some or most of the costs of Medicare prescription drug coverage. People whose income or assets are above the limit may still qualify, because certain types of income and assets may not be counted. Applications for Extra Help are available through the Social Security Administration. You can also apply online at www.ssa.gov.

People who have Medicaid, Supplemental Security Income (SSI) or a Medicare Savings Program (MSP) automatically qualify for Extra Help, and do not have to apply.

To compare plans, consumers can use the Medicare Prescription Drug Plan Finder tool at www.medicare.gov or call 800-MEDICARE to review all of their options and get details about the plans. Before signing up with a drug plan, people should call the plan and confirm all details.

Enrolling in a Medicare private drug plan is voluntary for most people, but people with both Medicaid and Medicare, and those enrolled in some state pharmaceutical assistance programs, must have one. Whether you should enroll depends on your current drug coverage, your prescription costs and your drug needs. If you have drug coverage that is considered as good as Medicare's ("creditable")-for example, from an employer-you can keep it and enroll in the drug benefit later without penalty, as long as you are not without creditable coverage for more than 63 days when you take part D. If you do not have creditable drug coverage, and do not enroll in the Medicare drug benefit when you are first eligible, you may have to pay a premium penalty when you do enroll.

The Medicare Rights Center offers the following resources, at no charge, to help people choose a drug plan that best meets their needs: