Call it déjà New Year's: Approaching the Jan. 1 effective date for the second year of the government's new prescription drug program, known as Medicare Part D, beneficiaries could be forgiven for having flashbacks. They no doubt remember the program's launch last New Year's Day amid confusion, controversy, and chaos.
Some of the rough edges have since been smoothed out. Despite initial confusion over the many insurance options available, three-quarters of 3,400 beneficiaries surveyed by J.D. Power and Associates last summer reported being satisfied with their new plan and 80 percent reported paying the same or less for prescriptions.
But, patient advocacy groups caution, there are serious considerations for newcomers and current Part D beneficiaries, even those happy with service so far. Many Part D policies harbor coverage limitations and restrictions, so consumers must pay close attention to year-to-year changes, not just premium prices.
“All we see in 2007 is more of the same problem,” says Deane Beebe, spokeswoman for the Medicare Rights Center, an advocacy group based in New York City. “There's no guarantee you'll be able to get the drug you need when you need it, at the price you expect to pay. Even if someone is happy with the plan they chose in 2006, they still need to check to see what changes are in store in 2007.”
The government's Centers for Medicare and Medicaid Services (CMS) issued its 2007 list of approved Part D plans Sept. 29, but not everyone likes the selection. Ron Pollack, executive director of Families USA, an advocacy organization based in Washington, D.C., says the marked increase in the number of choices makes the selection process even more daunting for seniors and people with disabilities.
“The incredible confusion that persisted in the past year is about to get worse,” he says. “There will be more plans to choose from—and those plans will continue to be different from one another.”
In addition, he says, many of the plans that charged the lowest premiums in 2006 have raised their prices. For example, the cheapest plan for a seven-state region in the Midwest will increase premiums more than five-fold for 2007.
CMS, having enrolled 38 million of the 43 million Americans eligible for the program, recently updated its online Prescription Drug Plan Finder and Plan D guidebook. Those resources are designed to help people compare plans, calculate monthly premiums, and understand specific program features.
If history repeats itself, many eligible beneficiaries will wait until the last minute to select a plan before the enrollment window closes Dec. 31. Last year, more than two million seniors over 65 and younger persons with disabilities signed up in the last few weeks of open enrollment, leading to processing delays that left them without drug coverage Jan. 1.
Missing the 2007 deadline carries a penalty for every month you delay—and this would increase your Part D premium for the rest of your life. So, whether you're enrolling for the first time or changing plans, CMS advises picking the most suitable one as soon as you can before New Year's.
Evaluate and choose from among the plethora of prescription drug plans as soon as you can.
New Year's rings in a second chance for the controversial drug program