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Medicare Drug Program News
Medicare Expects Transition to New Drug Plans to Go
Smoothly for Senior Citizens; Advantage Still Open
Medicare Advantage enrollment open until March 31,
2008
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Medicare
Advantage Still Open for Enrollment |
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Enrollment
is still open for Medicare Advantage plans only.
Beneficiaries can make one change in enrollment - enrolling in a
new plan, changing plans or canceling a plan - between January 1
and March 31, 2008. |
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Jan. 4, 2008 - Senior Citizens who have chosen to
change their health and drug coverage for 2008 should experience very
few difficulties when getting their covered prescription drugs through
Medicare Part D, the Centers for Medicare & Medicaid Services has
announced. The CMS has taken multiple steps to ensure that pharmacies
can obtain accurate enrollment information in 2008, particularly for
low-income beneficiaries.
“A top priority throughout the fall open enrollment
season has been to help beneficiaries prepare and compare their plan
choices so that they could make informed decisions about switching
plans. In addition, we’ve been working hard to ensure a smooth
enrollment process,” said CMS Acting Administrator Kerry Weems.
CMS has improved procedures for getting accurate
plan information into the E1 eligibility system, which is the computer
system that pharmacists use to identify current plan enrollment, often
for beneficiaries who were reassigned to new plans, or who may not have
received their new drug card.
The CMS says it has also implemented better
processing requirements for all enrollees, and CMS continues support a
point-of-sale facilitated enrollment process that provides immediate
coverage for people with Medicare who have Medicaid or have qualified
for extra help, but aren’t enrolled in a Medicare drug plan.
The CMS also has worked aggressively to ensure a
smooth transition for low-income subsidy (LIS) eligible beneficiaries
who would be responsible for paying a portion of their plan premium in
2008. Earlier this fall, these beneficiaries received letters explaining
steps they could take to remain in their plan by paying a small premium
and a list of all the zero premium plans available in their community.
Blue reassignment letters were mailed to people who
qualify for the full extra help and who will be reassigned to a new plan
in 2008. Tan letters were sent to beneficiaries receiving the LIS who
selected a plan, but who will be responsible for paying a portion of
their plan premium beginning in January 2008 unless they join a new
plan. Beneficiaries who received one of these letters can receive
personalized assistance at their local State Health Insurance Assistance
Program (SHIP) office.
While CMS does not expect beneficiaries to
encounter difficulties at the pharmacy counter due to the collaborative
work among beneficiaries, partners and advocates, pharmacies, and plans,
nevertheless, those beneficiaries who have newly enrolled or changed
plans should keep these four tips in mind when visiting the pharmacy:
★
Bring your red, white, and blue Medicare card, a photo ID, and your
new drug plan membership card – these items will help the pharmacist in
verifying your coverage;
★
Bring an enrollment acknowledgement, confirmation letter, or the
name of your new drug plan if you have not received a plan membership
card – your enrollment search might take longer, but these items will
assist the pharmacist in verifying your coverage;
★
Keep copies of your receipts – in the rare instance where the
pharmacist cannot confirm enrollment, you can work with your new plan
prospectively to obtain reimbursement; and
★
Don’t leave the pharmacy counter without your medicine – if you
cannot pay out of pocket, call 1-800 MEDICARE for assistance or ask the
pharmacist to dial the special hotline for these cases.
In addition, CMS and others have taken the
following measures to smooth beneficiaries’ transition into 2008:
Online Enrollment and Toll-Free Assistance :
Since November 15, 2007, Medicare’s online enrollment center has
processed more than 347,000 enrollments. In the same period, its Web
site has recorded over 100 million page views on
www.medicare.gov and over 19 million page views of the Medicare
Prescription Drug Plan Finder.
Since November 15, 2007, 1-800-MEDICARE has
received more than three million calls and more than 3,000 customer
service representatives are ready to answer questions about enrollment
status.
The Medicare ombudsman’s office has senior casework
analysts available to resolve problems for beneficiaries who need
individualized assistance because of a critical health need or financial
circumstance.
★
At the Pharmacy: National and local chains and independent
pharmacies have worked closely with beneficiaries to provide information
and assistance during the open enrollment period. Thousands of
pharmacies have helped beneficiaries through in-store informational
days, medication reviews, and community presentations.
For example, Rotz Pharmacy, an independent pharmacy
in Winchester , Va. , provides a navigation guide to the
www.medicare.gov Medicare Drug Plan Finder, other comparison tools
as well as personalized consultation to beneficiaries who need help in
finding a plan that best suits their needs. In-person counseling and
other enrollment assistance has been provided nationwide and regionally
by many chains, including: CVS; Kroger; Longs Pharmacy; Medicine Shoppe
International; Rite-Aid; Target; Stop & Shop, Giant Foods and Giant Food
Stores; Walgreens; and Wal-Mart.
★
In-person: At more than 10,000 events held nationwide, Medicare has
worked closely with its partner organizations, including the National
Aging Services network of state, local and community service providers,
to provide enrollment counseling and sign-up opportunities where people
with Medicare live, work, play and pray.
The 2007 CMS Mobile Office Tour visited 128
communities across the nation sharing information about Part D with
beneficiaries. That tour highlights the personalized assistance provided
by the many thousands of partners across the country who are helping
beneficiaries compare their drug plan options and change enrollment if
necessary.
Through the Secret Shopper initiative, CMS
officials have attended over 220 events to ensure that health plans are
adhering to marketing and enrollment guidelines.
Recent surveys show that a large majority of
seniors enrolled in the Medicare drug benefit are satisfied with their
plan and few intend to change their plan in 2008. A Wall St.
Journal /Harris Interactive survey of U.S. adults age 65 or older shows
that 87 percent of Medicare drug benefit enrollees are satisfied with
their plan.
“Our educational efforts are paying off and we will
continue to provide information and assistance throughout 2008,” said
Weems.
The annual open enrollment period for prescription
drug coverage began on November 15 and ended December 31, 2007.
Medicare Advantage Enrollment Still Open
For Medicare Advantage plans only,
beneficiaries can make one change in enrollment -- enrolling in a new
plan, changing plans or canceling a plan - between January 1 and March
31, 2008. However, beneficiaries cannot join or drop Medicare drug
coverage during this time.
Beneficiaries eligible for the LIS have the ability
to change plans at any time. They can continue to visit www.medicare.gov
and view all the health and prescription plans available in their area.
Users can compare plans based on costs, coverage, customer service and
quality of each plan. They can also receive the same online information
by calling 1-800-MEDICARE.
For more information on where to find a SHIP
counselor available to provide free one-on-one help with your Medicare
questions or problems, visit
www.medicare.gov/contacts/static/allStateContacts.asp
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