Beneficiaries in Two Medicare Part D Plans Must Choose One
The Bush administration on Monday sent letters to hundreds of thousands of Medicare beneficiaries to notify them that they are enrolled in two Medicare prescription drug plans and will soon be removed from one plan, the New York Times reports.
According to the Times, many beneficiaries who switched plans remained enrolled in the first plan. Beneficiaries in many cases "continued to use the first plan for some or all of their prescriptions, and pharmacies found that they could bill both plans for the same prescription." The administration has said that beneficiaries enrolled in two plans might be charged two premiums or improperly billed for other costs.
CMS Administrator Mark McClellan said that "[w]ell over a million" beneficiaries are enrolled in more than one plan, but many of them have only filed claims with one plan. An estimated 500,000 beneficiaries will receive notices, which are being sent by Medicare drug plans on government letterhead, as part of the "enrollment reconciliation process," HHS spokesperson Christina Pearson said.
The notice being sent to beneficiaries says, "The purpose of this notice is to confirm your choice of a Medicare prescription drug plan and to ensure that you are enrolled in the plan you want." According to the letter, beneficiaries who wish to stay in their original plan must call their insurers to inform them of their preference or otherwise "will no longer be able to use" their membership cards.
Beneficiaries who take no action will be dropped from the plan in which they were originally enrolled and will retain coverage under the second plan. Beneficiaries who are enrolled in two plans but have not used the first plan will be dropped from that plan but will not receive a formal notice to that effect, the Times reports.
In a memorandum to insurers who offer Medicare drug plans, the administration said, "Do not mail the special disenrollment letter or any other correspondence to these beneficiaries regarding their enrollment status. Deactivate these beneficiaries' pharmacy cards to prevent them from accessing plan benefits in the future."
McClellan said the beneficiaries who will not receive formal notices of the disenrollment are "fully enrolled in the new plan" and will not experience a disruption of benefits.
Jude Walsh, pharmacy affairs coordinator for Maine Gov. John Baldacci (D), said, "This mass disenrollment is fraught with a potential for trouble. It does not make sense to do it all at once."
Jeanne Finberg, a lawyer at the National Senior Citizens Law Center, said,
"It's very dangerous to disenroll people without informing them" (Pear, New York Times, 3/28).
In other drug benefit news, Roll Call on Tuesday examined how a new AARP campaign to educate beneficiaries about the drug benefit is "music to the ears of GOP lawmakers, who until now have expressed disappointment at AARP's relatively modest efforts to promote the GOP-backed plan after prominently endorsing it prior to passage."
AARP spokesperson Steve Hahn said the group will spend "several million dollars" on print and radio ads encouraging beneficiaries to enroll in the drug benefit before the May 15 deadline. According to Roll Call, the AARP campaign "comes at a crucial time" for Republicans because "many ... believe that public perceptions of the prescription drug program could make or break their re-election chances" (Pershing, Roll Call, 3/28).
The "real challenge -- to insurers and pharmacists, the media and congressional leaders -- is to demystify" the Medicare drug benefit by "help[ing] people face-to-face, one at a time," Mark Ganz, president and CEO of the Regence Group -- an affiliation of insurance plans -- writes in a Deseret Morning News opinion piece. Insurers "should pay the claims now and sort out the details later," Ganz writes.
"As with any public issue, media and congressional attention are good at creating heat and holding the responsible feet to the fire," he adds, concluding, "[L]et us not scare our seniors into shunning Part D for the sake of a snappy sound bite" (Ganz, Deseret Morning News, 3/27).