Changes to Medicare Rx Drug Plan Could Cause Shifts in Enrollment
Medicare rule changes intended to make it simpler for beneficiaries to pick prescription drug coverage could cause more than three million beneficiaries to change their plans in 2011, according to a new analysis by Avalere Health, the AP/Chicago Tribune reports.
When other changes are taken into account, as many as 3.7 million beneficiaries -- 20% of the 17.5 million beneficiaries enrolled in stand-alone drug plans -- might switch plans. Under the new rules, seniors would not lose coverage but their premiums and copayments could change under their new plan.
The rule changes are intended to decrease duplicative plans offered by the same insurer.
Medicare already has notified insurers that they will no longer be permitted to offer more than one "basic" drug plan in a given region, a practice employed by several major prescription plans, including CVS-Caremark and AARP. Eliminating those duplicate plans would result in 2.75 million beneficiaries' needing to find new coverage.
Another new rule will require insurers that offer multiple enhanced coverage plans to show that they are different. In 2010, almost 1,600 plans were available, many of which lacked significant differences from one another, according to the analysis.
Medicare is expected to release its list of drug plans for 2011 in late September. The options available in each state could drop from more than 40 per state to about 30.
Medicare Officials' Response
Medicare officials disagreed with Avalere's estimates.
Jonathan Blum, deputy administrator for Medicare, said that CMS is "not reducing the number of (insurers)" or "the number of quality plans," adding that fewer choices will be beneficial for seniors.
Blum also said that Medicare is working with insurers to ensure limited coverage disruptions. For example, beneficiaries might automatically be reassigned to a comparable plan from the same insurer if the original plan is eliminated (Alonso-Zaldivar, AP/Chicago Tribune, 8/25).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.