Understanding Medicare Plan D
Published 12:00 am Tuesday, October 31, 2006
Amid the current chaos of mistaken premium reductions and donut hole woes, Medicare beneficiaries need to be aware of the Period for Medicare Part D drug coverage, which starts Nov. 15, 2006 and goes through Dec. 31, 2006.
During this period, Medicare beneficiaries who do not have a Part D plan can enroll in one, and those who do have coverage can change plans.
Beneficiaries who take no action will remain in their current plan, with some exceptions for those who receive the low-income subsidy.
However, since plans may change their formularies (list of covered drugs), tiers, utilization management tools, exceptions and appeals processes, and other aspects of their Part D plans, even beneficiaries who were satisfied with their plan in 2006 need to review their options.
Multiple sources and large quantities of information will be available to beneficiaries about their options for 2007.
While beneficiaries can begin enrolling or changing plans Nov. 15, they do not have to make a decision until Dec. 31, 2006. In fact, some may purposely choose to wait in order to make the most informed decision possible.
Waiting to make an informed decision is especially important as Part D plans will begin marketing their plans Oct. 1, 2006, while Medicare will not publish information about 2007 in the Medicare & You Handbook until late October.
The Centers for Medicare & Medicaid Services (CMS) has indicated, however, that beneficiaries who enroll or change plans after Dec. 8 may experience delays in getting evidence of their enrollment in their new plan.
Every person with Medicare can be affected by changes to their drug coverage for 2007 and should therefore review his or her options.
Part D plans may make changes to their benefit package for 2007, including changes in covered drugs, utilization management tools, and premiums.
For example, Plan ABC offered in 2006 will not necessarily have the same benefits in 2007, even though it is offered by the same company and has the same name as in 2006.
It is therefore imperative that all beneficiaries review their current drug coverage &045; whether they are already enrolled in a plan, have retired or other creditable coverage, or have no coverage at all &045; and reevaluate their options for 2007, even if they were satisfied with their plan in 2006