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Medicare Drug Costs to Rise in '08
By
Suzanne Hoholik, Columbus Dispatch
December 7, 2007
For low-income Medicare beneficiaries enrolled in the prescription drug plans (Medicare Part D), the federal government has been subsidizing the costs of monthly premiums. But because five plans are raising their premium costs, these plans will no longer qualify for government subsidies. Due to these changes, low-income beneficiaries of these five plans will have to pay the monthly premiums starting next year. On December 31, beneficiaries can either switch plans or be randomly placed in other plans if they cannot afford to pay the premiums. Those opting to switch are advised to check the plan’s drug formulary and choose carefully and sooner rather than later.
The poorest Medicare beneficiaries should double-check their prescription-drug plan to make sure they can afford it next year.
Five plans that low-income beneficiaries in Ohio could pick in 2007 and pay no monthly premiums will cost them next year.
These plans are Aetna Medicare Rx Essentials, AdvantraRx Value, Humana PDP Standard, AARP Medicare Rx Saver and WellCare Signature.
The federal government pays the monthly premiums for drug plans that meet certain requirements so that the nation's poorest don't have to. But these five plans no longer qualify because their monthly premiums cost more than the benchmark of $26.82 or they don't meet other requirements.
This means certain people -- the ones who also get Medicaid or the 329,000 Ohioans who receive a low-income subsidy -- could face drug premiums of $3 to $6.90 a month.
Next year will be the third year of the Medicare prescription-drug program. It was designed, in part, to address concerns that older, poor Americans couldn't afford drugs and therefore would go without their medicines.
Because these five plans no longer meet subsidy requirements, federal officials will randomly reassign low-income beneficiaries to other drug plans unless individuals pick a new plan themselves. Those affected also can stay with their current plan if they are willing to pay the difference between the monthly premium and the federal subsidy.
Beneficiaries need to look beyond premiums when picking plans, experts say.
"Just because they're switching you into a monthly plan that would result in you not having a monthly premium in 2008, you could be spending more in the long run," said Andrew Haggard of the Central Ohio Area Agency on Aging. "And that has to do with co-pays and formularies."
People should check a plan's drug formulary to make sure their medicines are listed. Find out about deductibles and co-pays and make sure your local pharmacy accepts the plan, experts say.
The government won't be doing this legwork for you.
"We're concerned about these people," said Michael Marchand, Medicare spokesman. "And we'll work with them to help them as they go through this transition."
The deadline to sign up or switch drug plans is Dec. 31. Dual eligibles -- the older Americans and disabled who also qualify for Medicaid -- have more time, but government officials are urging people to act as soon as possible.
"You are that rare group that may opt out of a plan at any time," Marchand said. "If you find a plan that better suits your individual needs, you can switch plans at any time of the year. That cannot be said for others."
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