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Prescription Drug Plans in Colorado
OVERVIEW
• Every one of the more than 531,000 Medicare beneficiaries in the state of
Colorado can choose to enroll in the voluntary Medicare prescription drug
coverage beginning on November 15. While Medicare’s negotiations for
these plan choices are not yet finalized, it is clear that a range of drug
plans will be competing aggressively to serve Medicare beneficiaries. By
choosing the plan that best meets their needs, beneficiaries in Colorado
can take advantage of options that include lower premiums and additional
benefits. And all plans must meet Medicare’s standards for access to
medically necessary drugs and convenient pharmacies.
PRESCRIPTION DRUG PLANS
• Approximately 18 organizations will offer stand-alone prescription drug
plans throughout Colorado in 2006.
Premiums
• The monthly premium, which is the amount of money that the Prescription
Drug Plan will cost each month, can vary between plans depending on the
type and level of coverage offered. Of the stand-alone Prescription Drug
Plans available in Colorado, about 3 plans will have monthly premiums
under $20, about 3 plans will have monthly premiums between $20 and
$25, about 9 plans will have monthly premiums between $25 and $30, and
about 14 plans will have premiums between $30 and $35.
Benefit Options
• Many of the available plan options have zero deductibles or deductibles
lower than the $250 deductible in the “standard” Medicare benefit. Plans
with no deductibles provide help with drug costs starting with the first
dollar that a beneficiary spends.
• Many of the plan options are “enhanced” plans that offer additional
benefits beyond Medicare’s standard drug coverage. Some of these
enhanced plans have monthly premiums of less than $30. An example of
an enhanced benefit that will be available in Colorado includes coverage
for generic drugs in the coverage gap.
Access to Needed Drug Treatments
• All of the prescription drug plans in Colorado, regardless of their premium
and other benefits, must meet Medicare’s standards for access to drugs
that Medicare beneficiaries need. This includes coverage of essentially all
drugs in six categories of treatments (drugs for mental illnesses including
antidepressants, antipsychotics, and anticonvulsants; drugs for HIV/AIDS;
drugs for cancer; and drugs affecting the immune system) and coverage
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