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Medicare Drug Plans Offer Premiums of $20 Per Month or Less Lower
Deductibles, Enhanced Coverage Also Available
Medicare beneficiaries all over the country will be able to choose
prescription drug coverage that will cost less than originally expected,
including plans with premiums of $20 per month or less. Options will also
include plans offering zero deductibles or deductibles lower than $250 annually,
and plans that provide some coverage in addition to the "standard" Medicare drug
benefit.
"Choice and competition among prescription drug plans is working to reduce
premiums across the country making the drug benefit even more affordable for
seniors and other Medicare beneficiaries," HHS Secretary Mike Leavitt said. "For
just $20 or $30 per month, seniors will be able to get a Medicare-approved
prescription drug plan that will provide real help and protect their life
savings from ever being eroded by high prescription drug costs."
Earlier this month, the Centers for Medicare and Medicaid Services (CMS)
estimated that the national average monthly premium for coverage equivalent to
the Medicare standard coverage would be $32.20. The reviews of the drug plans by
CMS, which are nearing completion, show that Medicare beneficiaries will be able
to choose lower cost options and options with coverage in addition to Medicare's
standard plan, including:
At least one prescription drug plan with premiums below $20 per month, and in
some areas significantly below $20, in every region of the country except
Alaska. All regions have multiple plan options with premiums significantly below
$30.
In every region, prescription drug plans that will have zero deductibles or
deductibles lower than Medicare's standard $250 annual deductible.
Some prescription drug plans will offer coverage that exceeds Medicare's
standard plan. This includes help for beneficiaries to pay for costs beyond
$2,250 and before their out-of-pocket costs hit $3,600 a year – the gap in
Medicare's standard coverage. For example, some plans will cover generic drugs
in the coverage gap.
In every region, beneficiaries with limited incomes (including those eligible
for Medicaid and Medicare) will be able to choose from plans with zero premiums
offered by at least five organizations. All of these plans will meet all of
Medicare's standards for access to medications.
"The robust response by prescription drug plans is translating into better
benefits and lower costs for people with Medicare, however they prefer to get
their Medicare coverage," said CMS Administrator Mark B. McClellan, M.D., Ph.D.
"All plans, including the lower cost options, must meet Medicare's standards for
access to medically necessary drugs and convenient neighborhood pharmacies."
For the stand-alone prescription drug plans, regional figures and spreadsheets
accompany this release and can be found at www.cms.hhs.gov. Between 11 and 23
organizations will offer stand-alone prescription drug plans in each region of
the country.
People with Medicare will also have access to lower-cost coverage and additional
coverage in Medicare Advantage plans. Many of the Medicare Advantage
prescription drug plans will have additional benefits beyond the standard
Medicare coverage and have monthly premiums that are significantly less than $20
and CMS figures show that beneficiaries in Medicare Advantage plans are already
saving about $100 a month on average in out-of-pocket health care costs,
compared to traditional Medicare alone or with an individual Medigap plan.
CMS is now completing the review of the stand-alone prescription drug plans and
the drug plans to be offered by Medicare Advantage organizations. The final
review is evaluating important factors such as whether the plans meet the
Medicare law's standards for access to drugs at pharmacies convenient to their
homes. Consequently, the plans available may change somewhat between now and the
completion of the plan reviews.
"We will not approve any drug plans until we are convinced that they can meet
Medicare's standards for serving our beneficiaries, which means some plans may
not be approved," Dr. McClellan said. "While it is important for us to complete
our review and work with plans to make any refinements, we do not expect these
further refinements to substantially affect the major features of the plan
choices announced today."
CMS will provide more comprehensive details on the premiums, benefits, and other
features of the prescription drug plans and Medicare Advantage plans available
in each region as the plan review is completed, ahead of plan marketing in
October. All beneficiaries can begin to enroll in the plan of their choice
beginning November 15.
CMS will help beneficiaries get the information they need to choose a plan.
"This fall, Medicare will work with counselors, advocates, health professionals,
and other partners to assist seniors, people with a disability, and their family
members in making their choice about these important benefit options," said Dr.
McClellan.
CMS will mail the Medicare & You handbook to more than 41 million households by
mid-October. Around that time, beneficiaries will be able to get personalized
information on plans that reflect their own needs and preferences through
www.medicare.gov,
1-800-MEDICARE, or CMS partner organizations. Medicare officials are already
working with a wide range of groups to help deliver this information, including
health professionals, senior advocates and many other partners at the state and
local level. Information and assistance will also be available all across the
nation through the State Health Insurance Assistance Programs, local Area
Agencies on Aging, and many churches, senior centers, pharmacies and other
centers where seniors and people with disabilities work, live, play and pray.
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