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ROBUST MEDICARE HEALTH AND DRUG PLAN COVERAGE CONTINUES IN 2010 BENEFICIARY PROTECTIONS STRENGTHENED

ROBUST MEDICARE HEALTH AND DRUG PLAN COVERAGE CONTINUES IN 2010 BENEFICIARY PROTECTIONS STRENGTHENED

Medicare beneficiaries enrolled in Medicare health and prescription drug plans will continue to have a wide range of plan options in 2010, and those beneficiaries who decide to change plans should find choosing a new plan simpler than in previous years. The same percentage of Medicare beneficiaries who have access to a Medicare Advantage plan today (99.9 percent) will have access to a Medicare Advantage plan in 2010. In addition, all Medicare beneficiaries will have many prescription drug plans from which to choose. Plan marketing begins today.

CMS encourages beneficiaries enrolled in Medicare Advantage and Medicare Prescription Drug plans to review their current health and drug plan coverage for any changes their plans may be making for 2010 before the annual enrollment period begins Nov. 15. Beneficiaries should also remember that at no time will they lose their Medicare coverage, no matter what business decisions have been made by their Medicare Advantage or Prescription Drug Plan.

To protect beneficiaries from deceptive marketing practices conducted by sales agents and brokers who sell Medicare Advantage and Medicare Prescription Drug plans, or the plans themselves, CMS has strengthened its oversight of plan marketing activities. This includes stronger rules governing the commissions that can be paid to independent sales agents and new marketing guidelines around how Medicare Advantage plans identify themselves. In addition, CMS has plans to expand current surveillance efforts by conducting a greater variety of secret shopping activities, including one-on-one marketing sessions. Extra surveillance and outreach activities will also be focused on areas where Medicare beneficiaries are most impacted by non-renewals.

In 2010, nearly all beneficiaries will have access to a Medicare Advantage plan, most of which offer prescription drug coverage. Only 1.5 percent of all Medicare beneficiaries (and approximately seven percent of beneficiaries enrolled in Medicare Advantage plans) will need to choose a new health plan or Original Medicare in 2010 because their current plan announced earlier this year it would not renew in 2010. Most of these plans are private fee-for-service (PFFS) plans that made their business decisions to exit the program. These business decisions have been previously announced by the plan sponsors.

CMS also implemented a comprehensive review of plans that served less than 100 enrollees, had been in operation less than two years and were not serving a special population, such as beneficiaries enrolled in special needs plans. CMS also identified plans offered by the same sponsor with similar benefits – plans that made it hard for beneficiaries to distinguish differences between the plan offerings. Consistent with its 2010 Call Letter issued in March 2009, CMS worked collaboratively with plan sponsors to reduce the number of these low enrollment and duplicative plans while continuing to ensure beneficiaries had access to a range of plans.

In 2010, beneficiaries who are currently enrolled in Medicare Advantage plans can expect to see an average premium of about $39 a month, a $7 difference from 2009. Almost 87 percent of Medicare beneficiaries will have access to a Medicare Advantage plan that does not require a premium. Medicare Prescription Drug plan premiums will average $30, a $2 difference from 2009. The premium increase for Part D is less than previously expected – CMS had previously anticipated the average premium would be $32. Those who qualify for the full Medicare low-income subsidy will pay no premiums or deductibles in Medicare Prescription Drug plans. .

CMS is taking aggressive steps to address discriminatory benefit packages, those that would cost sicker enrollees more for the important health care services they need. In addition, beneficiaries will find more plans that will limit their out-of-pocket spending for the year to $3,400 or less for Medicare-covered health care services.

Beneficiaries should receive their 2010 Medicare & You handbook and find updated information at www.medicare.gov and 1-800-Medicare in mid-October. Users of the Medicare Plan Finder, available at www.medicare.gov , will be able to compare plans’ quality summary rating from the previous year, identify which drugs may or may not be on a plan’s formulary or be restricted, and compare the cost ranges for plans available in their community.

In addition, Medicare has joined forces with thousands of organizations and individuals across the country, including local State Health Insurance Assistance Programs (SHIPs), to assist in beneficiary decision-making.

Additional weblinks include:

Open enrollment center: http://www.cms.hhs.gov/center/openenrollment.asp

2010 Landscape Data Files (Downloads section): http://www.cms.hhs.gov/PrescriptionDrugCovGenIn/

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