MEDICARE PART D OPEN ENROLLMENT: ALL NEED TO REVIEW COVERAGE & OPTIONS

Medicare beneficiaries need to be aware of the looming Annual Coordinated Election Period (Open Enrollment period) for Medicare Part D drug coverage, which starts November 15, 2006 and goes through December 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. Every person with Medicare can be affected by changes to their drug coverage for 2007 and should therefore review his or her options. 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.

The Centers for Medicare & Medicaid Services (CMS) has indicated that beneficiaries who enroll or change plans after December 8 th may experience delays in getting evidence of their enrollment in their new plan.

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 and 2007 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 - whether they are already enrolled in a plan, have retiree or other creditable coverage, or have no coverage at all - and reevaluate their options for 2007, even if they were satisfied with their plan in 2006.

- Adapted from http://www.medicareadvocacy.org/AlertPDFs/06_09.28.OpenEnrollmentTips.pdf , referenced in ElderLawAnswers’ e-mail newsletter ElderLaw News, October 02, 2006.

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