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Many users of Medicare's Part D drug plan forced to switch
Sorting out options will be a challenge, experts say, and enrollment begins Nov. 15.
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Many of the 75,000 low-income Minnesotans who receive nearly free drugs under the Medicare Part D drug benefit will be forced to change drug-insurance plans next year because of changes in the plans that deliver the benefit.
Three of the 16 plans that this year offer the subsidized benefit to low-income people will raise costs for 2008, and no longer will qualify to offer them the subsidy benefit. But three new plans will be available to those beneficiaries.
Medicare officials are combing records now to determine how many low-income recipients in Minnesota and other states will have to change plans. They will be notified by mail in coming weeks, officials said.
"The potential problem is that each plan is different," said Kelli Jo Greiner, a Medicare expert. "They don't all cover the same drugs."
Added Greiner, who works for the Minnesota Board on Aging: "It's important for everyone to check to make sure that their Part D plan covers the drugs they are taking.
"But that's especially important for low-income people, who tend to take more medications and have fewer financial resources if things don't go right."
Medicare will not release details of the plans' drug costs or coverage until Thursday, when it launches its "plan-finder" tool on the Internet.
Average premium to rise
The tool will allow all of Minnesota's 740,000 Medicare beneficiaries eligible for the Medicare Part D drug benefit to compare costs and coverage among the 124 competing plans for 2008, up from 113 plans this year.
Enrollment begins Nov. 15 and state and federal counselors are gearing up for thousands of calls from Minnesota beneficiaries who wish to compare their current plans with options that will become available.
The drug program, now ending its second year, cuts drug costs for most beneficiaries. This year, 462,000 Minnesotans are enrolled, and another 112,000 receive similar coverage through former employers, including the federal government.
About 140,000 eligible Minnesotans have not enrolled, including about 20,000 who qualify for the low-income subsidy.
To qualify for the subsidy, a Medicare beneficiary must have income below $15,315 ($20,535 for a couple) and savings below $11,710 (or $23,410 for a couple).
It's impossible to compare the drug plans without using Medicare's computerized plan-finder tool -- used both by individuals and by counselors.
Plans vary widely in their monthly premiums, deductibles, prescription co-payments and lists of drugs covered. The average monthly premium for drugs-only plans will increase about 12 percent next year to $41.35.
Under the program, any Medicare beneficiary may enroll in one of 52 drug-only plans, 56 Medicare Advantage plans that combine medicare health and drug coverage, or 16 "special needs" plans for people on both Medicare and Medicaid.
Typically, a client pays the first $275 in annual costs, then 25 percent of each drug's price until the total paid by the recipient and the plan hits $2,510. Then they hit the gap in coverage often called the "doughnut hole." The recipient pays all costs between $2,510 and $5,726. After that, the recipient pays 5 percent of drug costs.
Warren Wolfe • 612-673-7253
Warren Wolfe • wolfe@startribune.com
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