Most Medicare Drug Premiums Same or Lower in 2009

THURSDAY Sept. 25, 2008 -- In 2009, premiums will not rise for 97 percent of the 10.5 million enrollees in Medicare's "stand-alone" drug plans, which only offer drug coverage, Medicare officials announced Thursday.

The various Medicare prescription drug plans in the agency's "Part D" program cover about 90 percent of all Medicare beneficiaries, Kerry Weems, the acting administrator of the U.S. Centers for Medicare & Medicaid Services (CMS), said during a late morning press teleconference Thursday.

Overall, 22.5 million Americans are currently enrolled in some type of Medicare Part D prescription drug coverage. Open enrollment in the 2009 Part D plans begins Nov. 15 and ends Dec. 31.

There was more good news, according to Weems. "Part D continues to come in under budget and has consistently high satisfaction rates, and with it, millions of Americans are living better lives," he said, noting that, "Medicare's Part D prescription drug plan will enter its fourth year when open enrollment begins in November."

From year to year, Medicare prescription drug providers do change their plans, Weems said, so it's important that enrollees check up on their plan to see if anything has been altered.

"Some beneficiaries will see significant changes in their plans. These could be changes in premiums or changes in coverage," Weems said. "We are encouraging all beneficiaries to review how their plans are changing and what other options are available to determine which plan best meets their needs," he said.

Medicare beneficiaries across the United States will be able to access at least one prescription drug plan with premiums of less than $20 a month, except for people living in Alaska, where the one prescription drug plan has a premium of $23 a month, Weems said.

People who qualify for the full Medicare subsidy will have no premiums or deductibles on these plans. The average monthly premium for the basic Medicare drug benefit in 2009 is expected to be about $28, Weems said.

Medicare beneficiaries will also continue to have access to drug plans with a wide range of options, including plans with no deductibles. In addition, plans that cover the gap for generic drugs are available in all states.

All Medicare beneficiaries will have access to Medicare Advantage plans, Weems noted. These plans cover all Medicare services, including prescription drugs. Many of these plans have prescription drug coverage that will enable more than 93 percent of those enrolled in the plan to get their drugs with no premiums and no deductibles, Weems said.

He added that the marketing of prescription drug plans in 2009 is covered by new regulations intended to protect Medicare beneficiaries from "deceptive or high-pressure marketing tactics by insurance companies and their agents."

Paul Precht, director of Policy and Communications at the Medicare Rights Center, said people should shop around for the best prescription drug plan and not just continue on with the plan they have.

"The first thing consumers should look for is the premium," Precht said. "But the more important and the more difficult challenge is to figure out if there are changes in the coverage," he said.

Consumers should also look to see if there are drugs that were covered in 2008 that won't be covered in 2009, Precht said. "You need to find out if there are drugs that are covered without restriction this year that will now be subject to prior authorization or step therapy [using the most cost-effective drug first]," he said.

People considering switching to Medicare Advantage should first find out if their current doctor and hospital are part of the plan and what the plan covers and doesn't. In addition, they should also find out which drugs are covered and which are not, Precht said. "For example, there are a couple of plans which exclude chemotherapy drugs, which are quite expensive," he said.

More information

For more on Medicare Part D, visit the U.S. Centers for Medicare and Medicaid Services.

Posted: September 2008


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