Tuesday, October 04, 2005

Choosing Medicare Prescription Drug Coverage Wisely

For the first time ever, prescription drug coverage will be available to everyone eligible for Medicare. Since enrollment in the program is not automatic, consumers will need to sign up between November 15, 2005 and May 15, 2006 or risk paying more for coverage later on.

Medicare beneficiaries can choose between two ways of receiving prescription drugs. The first is signing up for a prescription drug-only plan, or PDP; the second is choosing a Medicare Advantage plan. Those with limited incomes will pay no premium or deductible, or a reduced cost with no gap in coverage.

What are the differences between these alternatives? A PDP plan lets people with Medicare add private drug coverage to their existing benefits. Those who opt for Medicare Advantage select one health plan in their area that will cover all aspects of care – including traditional benefits like hospital and doctor’s office visits, as well as the new drug benefit and others.

Private companies sponsoring PDP and Medicare Advantage coverage will be marketing many different plans, so consumers should weigh their options carefully before making a decision. Medicare recipients can identify programs in their area and compare offerings online at http://www.medicare.gov or by calling 1-800-MEDICARE. This will allow them to examine monthly premiums for each plan. Then, they should consider the prescriptions they take as well as other health care needs and determine which option provides the right level of coverage at the best cost.

Beneficiaries should analyze their current coverage versus that offered under the new plan to see if enrolling is the right choice for them. Those with retiree health benefits should consult their former employer or union to address any questions they have. People with Medicaid will receive targeted information about their options.

Consumers should also consider the quality of care offered by the plans in their area. The National Committee for Quality Assurance and Medicare offer online resources that allow people to compare plans for themselves.

“It’s important for people with Medicare to get prescription drugs,” said Jack Ebeler, president and CEO of the Alliance of Community Health Plans, whose members participate in Medicare Advantage. “The best coverage options offer comprehensive benefits, high-quality, well-coordinated care and lots of experience in Medicare in their communities.”

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On the Net:
Alliance of Community Health Plans site: http://www.achp.org

National Committee for Quality Assurance site: http://www.ncqa.org
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