WASHINGTON, Nov. 18 Over 2 million low-income Medicarebeneficiaries may face a disruption to their prescription drug coverage inJanuary. Changes to the 2009 Medicare Part D plans will force low incomebeneficiaries to switch plans or face premiums they cannot afford or limitaccess to their prescriptions, according to a new report by the NationalSenior Citizens Law Center (NSCLC). Part D open enrollment runs from November15th through December 31st.
The Low Income Subsidy (LIS) program provides premium assistance to over9 million low-income seniors and individuals with disabilities. Beneficiariesonly receive the full subsidy benefit if they enroll in plans with premiumsbelow an amount set by Medicare. Because benefits are administered throughprivate companies, premium costs change from year-to-year as do the plans thatare fully subsidized.
Approximately 25% of subsidy recipients are currently enrolled fullysubsidized plans in 2008 that will not be subsidy-eligible in 2009. Thesebeneficiaries will need to switch plans to avoid paying a premium in 2009.1.6 million of these beneficiaries will be reassigned to a new plan byMedicare. But since Medicare's reassignment process does not consider theprescription needs of the beneficiary, the new plan may not cover their drugs.
The remaining 620,000 impacted Low Income Subsidy recipients must changeplans themselves to avoid the new premium costs in January. It is likely thatmany beneficiaries will not understand the importance of changing plans.
"We are getting the word out to help beneficiaries avoid a disruption inaccess to their medications," said Kevin Prindiville of NSCLC. "Beneficiariesneed to make sure that their 2009 plan covers the drugs they need."
Plan choice under Part D is shrinking, particularly for those who benefitfrom the Low Income Subsidy. LIS recipients face increasing obstacles infinding affordable plans that cover their medications. Between 2008 and 2009,the total number of LIS plans offered decreased in all but one state. Thenumber of LIS plans offered across all states decreased by nearly 40% between2008 and 2009.
"2009 may find low income beneficiaries unable to access theirprescription medication, paying a monthly premium that they cannot afford, orboth," said Hector Javier Preciado of the Greenlining Institute.
Today's report recommends changes to the Part D system that would reduceannual disruption to low income beneficiaries, including:
-- Establishing a Medicare-administered Part D plan to provide enrolleesthe same options and choices they have in other parts of the Medicare program;and
-- Improving the reassignment process so that it also takes abeneficiary's known prescription needs into account.
Beneficiaries seeking assistance about their 2009 coverage should contacttheir local State Health Insurance Assistance Program(http://www.shipusa.org). For a copy of the full report, seehttp://www.nsclc.org/areas/medicare-part-d.
About the National Senior Citizens Law Center
Since 1972, the National Senior Citizens Law Center has advocated topromote the independence and well-being of low-income elderly and disabledAmericans.
SOURCE National Senior Citizens Law Center