DAVID SCOTT - CONGRESSMAN, REPRESENTING GEORGIA'S 13TH DISTRICT

Jonesboro, Nov 29, 2007 -

                                                                             
                                                                       -Things to Consider -
                                            Complied by the Committee on Ways and Means


Open enrollment period. From November 15th until December 31st, Medicare beneficiaries can enroll in a new prescription drug or Medicare Advantage plan. Beneficiaries in every state must choose from more than 50 plans that vary in terms of monthly premiums, co-pays and restrictions on coverage of prescription drugs.

Beneficiaries should seek independent assistance to choose from the numerous Medicare plan options. Beneficiaries should call 1-800-Medicare (1-800-633-4227) or call their State Health Insurance Assistance Program for free personalized health insurance counseling. See the “Medicare & You” handbook or call the 1-800-Medicare for the telephone number in your state. TTY users should call 1-877-486-2048. People who use the Internet can also search for plans at www.medicare.gov.

Many of the Medicare beneficiaries who are eligible for the low-income subsidies (LIS) have not enrolled. Medicare beneficiaries who earn less than $15,315 annually if single (or $20,535 for a couple)* may be eligible for additional assistance from Medicare for prescription drug costs. These beneficiaries should apply for the low-income subsidy at https://s044a90.ssa.gov/apps6z/i1020/main.html, call 1-800- MEDICARE or visit their local Social Security Office or Medicaid office.

Premiums Are Rising. The average beneficiary will pay 21% more in premiums if they remain with their current plan.1 Premiums are increasing for three-fourths of Medicare beneficiaries in drug-only plans if they do not switch plans. The average increase is $4.60 per month, and one in five beneficiaries will pay $10 or more a month if they do not switch plans.2

Some low-premium plans have higher total out-of-pocket costs. Beneficiaries should look closely at both the monthly premium and the cost-sharing for needed drugs before choosing a plan. Some of the lowest premium plans have increased the co-pays for drugs. In fact, a recent study from Consumers Union found that some plans decreased their premiums from last year, but increased co-pays for the five most commonly used drugs. Beneficiaries and others can use the Medicare website (www.Medicare.gov) to check overall drug costs.

Almost 2 million low-income subsidy beneficiaries must transition to new plans before December 31st in order to avoid paying higher premiums. CMS has sent beneficiaries a TAN letter if they must choose a plan themselves. CMS sent beneficiaries a BLUE letter if CMS will automatically enroll them in a new plan if they do not choose one themselves. Low-income beneficiaries in every state have at least five plan choices where they will pay no premium. The drug coverage and expected spending for beneficiaries in these plans varies tremendously; beneficiaries should carefully review their options and choose the plan that is best for them before CMS randomly reassigns them to a new one.


*Levels for 2007 are $19,155 ($25,680) in Alaska and $17,625 ($23,625) in Hawaii.
1 Avalere Health.
2 Kaiser Family Foundation.