A non-government resource for the Medicare community
Powered by Q1Group LLC
A non-government Medicare community resource
  • Menu
  • Home
  • Contact
  • MAPD
  • PDP
  • 2024
  • 2025
  • FAQs
  • Articles
  • Search
  • Contact
  • 2024
  • 2025
  • FAQs
  • Articles
  • Latest Medicare News
  • Search

CMS Press Release: Medicare's Online Tools Will Help Beneficiaries With Prescription Drug and Health Plan Choices For 2009

Category: Changing Medicare plans
Published: Oct, 10 2008 03:10:40


For Immediate Release: Friday, October 10, 2008
Contact: CMS Office of Public Affairs
202-690-6145


MEDICARE'S ONLINE TOOLS WILL HELP BENEFICIARIES WITH PRESCRIPTION DRUG AND HEALTH PLAN CHOICES FOR 2009

The Centers for Medicare & Medicaid Services (CMS) today announced that beneficiaries, their caregivers, and family members can begin to review 2009 Medicare prescription drug plan and health plan information online through the Medicare Prescription Drug Plan Finder and Medicare Options Compare at www.medicare.gov.

“This year it is especially important, now and throughout the upcoming open enrollment period, for beneficiaries to use our online tools to compare their current drug and health plan coverage to the options available for 2009 and take action to choose a plan that best meets their needs,” said CMS Acting Administrator Kerry Weems .  “Some beneficiaries may see significant premium increases or changes, such as reduced coverage in the gap, if they stay in the same prescription drug plan in 2009.  Yet, almost 97 percent of beneficiaries enrolled in a stand-alone prescription drug plan (PDP) will have access to Medicare drug and health plans in 2009 whose premiums would be the same or less than their coverage in 2008.

The 2009 Plan Finder allows beneficiaries to compare prescription drug coverage from both stand-alone Prescription Drug Plans (PDPs) and Medicare Advantage (MA) plans that provide prescription drug coverage (MA-PD plans) and to view premiums, formularies, and availability of coverage in the gap. Additionally, the 2009 Medicare Options Compare tool allows beneficiaries to compare Medicare health plan options, such as HMOs and PPOs. 

Additional information Plan Finder offers to help beneficiaries search drug plans for the best price and coverage include, estimated out-of-pocket costs, pharmacy networks, and Medicare news and updates.   CMS has added a feature to allow beneficiaries to view estimated monthly mail order drug costs in a bar-chart which can be compared to retail drug costs.  The Web site also includes an enhancement that allows beneficiaries the potential to further reduce costs based on the substitution of drugs which are lower cost but within the same therapeutic class.  This feature allows users to choose among all less expensive drugs available with similar functions, not just generic products.  CMS encourages beneficiaries to discuss these alternatives with their physicians.
 

CMS suggests that beneficiaries gather their Medicare card along with information on their current medications for reference as they use the online tools.   Additional useful information to have at hand may include mailings they have received from Medicare, Social Security, or their current drug plan.  The annual open enrollment period begins Nov. 15 and runs through Dec. 31, 2008. Beneficiaries who wish to enroll for the first time or change their coverage for 2009 should do so by early December to ensure a smooth transition in the new plan year. 

People without Web access can get the same information provided by the online plan comparison tools by calling 1-800 MEDICARE (1-800-633-4227), by visiting their local State Health Insurance Assistance Program (SHIP) office for free personalized counseling, or by attending one of the thousands of local enrollment events taking place across the country through December 2008.

Beneficiaries can also get detailed plan information and tips on selecting a plan through the 2009 Medicare & You handbook, arriving in mailboxes later this month.   The handbook includes tips on selecting a plan and an overview of plan options.   Beneficiaries already enrolled in a Part D plan or health plan will also receive an Annual Notice of Change that describes any changes in the benefits of their current plan.   Beneficiaries will find contact information for their state’s SHIPs in their handbook or at https://www.medicare.gov/ Contacts/ Include/ DataSection/ Results/ Results.asp? Organizations=F%7CSHIP+--+State+Health+Insurance+Assistance +Program& State=Select+All+States& amp;Type=ORGANIZATION.

CMS anticipates that the Plan Finder site will average close to one million page views per week, similar to the volume experienced last year.  For the 2008 plan year, more than half a million people enrolled online, a 49 percent increase over the number who enrolled online for the 2007 plan year. More than 5.8 million people with Medicare have enrolled online in a drug plan since the program began.

Medicare beneficiaries with limited income and resources, and those who are dually eligible for both Medicare and Medicaid, may qualify for extra help paying for their Part D premium through the low-income subsidy (LIS), provided by Medicare.  CMS’ Web site is a comprehensive resource for beneficiaries who are eligible for Medicare’s extra help.  This information will help Medicare partners identify and counsel LIS eligible beneficiaries who are experiencing a change in their LIS status.  The site also includes an annual LIS Outreach Toolkit providing LIS data in both interactive maps and sortable spreadsheets.

“In addition to urging beneficiaries to explore their options now, I want to assure seniors that the marketing of 2009 plans will be under tough, new marketing requirements from CMS,” said Weems.  “These requirements are intended to protect Medicare beneficiaries from deceptive or high-pressure marketing tactics by insurance companies and their agents. We are broadening our oversight of plans, including expanding our ‘secret shopper’ program.”

For more information and to view the plan finder tool please visit:

https://www.medicare.gov/MPDPF.

The LIS Outreach Toolkit can be accessed at: http://www.cms.hhs.gov/ Partnerships/ Toolkits/ itemdetail.asp? itemID=CMS1188820

######


(Source: CMS/Medicare http://www.cms.hhs.gov/ apps/media/press /release.asp)







Tips & Disclaimers
  • Q1Medicare®, Q1Rx®, and Q1Group® are registered Service Marks of Q1Group LLC and may not be used in any advertising, publicity, or for commercial purposes without the express authorization of Q1Group.
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDPCompare.com and MACompare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
    Statement required by Medicare:
    "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.