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Katherine C. Pearson, Editor, and a Member of the Law Professor Blogs Network on LexBlog.com

From CMA: Part D Open Enrollment Begins Nov. 15, 2006

Amid the current chaos of erroneous premium reductions and donut hole woes, Medicare beneficiaries need to be aware of the looming Annual Coordinated Election Period for Medicare Part D drug coverage, which starts November 15, 2006 and goes through December 31, 2006.  During this period, Medicare beneficiaries who do not have a Part D plan can enroll in one, and those who do have coverage can change plans.  Beneficiaries who take no action will remain in their current plan, with some exceptions for those who receive the low-income subsidy.  However, since plans may change their formularies (list of covered drugs), tiers, utilization management tools, exceptions and appeals processes, and other aspects of their Part D plans, even beneficiaries who were satisfied with their plan in 2006 need to review their options.

Multiple sources and large quantities of information will be available to beneficiaries about their options for 2007.  While beneficiaries can begin enrolling or changing plans November 15, they do not have to make a decision until December 31, 2006, and in fact may purposely choose to wait in order to make the most informed decision possible.  Waiting to make an informed decision is especially important as Part D plans will begin marketing their plans October 1, 2006, while Medicare will not publish information about 2007 in the Medicare & You Handbook until late October.  The Centers for Medicare & Medicaid Services (CMS) has indicated, however, that beneficiaries who enroll or change plans after December 8th may experience delays in getting evidence of their enrollment in their new plan.

Every person with Medicare can be affected by changes to their drug coverage for 2007 and should therefore review his or her options. Part D plans may make changes to their benefit package for 2007, including changes in covered drugs, utilization management tools, and premiums. For example, Plan ABC offered in 2006 and 2007 will not necessarily have the same benefits in 2007, even though it is offered by the same company and has the same name as in 2006.  It is therefore imperative that all beneficiaries review their current drug coverage – whether they are already enrolled in a plan, have retiree or other creditable coverage, or have no coverage at all – and reevaluate their options for 2007, even if they were satisfied with their plan in 2006.

More information and advice to consumers is available from the Center for Medicare Advocacy.

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