Medicare Watch

Program to Close the Coverage Gap Moves Forward

People with Medicare who enter the Part D prescription drug coverage gap, also known as the “doughnut hole,” in 2011 will automatically receive a 50 percent discount on brand-name drugs and biologics at the time they purchase their medicines, according to final guidance released by the Centers for Medicare & Medicaid Services (CMS) on May 12, 2010. CMS expects that all drug manufacturers will enter into discount agreements, which effectively means that the discount program will not change the brand-name drugs and biologics that are covered under Part D.

Read the Final Guidance on the Coverage Gap Discount Program

Medicare Rights has produced a timeline that shows how health care reform will affect Part D. To learn more, see Medicare Part D and Health Reform: A Timeline of Changes to the Medicare Prescription Drug Program.

Medicare Physician Payments Still Under Threat

Congress has not yet voted on the American Jobs and Closing Tax Loopholes Act (H.R. 4213), which would prevent a 21 percent reduction in Medicare payments to doctors from taking effect on June 1. The latest version of the bill prevents Medicare payment cuts from taking place until 2012, while providing a 2.2 percent increase for the rest of 2010 and a 1 percent increase in 2011.

The Medicare Rights Center hotline has received calls from consumers who are concerned because their doctors have told them that they may no longer see Medicare patients due to the impending cuts. The cuts are the result of a payment formula established by Congress in 1997, and are unrelated to health care reform.

It is still not too late to take action. Contact your senators and representatives, and ask them to stop the payment cuts.

Medicare Reminder

On June 1, several changes to Medicare supplemental insurance plans, also known as “Medigap” plans, will take effect. Starting June 1, there will be two new Medigap plans (M and N), and four plans (E, H, I and J) will no longer be sold.

Furthermore, Medigap plans sold after June 1 will feature different benefit packages. If you bought a plan before June 1, 2010, you can keep it, and your benefits will not change. In general, if you are happy with your current plan, there is no reason to switch.

Remember that plans are not required to sell you a policy if you are not within a time that you have the right to purchase a Medigap. If you would like to switch, you should contact your State Health Insurance Assistance Program (SHIP) or state Department of Insurance for unbiased advice.

Learn more about Medigap plans and the new M and N plans on Medicare Interactive, the Medicare Rights Center’s free online counseling tool.

 

Spotlight

Medicare consumers will soon receive a brochure that describes how people with Medicare will be affected by health reform. The brochure, “Medicare and the New Health Care Law – What it Means for You,” was mailed earlier this week by the Centers for Medicare & Medicaid Services (CMS).

Read the brochure.