Medicare Watch

Part D Premiums Are Stable in 2011

Part D premiums will remain mostly unchanged in 2011, according to the Centers for Medicare & Medicaid Services (CMS). According to CMS, the average monthly premium for Medicare prescription drug plans will be $30 in 2011, compared to $29 in 2010. CMS anticipates that the majority of Medicare consumers will be able to find plans for 2011 that have the same or less expensive premium than what they paid in 2010.

In addition, CMS estimates that changes included in the Affordable Care Act (ACA) will reduce the number of consumers with Extra Help who are automatically reassigned to new Part D plans in 2011, from 2.1 million to as few as 500,000. Extra Help, also known as the Low-Income Subsidy program (LIS), helps people with limited incomes pay their prescription drug costs, including premiums. People with Extra Help can choose any plan that offers drug coverage, but if they enroll in a plan whose premium is at or below a specified regional “benchmark” amount, the premium is paid by Extra Help and the consumer pays nothing. Because premiums change annually, CMS automatically reassigns some Extra Help consumers each year to assure that they will not be required to pay extra costs. The consumers who are reassigned by CMS are people who did not choose their current plan but whose current plan’s premium is increasing above the regional benchmark in 2011.

The ACA excluded Part C rebates to Medicare Advantage plans that offer drug coverage (MA-PDs) from the Part D benchmark calculation, which is used to determine zero-premium plans for those with Extra Help. Including these rebates in past calculations had lowered the benchmark amount, which meant that fewer plans could meet the benchmark and there were thus fewer zero-premium plans. The health reform law also codified the “de minimis” policies that allow plans to keep consumers with Extra Help if the plan’s premium exceeds the benchmark amount by a pre-determined amount. For 2011, This de minimis amount is two dollars. It is these changes in the law that reduced the number of total expected reassignments.  

Additional information on 2011 Medicare Advantage and prescription drugs plans will be available in September. 2011 plan information will be available on Medicare.gov’s plan finder tool on October 8.
 
Read the CMS press release on 2011 Part D average premiums and benchmark.

Read CMS’s Part C and Part D announcement and guidance to plans.

 

Improvements in Medicare Payment Policies Means Better Access to Preventive Care

This week, in comments to a proposed rule released by the Centers for Medicare & Medicaid Services, the Medicare Rights Center applauded the elimination of cost-sharing for preventive services and the coverage of a new annual wellness exam beginning next year. However, our comments also recommended the inclusion of additional screenings—for depression and functional impairments—in the annual wellness visit, and for consumer education and outreach about available preventive benefits.  In addition, Medicare Rights asked CMS to address a growing trend among Medicare providers of charging extra fees to consumers for services that are not included in Medicare payments.  Currently, there is a lack of guidance on the appropriate use of extra fees, which may lead to consumers paying higher out-of-pocket costs than allowed.

Medicare Rights also submitted comments as a member of the Campaign for Better Care, a coalition of organizations dedicated to improving the quality and efficiency of care for older consumers. The Campaign’s comments encourage higher-quality and better coordinated care for people with Medicare through changes to Medicare payments and reporting systems, such as increased payments to primary care physicians.

CMS published the proposed rule for Physician Payment Policies under Medicare Part B for 2011 in the Federal Register on July 13, 2010. 

Read Medicare Rights Center’s comments.

Read the Campaign for Better Care’s comments.

Medicare Reminder

If you have limited monthly income (below $1,354 for individuals and below $1,822 for couples) and your assets are below specified limits, you may be eligible for Extra Help, a federal program that helps you pay for some or most of the costs of Medicare prescription drug coverage.

Even if your income or assets are above the limit, you may still qualify for Extra Help because certain types of income and assets may not be counted. For example, part of your earned income and the value of your house will not be counted.

Learn more about Extra Help and how to apply at www.MedicareInteractive.org.

Spotlight

On Wednesday, September 8, Medicare Rights Center President Joe Baker will serve as a panelist at a policy forum on health reform and people with disabilities. Organized by the Kaiser Family Foundation, the forum will be held in Washington, D.C., and is open to the public. PBS NewsHour coanchor Judy Woodruff will moderate the discussion.

Learn more about the forum.