Press Release             

Contact: Akiko Takano
Deputy Director of Communications

April 6, 2010

Statement by Medicare Rights Center President Joe Baker on
the Final Rules Governing Medicare Private Health and Drug Plan Offerings for 2011

New York, NY—The final rules that govern the Medicare private health and drug plan offerings for 2011 that the Centers for Medicare and Medicaid (CMS) released today bring good news to people with Medicare.

CMS will impose a limit on overall out-of-pocket cost-sharing (known as a mandatory out-of-pocket, or MOOP, limit) for people in Medicare private health plans. Every year, our hotline counselors receive calls from people who, after being diagnosed with a serious illness, discover that their Medicare private plan will not cover the costs of the care they need. People in similar situations next year will have the comfort of knowing that they will not have to pay more than a certain amount for their care.

CMS will also begin setting cost-sharing thresholds for some Part A and Part B services, beginning with those services that have had a discriminatory impact on people with serious illnesses. Medicare private health plans will no longer be able to set high cost-sharing rates for certain services that are needed by people who have serious or chronic illnesses.

People with Medicare will also be able to compare their 2011 options more easily, now that CMS has required insurance companies to offer plans that are significantly different from each other. Meaningful differences among plans from the same sponsor can include differences in premiums, cost-sharing, formularies and benefits packages.

We are delighted that CMS has issued these rules, which will significantly improve plan offerings for 2011 and better protect people with Medicare.


- end -

The Medicare Rights Center is now on Twitter. Follow us at

Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives.


520 Eighth Avenue, North Wing, 3rd Floor  ∙  New York, New York 10018
1224 M Street, NW, Suite 100  ∙  Washington, D. C. 20005  ∙