Medicare's New Prescription-Drug Benefit: Open for Business
On Nov. 15, America's seniors started enrolling in the new, voluntary Medicare prescription drug program, which will begin dispensing its first medicine at the start of next year.
Formal notices to those eligible for both Medicaid and Medicare have been mailed out and should have been received by now. The yellow publication offers information about changes in drug coverage and explains that those who do not choose a plan by the end of the year will be enrolled in one automatically unless they choose not to be. It should also provide notification of which plan is the default and what it will cost.
Anyone who hasn't received their mailing can find the information on the Internet at www.cms.hhs.gov/medicarereform/Enrollment-Q&A-10-20-05-with-cover-sheet.pdf, and more at .
For those undecided on a drug coverage plan, the Centers for Medicare and Medicaid Services recently unveiled new features on its Web site (www.medicare.gov ), including a "Medicare Prescription Plan Drug Finder," which allows beneficiaries to compare features, such as annual cost, deductibles, premiums and co-payments, for their specific needs. Such a direct, "apples-to-apples" comparison has never before been available, and seniors can choose from as few or as many options as they want.
It's critical to be as informed as possible, because some inaccurate rumors have circulated that could discourage participation in the program. When it was first enacted as part of broad Medicare reform in 2003, critics complained that it offered too little help on prescription drugs to be of much benefit to anyone. A few months later, many of those same critics were warning that the program threatened to break the federal budget.
Both allegations are false, and it's worth bearing in mind that many of those critics had partisan motivations.
It is true that the new prescription drug coverage will not cover all costs of all drugs for all people eligible for Medicare. It is also true that some of the rules of the system can be complex. However, there are 10 million reasons to focus on the benefits--the 10 million Americans who have no prescription drug coverage at all today. Under the new law, they will soon be eligible for substantial help.
Multiple plans have been approved for each of the Medicare-designated regions across the country, and as of Oct. 1, they have been competing with each other for enrollees based on cost, coverage and convenience. (All will allow prescriptions to be filled at local pharmacies or by mail, and cover both brand name and generic medicines).
In addition to the stand-alone plans, in most regions people with Medicare will be able to select managed care plans that combine drug coverage and other health care services. Initial estimates are that more than 40 percent of beneficiaries will have access to a prescription drug plan with a monthly premium of less than $10, and 93 percent will have access to one below $15. Nearly half of the plans will offer enhanced coverage, such as low or no deductibles, lower co-payments, or little or no gap in coverage. Every single state has at least one stand-alone plan with no deductible.
The new prescription drug program will not solve all of the challenges facing Medicare. But for many of Arizona's 800,000 beneficiaries, it could make the difference between being able to afford prescription drugs, and not. The new benefit is a major addition to a bedrock institution upon which millions of seniors depend. As with all big changes, there will be glitches, and some things may seem confusing at first. But there will be plenty of opportunities to review progress and adjust as needed.
In his State of the Union address two years ago, President Bush declared that "health-care reform must begin with Medicare" because "Medicare is the binding commitment of a caring society."
Providing prescription drug benefit coverage, for the first time ever, demonstrates our commitment to that principle.
(Senator Kyl, R-Ariz., serves on the Senate Finance and Judiciary committees and chairs the Senate Republican Policy Committee.)
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