Protecting Medicare Benefits and Offering Clear Choices for Seniors

We’ve heard from seniors and other Medicare beneficiaries that sorting through the over 4,000 prescription drug plan choices, many of which offer similar benefits, can be a confusing and time-consuming process. Experts agree. That’s why seniors on Medicare, health policy researchers supported CMS’ efforts to make the Medicare Prescription Drug program less confusing by eliminating duplicative plans and making it easier for seniors to choose the plan that works for them.

Making Medicare Part D easier to use is one of our top priorities. A report for the Commonwealth Fund discussing seniors and the program found that “A significant majority of them reported that the benefit was too complicated, and some observers suggest that the complexity may have thwarted some beneficiaries from finding the plan that was best for them.” 

Seniors shouldn’t have to wade through a mountain of paperwork to get their prescription drugs. So, this spring, as part of our continuing effort to make the Medicare prescription drug program easier to use, we let seniors know that the Centers for Medicare & Medicaid Services would be ensuring that the choices available to them for coverage of prescription drugs would be meaningful and clear.

By phasing out duplicate and confusing drug plans, seniors and people with disabilities will have better choices available to them without any disruption in coverage. As a result of our continuing negotiations with part D plan sponsors we will reduce the number of duplicative plans by more than 700.  But even after that, Medicare beneficiaries will still have 3,240 Part D drug plans to choose from.

And seniors enrolled in the Part D won’t spend a single day without coverage The change is seamless, and doesn’t require action by beneficiaries. Of course, if seniors want to change their plan, they can. All beneficiaries – including those enrolled in consolidated plans –can still evaluate all 2011 plan offerings to select the one that best suits their needs, as they’ve always been able to do. But now, these reforms will give beneficiaries more control over their health care.

It isn’t known at this time how many beneficiaries are enrolled in plans that are being consolidated, but we know that their benefits- and choices- will remain in place. These reforms provide more clarity for beneficiaries while keeping faith with the principle that if you like your plan, you can keep it.

These reforms are just one of the steps we are taking to improve Medicare. Through the Affordable Care Act we are making Medicare stronger and more secure. Before the new law passed, each year about a quarter of Medicare Part D beneficiaries hit the coverage gap known as the “donut hole”, where they would have to bear all the costs of their prescription drugs.  That’s why this year, eligible beneficiaries who fall in the donut hole are receiving a one-time rebate check of $250 to help pay for their prescriptions. Next year, eligible beneficiaries who hit the coverage gap will receive a 50 percent discount on all covered brand-name prescription drugs. And we’ll continue to take steps each year to close the donut hole for all Medicare beneficiaries.

The Obama Administration is committed to ensuring that the benefits of Medicare are secure and that seniors gain more control and can more easily make choices that best meet their needs. We at the Centers for Medicare and Medicaid Services will continue to keep seniors informed of their choices, and as always encourage people to call 1-800-MEDICARE with any questions.