More than 2 million low-income Medicare beneficiaries may face a disruption in their prescription drug coverage in January due to changes to the 2009 Medicare Part D plans.
According to a new report by the National Senior Citizens Law Center, changes to Medicare Part D will force low-income beneficiaries to switch plans or face premiums they can't afford.
As explained in the report, the Low Income Subsidy program provides premium assistance to more than 9 million low-income seniors and individuals with disabilities. Beneficiaries only receive the full subsidy benefit if they enroll in plans with premiums below an amount set by Medicare.
Because benefits are administered through private companies, premium costs change from year to year, as do the plans that are fully subsidized.
According to the NSCLC report, approximately 25 percent of subsidy recipients are enrolled in fully subsidized plans in 2008 that will not be subsidy-eligible in 2009.
These beneficiaries will need to switch plans to avoid paying a premium in 2009. Medicare will reassign 1.6 million to a new plan, but since Medicare's reassignment process doesn't consider the prescription needs of the beneficiary, the new plan may not cover their drugs.
"We are getting the word out to help beneficiaries avoid a disruption in access to their medications," said Kevin Prindiville of NSCLC. "Beneficiaries need to make sure that their 2009 plan covers the drugs they need."
Prindiville said the remaining impacted Low Income Subsidy recipients must change plans themselves to avoid the new premium costs in January. But he thinks many beneficiaries will not understand the importance of changing plans.
The NSCLC report notes that plan choice under Part D is shrinking, particularly for those who benefit from the low income subsidy. LIS recipients face increasing obstacles to finding affordable plans that cover their medications.
Between 2008 and 2009, the total number of LIS plans offered decreased in all but one state. The number of LIS plans offered across all states decreased by nearly 40 percent between 2008 and 2009.
"2009 may find low income beneficiaries unable to access their prescription medication, paying a monthly premium that they cannot afford, or both," said Hector Javier Preciado of the Greenlining Institute.
The NSCLC report recommends changes to the Part D system that would reduce annual disruption to low-income beneficiaries. These recommendations include:
- Establishing a Medicare-administered Part D plan to provide enrollees the same options and choices they have in other parts of the Medicare program; and
- Improving the reassignment process so that it also takes a beneficiary's known prescription needs into account.