The Centers for Medicare and Medicaid Services has announced that some people enrolled in Medicare drug plans may need to take steps to ensure they have the coverage they need when 2010 open enrollment begins later this year.
"The majority of beneficiaries enrolled in prescription drug plans should see only small changes in their Part D premiums or benefits in the coming year," said Jonathan Blum, acting director of CMS' Center for Health Plan Choices. "Although most Part D plans should have relatively stable premiums, all beneficiaries should compare their current coverage with the plans that will be offered in 2010 when information becomes available in October."
Blum said some beneficiaries who receive the low-income subsidy to pay for their premiums will need to move to a new plan to ensure they can remain in a zero-premium plan in 2010 because the plan's premium will be higher than the 2010 subsidy amount.
CMS estimates that the average monthly premium that beneficiaries will pay for standard Part D coverage in 2010 will be $30, an increase of $2 over the 2009 average premium of $28.
The agency will announce premiums and benefits for Medicare Advantage plans and more details about the Part D plans in September and provide a list of plans that are not renewing their contracts with Medicare for 2010.
Basic premiums paid by Part D enrollees cover about one-fourth of the cost of the standard Part D drug benefit. Enrollees with low incomes qualify for subsidies that typically cover the full amount of these premiums.
Nearly 10 million beneficiaries are receiving drug coverage through the Low-Income Subsidy (LIS) benefit. The average value of the Part D benefit, premium subsidy and cost-sharing subsidy for low-income enrollees is estimated to be about $4,000 in 2010.
When individuals become eligible for the LIS benefit, CMS randomly auto-enrolls them in a Part D plan that has a premium at or below the premium subsidy amount if they do not choose a plan themselves. As a result, these beneficiaries do not have to pay any Part D premium.
According to Blum, in cases where an LIS-eligible beneficiary is enrolled in a plan where the 2010 premium will be higher than the 2010 subsidy amount – unless the beneficiary affirmatively chooses to stay in the plan or chooses another plan – CMS will assign the beneficiary to a new plan sponsor where they will not have to pay a premium.
CMS expects that about 800,000 beneficiaries will need to move to a plan below the benchmark amount or be automatically reassigned.