Medicare Rule Guarantees Continuity of Drugs

New York Times ^ | 4/27/06 | ROBERT PEAR

[Pop Fly]

WASHINGTON, April 26 — The Bush administration issued a new policy on Wednesday that protects Medicare beneficiaries against the sudden loss of coverage for drugs they are taking under the prescription drug program.

Under the policy, insurers can still change their lists of covered drugs, known as formularies. But if they drop any drugs or impose new restrictions, they must exempt beneficiaries who are now taking those drugs.

Dr. Mark B. McClellan, administrator of the Centers for Medicare and Medicaid Services, summarized the policy this way: "In general, a plan cannot change your coverage for the drugs you are using during the year. The stability of drug formularies is extremely important for many of our beneficiaries."

The policy addresses one of the chief criticisms of the Medicare drug benefit. Democrats and a few Republicans in Congress had said it was unfair that drug plans could change their formularies at will while most beneficiaries were locked into a drug plan for the full year. This disparity was a major concern for many consumer advocates and for some beneficiaries.

The new policy says, "No beneficiaries will be subject to a discontinuation or reduction in coverage of the drugs they are currently using," with some limited exceptions.

[Pop Fly]

With the deadline for signing up for the Medicare bill approaching, it's great that Bush put this rul in affect to better protect Medicare beneficiaries. From what I hear the response to the plan has been good and a lot of people have been signing up.

[Paul8148]

this can be the reason the republicans stay in power. We know the seniors will turn out in NOV.

[Wolfie]

Hey, as long as we're srewing with markets, lets get the Feds to start calling the tune the oil companies dance to.

[Semper Paratus]

I just started an IT contract with a Medicare claims processor to QA the Plan D coverage processing. The processing rules are byzantine and I see potential for a lot of fraud.

[Jim Noble]

Ka-ching!

[thoughtomator]

Well, it's good for the drug companies, for whatever that's worth.

[Pop Fly]

Well until changes are made, as long as the Medicare Drug plan is in place, we obviously want to encourage seniors to sign up for it. I've heard that over their recess Republicans were getting a lot of good feedback in their districts about seniors signing up for the plan.

[sandbar]

There is a coverage gap from $2250 to $5100 (that's insurance plan AND consumer cost totaled). My father's 'retirement health benefits' have been dumped now that he 'is on medicare and has drug coverage'. So he worked for 40 years at a place, staying sometimes just because of the good retirement package and now he has a $3600 out of pocket (not including the plan fee and co-pays and the drugs that AREN'T coverered he has to pay for).

Thanks Medicare Part D.

[Pop Fly]

Yeah, still tweaks to be worked out for sure. But this rule change is a good start by Bush, and all the Republicans who went back to their districts to encourage seniors to sign up before the deadline will help get things moving with the program.