3 Million May Need Medicare Switch

More than 3 million seniors may have to change their Medicare prescription drug plan as soon as October, according to a report from private research firm Avalere.

The report states that fewer plans will be offered in 2011, as Medicare officials attempt to eliminate confusion caused by too many existing alternatives.  

Avalere, which has conducted studies on Medicare before, says its analysis was based off of new Medicare specifications. For example, earlier this year, Medicare notified insurers that they would only allowed to offer one “basic” plan in a given location. This means that certain insurers, such as AARP and CVS Caremark, will have to eliminate one of their basic options, a stipulation that will force 2.75 million beneficiaries to find new coverage. About 17.5 million seniors are currently enrolled in the Medicare program.

Under the Medicare Prescription Drug, Improvement and Modernization Act, Medicare recipients choose a stand-alone Prescription Drug Plan or Medicare Advantage plan with prescription drug coverage each year from October to December. These programs are approved and regulated by the Medicare program, but have been designed and administered by private health insurance companies.

Currently, seniors choose from 40 or more plans, depending on their home state. Avalere estimates that downsizing will require beneficiaries to chose from about 30 plans come this October. According to the report, downsizing will not cost seniors coverage, but could result in changes to their premiums and/or co-pays. There will, however, be many low-cost options still available under the restructuring.  

Despite this assertion, Medicare officials were quick to dismiss the estimates.

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