Insurers flock to offer nationwide drug coverage under Medicare

Friday, September 29th 2006, 12:12 pm
By: News On 6

WASHINGTON (AP) _ Many elderly and disabled Americans participating in the Medicare drug benefit next year will have more plans to choose from as the number of companies offering coverage nationwide jumps to 17.

Officials stressed that seniors happy with their prescription drug coverage won't need to take any action when Medicare's open-enrollment period begins Nov. 15. But if they do want to look around, they'll have plenty of chances to comparison shop.

This year, nine companies offered nationwide coverage. Next year, that number will be 17, plus scores of regional companies also will offer plans. In most states, beneficiaries had more than 40 plans to choose from this year.

For example, Oklahomans had 42 stand-alone plans to select from this year. Next year, they will have 57. North Carolinians had 38 stand-alone plans to select from this year. Next year, they'll have 51.

Some seniors have complained about a dizzying array of choices. Officials with the Health and Human Services Department stressed on Friday that new plans will offer coverage that seniors have been asking for, such as no deductible, or the plans will offer coverage in a gap often referred to as the doughnut hole. That's the point where seniors have to pay for all the costs of their drugs, plus pay their monthly premiums.

``The new options that are available are primarily options that provide enhanced coverage,'' said Mark McClellan, administrator for the Centers for Medicare and Medicaid Services. ``The number of variations for basic coverage have gone down significantly.''

McClellan's comments came as the Department of Health and Human Services formally announced Friday which options Medicare beneficiaries in each state will have available to them. The officials said the monthly premium that beneficiaries pay next year will average $24 _ about the same as in 2006.

The benefit ``is saving seniors an average of $1,200 a year, and it just keeps getting better,'' HHS Secretary Mike Leavitt said. ``In 2007, there will be more plans with coverage in the gap, more drugs covered, and more help from Medicare in choosing the plan that's best for you.''

While some people will see an increase in their current plan premiums, Leavitt said they have the option to switch plans. Nationally, 83 percent of beneficiaries will have access to plans with premiums lower than they are paying this year.

With the new year, insurers get to update their offerings to senior and the disabled. Some are lowering their premiums. Others are raising them. Plans also are including more drugs on the list of prescriptions that they will cover. On average, plans will cover about 13 percent more drugs next year, Leavitt said.

However, Deanne Beebe, spokesman for the Medicare Rights Center, said seniors and the disabled should assume nothing about what their coverage will look like next year. The center has often been critical of the drug program.

``Just because a plan may have worked for you this year, there is no guarantee it will help or be affordable next year,'' she said.

Beebe also said that seniors won't be won over by all the additional options.

``They don't want dozens of choices,'' she said. ``They want one affordable drug benefit they can count on when it comes time to fill their prescription.''

Besides the national plans, there will continue to be those companies that only offer coverage on a regional basis. HHS officials noted that beneficiaries will also have more access to Medicare Advantage plans, which offer drug coverage plus more complete medical coverage, such as for visits to the doctor's office.

Dan Mendelson, president of Avalere Health, a consulting firm, said he's not surprised by the expansion of insurers offering drug coverage nationally. He said several companies, such as Humana, already operated in most states.

``Some plans wanted to experiment and might not have gone into certain regions. Now they're more confident because they're having a profitable experience,'' Mendelson said.

The 17 companies approved to operate nationally are: Aetna Inc., Caremark Inc., CIGNA, Coventry Health Care Inc., EnvisionRX Plus Inc., Express Scripts Inc., Health Net Inc., Humana Inc., Long Drug Stores Corp., Medco Health Solutions Inc., Member Health Inc., NewQuest Health Solutions LLC, NMHC Systems Inc., Torchmark Corp., UnitedHealthCare-Pacificare, WellCare Health Plans Inc., and Wellpoint Inc.