More than 3 million seniors may have to switch their Medicare prescription plan next year, even if they are happy with it, as a result of an attempt by the government to simplify their lives.
The policy change could turn into a hassle for seniors who hadn’t intended to switch plans during Medicare’s open-enrollment season this fall.
And it risks undercutting President Obama’s promise that people who like their health care plans can keep them.
A new analysis by a leading private research firm estimates that more than 3 million beneficiaries will see their current drug plan eliminated as Medicare tries to reduce duplicative and confusing coverage in order to offer consumers more meaningful choices. Instead of 40 or more plans in each state, beneficiaries would pick from 30 or so.
“As a result of this policy, there are going to be fewer plans offered in 2011,” said Bonnie Washington, a senior analyst with Avalere Health, which made the study. “There is still going to be robust choice for beneficiaries, but those who have to change plans could experience some disruption and inconvenience.”
While seniors would not lose Medicare coverage, they could see changes in their premiums and copayments.
Medicare officials dismissed the Avalere estimate without offering their own number. “Anybody who is producing that kind of analysis is simply guessing,” said Jonathan Blum, deputy administrator for Medicare.
Avalere’s Miss Washington said the analysis used Medicare’s specifications.
For example, Medicare has already notified insurers they will no longer be able to offer more than one “basic” drug plan in any given location. Several major prescription plans, including CVS-Caremark and AARP, offered two basic options throughout the country this year, Miss Washington said. Eliminating that particular kind of duplication would force 2.75 million beneficiaries to find new coverage, according to Avalere’s estimate.
When other changes are taken into account, as many as 3.7 million Medicare recipients may have to switch, the analysis concluded. That’s about 20 percent of the 17.5 million enrolled in stand-alone drug plans.
Founded by a former Clinton administration budget official, Avalere serves industry and government clients with in-depth research on Medicare and Medicaid.
Former Medicare chief Leslie Norwalk said the change might make things easier for people signing up for a drug plan the first time, but harder for those already in the program.
Insurance industry representatives declined to comment, saying privately that the companies do not want to antagonize Medicare.
Reducing the number of drug plans has long been a goal for consumer advocates. This year, nearly 1,600 plans offered a bewildering range of options, many of which were not significantly different.
But Medicare is going ahead with the consolidation in a hard-fought election year. Republicans have barraged seniors with charges that Mr. Obama and the Democrats raided the program to expand coverage for younger generations under the health care overhaul. Obama’s promise that people can keep health plans they like was made in the context of that broader debate, but the president has repeatedly assured seniors their Medicare benefits are safe.
Please read our comment policy before commenting.