Medicare approves plans to offer drug coverage in Florida
Many plans will offer premiums lower than $20.
Article published on Wednesday, Sept. 28, 2005 |
People with Medicare in Florida will be able to get prescription drug coverage in January, through their choice of either a newly approved stand-alone prescription drug plan that works with traditional Medicare, or a Medicare Advantage plan that offers drug coverage and other benefits, the Centers for Medicare & Medicaid Services (CMS) announced recently.
In Florida, 18 organizations will offer stand-alone prescription drug plans, including four with premiums of less than $20 a month.
People with Medicare in Florida can also get drug coverage with additional benefits and even lower total out-of-pocket costs by enrolling in Medicare Advantage plans.
The Medicare Advantage options include two new statewide PPO plans and in 2006, twenty-three Medicare Advantage organizations will provide prescription drug coverage for no additional cost.
Prescription drug coverage will be available to everyone in Medicare, regardless of his or her income or how he or she gets his or her Medicare coverage. Extra assistance is available to those with limited incomes and resources. Of the organizations offering drug coverage in Florida, six will have prescription drug plans available with no premium to beneficiaries who qualify for that extra help.
All plans approved in Florida have met Medicare's requirements for providing access to medically necessary drugs, including formulary standards as well as standards for access to convenient retail pharmacies and to drugs in nursing homes.
All plans are required to provide coverage at least as good as Medicare's standard coverage, which pays on average 75 percent of drug costs after a $250 deductible up to $2,250 in total drug spending. The coverage also pays approximately 95 percent after $3,600 in out-of-pocket costs to protect against very high drug expenses.
This means that for a monthly premium that is lower than expected, Medicare would pay more than half of a typical beneficiary's drug costs, or more than $1,100.
In early October, the Medicare & You 2006 handbook will be mailed to every Medicare household. Beneficiaries with coverage now, for example from a former employer, should also get information by Nov. 15 on how that coverage will work with Medicare's new benefits.
Beginning in mid-October, Medicare's website, www.medicare.gov and its 24-hour toll-free number, (800) 633-4227, will also have specific information available to help beneficiaries find the drug coverage that suits their needs.
To get a fit that works for them, beneficiaries should make a note of any current drug coverage, their prescription drugs and their preferences about pharmacies or additional coverage.
Medicare beneficiaries in Florida can also get personalized, local assistance by calling Serving Health Insurance Needs of Elders at (800) 963-5337.
A map of the prescription drug plan and Medicare Advantage plan regions can be found at www.cms.hhs.gov/medicarereform/mmaregions.
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Article published on Wednesday, Sept. 28, 2005
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