September 28, 2005

CHOOSING THE RIGHT PLAN FOR YOU

Guest opinion submitted by Idaho Senator Mike Crapo

CHOOSING THE RIGHT PLAN FOR YOUGuest opinion submitted by Idaho Senator Mike CrapoConsider the fact that 60 years ago there was no such thing as a vaccine for polio, measles, German measles, mumps, and chicken pox; now the vaccine for many illnesses comes in one shot. The last half-century has seen historically unparalleled advances in surgeries, treatments for chronic and fatal diseases and health care prevention. Like the amazing technological advances over the past two decades, the progress and changes in health care over the past half century are nothing short of miraculous.These changes bring hope where there was none, life where death was certain, and prevention for all. Yet, change isnâ??t always easy. Ironically, while the oft-cited goal of technology, for example, is to simplify our lives, learning to use that technology can be challenging. The same holds true for some changes in Medicare. The new prescription drug plans, which will provide most Medicare recipients with medication at reduced prices until the Medicare Modernization Act takes effect in 2006, might seem complicated at first glance. But with some time devoted to research, recipients will find a plan that will save money and resources. Earlier this summer, the Center for Medicare Services (CMS) regional office in Seattle had recruited over 30 partners in Idaho who committed to hold one-on-one counseling and enrollment events for beneficiaries. Other partners have committed to distribute information and refer clients who need additional assistance. At the end of August, 34 outreach activities had been conducted by CMS in Idaho so that beneficiaries enter the enrollment period armed with accurate and complete information. The following information may be helpful to potential prescription drug plan recipients as they identify their personal medication requirements and choose between options:-Enrollment begins on November 15.-Eighteen organizations will offer stand-alone prescription drug plans.-Two of these have premiums of less than $20 a month.-Twelve organizations offering coverage in Idaho will have prescription drug plans with no premium for beneficiaries who qualify for extra assistance.-All plans meet Medicare requirements for access to medically-necessary drugs, access to convenient retail pharmacies and access to drugs for those in nursing homes.-All plans are required to meet the minimum Medicare standard which covers an average of 75 percent of drug costs after a $250 deductible up to $2,250. The coverages also pay 95 percent after $3,600 in out-of-pocket costs.-Medicare Advantage plans provide beneficiaries with additional benefits and even lower total out-of-pocket costs.-In early October a book, â??Medicare & You 2006,â?? will be mailed to every Medicare household. It has comprehensive information about the upcoming changes in the law and provides resources to obtain further information.-The Statewide Insurance Benefits Advisors organization has trained volunteers to help with questions about health insurance, benefits, and health care and prescription access. The number is 1-800-247-4422.-In mid-October, both the website www.medicare.gov and Medicareâ??s 24-hour toll-free number 1-800-633-4227 (I-800-MEDICARE) will have information to help beneficiaries discover the plan that is right for them. There is help out there in charting a course through the new plans and changes in the law. Itâ??s important for the families and friends of Medicare beneficiaries to also examine the new offerings. The advice of loved ones is invaluable in this process, and can help beneficiaries select the appropriate plan. If you have questions, please contact any one of my offices; my staff will be happy to help. Changes can be challenging, but in this case, like changes in medicine and technology, the end result will be more responsive health care for all. WORD COUNT: 583