Medicare Part D. William J. Hogan American National Insurance Company
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1 Medicare Part D William J. Hogan American National Insurance Company
2 Introduction The 2003 Medicare Prescription Drug, Improvement and Modernization Act (MMA) Title I includes Prescription Drug Plans Title II includes Medicare Advantage
3 Introduction (cont.) Part D provides drug coverage to all individuals over 65 or otherwise eligible due to disability Becomes effective January 1, 2006 Part D is not a discount card Excludes those drugs for which payment would be available under Medicare Parts A and B
4 Part D Highlights Covers over-65 and those otherwise Medicare eligible due to disability Part D is voluntary warning- if eligible and decide not to enroll then subject to penalty of up to 1% per month Initial Open Enrollment begins November 2005 and continues until May 2006
5 Highlights (cont.) Part D plans are one year plans currently set to renew each February Current premium is set at $37 per month Industry talk thinks it may go as high as $40- $45 when finally implemented
6 Standard Plan Details $250 deductible Medicare pays 75% from $ to $2,250 No coverage from $2, to $5,100 Medicare pays 95% after $5,100 (assuming TrOOP of $3,600)
7 Drugs Excluded Currently excluded or restricted are anorexia/weight loss/gain; fertility; cosmetic/hair growth; cough/cold medicine; prescription vitamins except prenatal; OTC drugs; barbiturates; benzodiazepines Those otherwise eligible under Medicare Parts A and B
8 Formularies Plans must have two drugs from each therapeutic class or category Formularies reviewed and approved by CMS for adequacy Should formulary change, plan must provide 60 day notice to beneficiary (unless due to recall)
9 Part D and Retiree Benefits Plans have a number of options Maintain status quo and apply for federal subsidy Make individual Part D primary and provide a supplement Become a PDP or contract with one Drop retiree coverage
10 Retiree Benefits (cont.) At a minimum plans must determine creditable coverage status of the individuals and send notice of part D benefits CMS has the forms on the web Notices must go out prior to the November 15, 2005 initial Open Enrollment period
11 Subsidy Feds want to encourage plans to continue offering drugs to retirees Tax free Currently equal to about 28% of eligible costs between $250 and $5,000 up to a $1,330 maximum Again does not include cost for drugs not covered by Part D
12 Subsidy (cont.) Plan must be at least actuarially equivalent to Part D (see later slide) Beneficiaries may not enroll in Part D (those who do can t count) Potentially low cost option and ease of administration Good stop-gap measure to use while studying other options
13 Actuarial Equivalence Gross test is a basic evaluation and compares a plan s benefit to the standard Part D benefit Net test is a bit more detailed and takes into account other factors such as beneficiary contribution and compares that to Part D benefits When utilizing the subsidy plans must submit actuarial certification
14 Wrap Around-Supplemental Plan Similar in principle to a Medicare Supplement policy Retirees must enroll in two plans, the individual Part D and the wrap Runs the risk of communication problems especially with coordination of benefits Beneficiary needs to understand interplay between Part D and wrap
15 Wrap (cont.) Typical plan would fill in the gaps where no coverage is available Plans can decide what level they provide benefits, i.e. 50%, 75%, and price accordingly
16 PDP Sponsor Option Usually the most expensive and technical of options Must contract with CMS to be approved national or regional PDP Complex relationship with CMS and subject to government auditing, bidding processes, reporting etc. usually best for larger entities that can spread cost
17 Drop Retiree Coverage Possible alternative when retiree pool is small and current plan is not actuarially equivalent Low cost alternative but beware of possible retiree reaction and impact on current and future employees
18 Important Dates June 6, plan bids are due July 15, last date to receive favorable ruling on denied application September 1-14, CMS signs approved contracts October 13- CMS comparative website goes live November 15, Open Enrollment begins
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