Healthcare costs are exploding for unsuspecting seniors this year.  Millions of Medicare Part D enrollees are impacted by a new government policy that required Part D insurers to reduce the number of plans they offered in 2011.  TSCL is concerned that rules regarding notification to seniors about the changes were too lax, and a lack of timely clear explanation about new costs is resulting in sticker shock at the pharmacy.

TSCL believes that hundreds of thousands of seniors and the disabled are discovering —too late —about higher premiums, new deductibles, loss of coverage and higher drug costs that will make a big difference in what they must pay for healthcare in 2011.  Medicare’s Open Enrollment period, the opportunity to switch drug plans, ended December 31st.

The changes came as a shock to 85-year old Irene Haney who lives in Central Virginia.  Irene always checks her Part D coverage around October 15th every year prior to the Open Enrollment period, with the help of her neighbor, Advisor editor Mary Johnson.  Using the Medicare Drug Plan Finder at www.medicare.gov, seniors can check their current drug plan enrollment, costs and coverage changes for the following year, and see at a glance if there are less costly plans offering better coverage on their current prescriptions.

Last fall, Irene learned that her Part D drug plan was closing at the end of December.  Although Medicare Part D plans are required to notify enrollees of changes in coverage, the information that Irene received was unclear, and even the plan’s website did not spell out that her plan would close by December 31st, 2010.  In fact her 2010 plan was still enrolling people on October 28th , 2010.

Irene learned that, without her knowledge, she had been automatically enrolled in a different drug plan that would take the place of her old one, effective January 1, 2011.  Medicare allowed the insurance companies that closed plans to do so.  But the new plan that Irene was transferred to cost much more than her old one, and didn’t cover her expensive brand name eye drop prescription.

If she had done nothing, her estimated costs for 2011 would have almost doubled — from $1,014 in 2010 to $1,957 in 2011.  Instead, Irene switched to a new drug plan.   According to the estimate from the Medicare Drug Plan Finder, she will save at least $1,164 in 2011.  The chart below illustrates:

How Irene’s Drug Plans Choices Compared

TSCL believes that the seniors were not given adequate notice about the changes or fully informed about the financial impact of closing drug plans.  Hundreds of thousands of seniors may be enrolled in inappropriate Part D drug or Medicare Advantage plans that might add up to thousands of dollars in new out-of-pocket costs.  This comes at the very worst possible time, when there was no annual cost-of-living adjustment to help offset any higher costs.   TSCL is calling on CMS to extend the Medicare Part D and Medicare Advantage Open Enrollment period through March 2011 to allow adequate time for seniors to become informed of their costs for 2011 and to make appropriate plan changes.

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