In response to criticisms that there are too many insurance plans being offered under Medicare D(isaster), the administration is now considering ways of making the program easier to understand and participate in. According to the WaPo, CMS’s current brainstorm is to limit the number of plans that are being offered. A 39-page draft memo to insurers, employers and others administering the drug benefit requests their advice and input, including
limiting to two the number of drug plans a company can offer per region. Many insurers now offer three, and since there are often more than a dozen insurers per region, consumers often have more than 40 choices.
CMS is also expecting an insurer’s two plans must have differences to make comparisons easier for senior citizens and people with disabilities.
According to Ron Pollack, executive director of the activist group Families USA, the plans can’t generate enough enrollment to generate bargaining clout with drug manufacturers and the reduction of the number of plans won’t change that or make it less complicated.
“When you have such a huge number of companies providing this coverage and no effort to standardize benefits it creates chaos.”
continued
It appears that in the year 2007, the Medicare D(isaster) plans that are being consided may be structured similar to the following description:
one company will offer a plan that charges consumers less, but the trade-off can be a more limited choice of drugs. Another plan will offer more drug coverage but the customer will have to pay higher premiums.
That sounds alot like the Medicare D(isaster) that is already in effect, but, with a smaller number of plans.
The WaPo also states
Beneficiaries also can choose from more comprehensive medical coverage, called Medicare Advantage, which operates like an HMO. Most beneficiaries can choose from more than a dozen Medicare Advantage plans.
Interestingly enough, the following was written earlier:
Humana is using high commissions to encourage its sales representatives to enroll the elderly in such HMO-type policies and paying increased commissions for managed-care enrollees as it pays for customers who sign up for one of its drug-only plans which is being offered as part of the new Medicare D.
Humana sales appears to be using Medicare D policies for marketing purposes to attract seniors. This is referred to as an
“enroll and migrate” strategy.
Seniors sign up for drug-only plans, and are encouraged them to enroll in one of the more profitable managed-care plans. It is also claimed that sales staff advise some senior to sign up for a managed-care plan as well.
Health and Human Services Secretary Mike Leavitt said earlier this month.,
“We’re seeing the cost of drugs come down in a rapid way because of an organized, competitive marketplace.”
What about the profits of the insurance companies, the rx manufacturers and Walmart? The latter is being asked due to this:
Humana also has Medicare Part D sales representatives inside some Wal-Mart stores and markets a card that carries only the Wal-Mart logo.
And, finally, what about the statement by Rep. Henry Waxman, D-Calif.
Medicare officials had lost credibility. “They tell us that prices are amazingly low when seniors can see with their own eyes that that isn’t the case.”
There is also a thing called increased co-pays that you have not addressed, let alone the “donut hole”.
xpopsted at Mlw and dkos
anyone else think that since this is from the WaPo, Mc Clellan is at it again?
Well, first you scare the hell out of (poor and low income) seniors and disabled folks by allowing drug prices and medical care to get priced so far out of their reach in the first place that they are scared there’re gonna croak before tehy have to from lack of both. Then you pretend to help them by introducing "new benefits" that it would take a combination accountant and experienced insurance expert to even begin understand, and turn the whole thing over to private insureres who use professional marketers with psy op level marketing skills. Then threaten the ol folks with even higher premiums if they don’t sign up SOON!
You BETCA they will listen to the insurance company smoothies who want to "help them", they’re scared NOT to.
And why SHOULDN’T the insurance companies make as much profit as they possibly off the backs of the the poor sick, disabled, and elderly? All the other corporate enterpises that now own health care do, and it’s only fair, really, in a "free market."
Because it’s true that these people could take advantage of stuff like Health Savings PLans is they really wanted to. They could easily take, say, 200.00 our of thier 600.00 monthly SS income every month to slam into tax free savings, if they just planned better, and stopped thinking the had "entitlement rights" to stuff like rent and groceries.
Give me a f*ing break, Bush and Company, INC.
I am old, not stupid.
And really, really pissed off.
Give me a f*ing break, Bush and Company, INC.
I am old, not stupid.
And really, really pissed off.
That is it, they are implying that everyone is stupid. And I hear you on that–can’t remember the times that I have said, “Just because I have a traumatic brain injury doesn’t mean that I am stupid.”
Simplified..ha..like the tax code the government will tinker around and add more/more bandaids making this even more fucked up then it already is-if that’s even possible.
And what happens if the insurance companies drop certain plans..then you’re back at square one trying to figure out what gdman ‘plan’ you should sign up for…for a year anyway as each ‘plan’ according to my understanding is up every year.
I can’t even begin to imagine what is going to happen when this ‘donut hole’ thing starts to hit people…seems it’s going to be one big scary mess for way way to many of the seniors or the disabled.
I’m starting to worry about what they’re going to do to the hold-outs. I haven’t signed up because while my medical costs can be high, so far my medicine costs are generally pretty low. (If I get an MS diagnosis this won’t be the case, but so far it’s just “possible MS” along with the confirmed autoimmune disease.) If I signed up, I wouldn’t get a benefit from it because of the deductible, so it would wind up just costing me extra money to pay the premium every month. And like a lot of elderly and/or disabled folks, I simply can’t afford to pay that extra money.
I already know they’re planning on instituting that penalty starting in May where the premiums will go up by 1% per month for every month I don’t sign up. What’s worrying me is that the whole plan seems based on the idea that people like me, with low medicine costs, will pay the premiums and thus cover the cost of people with high medicine costs, like how most insurance works. But people haven’t been enrolling, and many people who were automatically enrolled through Medicaid programs but also have low medicine costs may also drop out soon.
So I’m starting to get worried about what they’re going to do to us once they realize that not enough people are enrolled to cover the costs of the folks with really expensive medicine needs — at least, not enough to be turning huge profits for the insurance and pharmaceutical industries. They won’t let Big Business take the hit, that’s for sure. They’ll come after us.
I don’t know…I was autoenrolled and so far it seems to be working, but I know there is a catch somewhere.
It may wind up working for you — it all depends on your particular costs.
I usually spend about $200 per year on medicine. (Most of my costs are spent on doctors and medical tests, like the expensive MRIs, and Medicare helps with that a lot even though sometimes I have to fight with them.) There’s a $250 deductible for Medicare D, though, so if my needs stay the same as they are right now then I would never get any coverage out of the deal if I signed up — I would just have to pay out the premiums every month on top of what I’m already paying for medicine.
But your medicine costs are probably higher than mine due to the nature of your disability, so it may well save you some money. IF you don’t get creamed by the donut hole, that is. But that goes back to depending again on your specific circumstances. You’ll probably be able to figure out if it’s saving you money after the first year, if you are able to compare just your medicine costs from this year to what you spent last year.
Yeah, the donut hole is one of the things that I am concerned about, as the price of my rx’s are high!
And I also cannot take generic drugs, those that are available for me. My late father was the same way, generics didn’t work for him either. And according to my pharmacist and my doctor, that is not unusual for a generic not to work as opposed to a DAW rx.
Another thing that was not taken into consideration!
I really hate this thing!
wish I knew what to tell you…but I don’t think anyone really knows yet all the bad ramifications of this ‘Plan’.
I’m curious about the whole deal on the profit for the insurance companies myself..if everyone in their plans have high monthly drug lists and are paying little where is their profit going to come from..we know they aren’t doing this out of the goodness of their fucking hearts. If most of the people so far who are enrolled are the ‘dualies’ then there will be no profit at all for them.
SSD has already said that the funding and people working on claims for disability is going to fall by the wayside..like it wasn’t way behind anyway…so longer wait times for people filing SSD claims..and more people also given the number of returning soldiers that will be filing…
If most of the people so far who are enrolled are the ‘dualies’ then there will be no profit at all for them.
Some of the carriers are realizing that. Probably antohre reason why the number of plans are being cut back. Gotta keep the insurance companies happy!
That’s the way that I understand it, the plans are allowed to change at the carrier’s will. Makes no goddamn sense, unless of course you believe DF’s theory re: polutation control (and I have been believing that one for awhile.)
But I can’t help but think there is something else hidden in other social programs…a funding cut, maybe?
are just vestigial tokens, and the amount of money spent on them may look small, but it is still money that can be diverted to the war on terror.
The cost of the Iraq crusade alone is expected to go into the trillions, and Afghanistan is hardly cheap, and when you consider that Iran is several times larger than Iraq, with 3 times the population, you can see that every cent is important, and we have not even mentioned the spiraling costs of maintaining crackdown on client state populations, nor the costs of torture camps, or similar programs to help eradicate terror in the US itself.
All the bullshit in the Middle East is what is destroying the country, IMO. Make that the world!
paying all those commercial gunmen in South America, not to mention 37000 of so regular government ones in Korea, I think US maintains” bases” in something like 128 countries, the last thing it needs are millions of unprofitables, undesirables and near-unusables who are generating little or no revenue for any company, much less the energy and defense sector.
Failure to eliminate these de facto obstructionists would not only impede the war on terror, it would simply not be business-friendly.