Some drug premiums lower than expected
But Medicare officials say isle retirees might have better plans than those being offered
Medicare officials announced it has approved 12 companies to offer stand-alone prescription drug plans in Hawaii, including three with premiums under $20 a month.
Mike Leavitt: The health secretary says the drug plans will save isle residents more money
The companies offering at least one plan with a premium below $20 are First Health Life and Health Insurance Co., Unicare and Wellcare Health Plans, said the Centers for Medicare & Medicaid Services.
"For premiums that are in many cases much lower than expected, seniors will be able to get Medicare-approved prescription drug coverage that will help protect their health as well as their savings," Health and Human Services Secretary Mike Leavitt said in a news release.
The 12 companies offering Medicare Part D plans -- plus five others that will offer drug coverage with additional benefits and lower total out-of-pocket costs -- will begin marketing their plans Sunday, with enrollment of Medicare beneficiaries beginning Nov. 15.
"The first real big decision for people in Hawaii is, Do I even need this thing or not?" said Mary Rydell, federal Health Care Financing Administration regional administrator in Hawaii.
A large percentage of Hawaii's 186,000 Medicare beneficiaries are retirees with drug benefits from former employers, she said.
"We're kind of lucky in Hawaii, at least right now -- we have rich retiree coverage," she said, noting there are 40,000 state and county retirees, 26,000 federal retirees and about 28,000 residents eligible for both Medicare and Medicaid.
People should take their time and look at benefits they have and what the options are, she said.
"One of the biggest fears is that people who already have good drug coverage will drop it and pick up something that's not as good," Rydell said.
"Plans are going to be telling people how great their plans are, and that's OK," she said. "But people really shouldn't sign anything until they know what they're signing, and they don't have to do it on the day of a presentation by a company or a seminar."
People should take their time and look at benefits they have and what the options are, Rydell advised. She said the companies will be sending information on plans through the mail and going to senior centers.
"Everyone's kind of worried and confused about what's going on. Talk it over with family and friends, and come to Medicare or SagePLUS (for help). We always recommend getting information from a neutral source."
Medicare beneficiaries who have prescription drug benefits should not do anything until they receive a notice telling them whether their present coverage is as good or better than Medicare is offering, she said. The law requires notice by Nov. 15 from employers.
If the benefits are not as good or a person has no drug coverage, they need to start looking at what plans are available to them, she said.
Beneficiaries should look at the medicine they are taking, decide where they want to get it, from a pharmacy or through mail order, and start comparing plans, she said.
Medicare will do that for them if they call or put their ZIP code, list of medications and pharmacy preference into the computer, she said.
"Thanks to the range of options available, everyone in Medicare who lives in Hawaii will be able to choose a prescription drug plan that addresses their individual concerns about cost, coverage and convenience," Leavitt said.
Extra assistance is available to people with limited income and resources. Seven companies offering drug coverage in Hawaii will have plans available with no premium to people qualifying for extra help, the Centers for Medicare & Medicaid Services said.
All plans approved by Medicare in Hawaii met requirements to provide access to medically necessary drugs and coverage as good as Medicare's standard coverage.
The standard pays an average of 75 percent of drug costs after a $250 deductible up to $2,250 in total drug spending and about 95 percent after $3,600 in out-of-pocket costs to protect against 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," the federal agency said.
Mark McClellan, director of the Centers for Medicare & Medicaid Services, said because of strong competition in Hawaii, Medicare coverage will include options that cost less and provide coverage going beyond Medicare's standard benefit.
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Prescriptions for savings
Details on the Medicare Part D prescription drug plans to be offered in Hawaii:
» Twelve companies offering stand-alone drug plans: Aetna Life Insurance Co., Connecticut General Life Insurance Co., Medco Containment Life Insurance Co., MemberHealth Inc., Pacificare Life and Health Insurance Co., RXAmerica LLC, Silverscript Insurance Co., Sterling Insurance Co., United Health Care Insurance Co., First Health Life and Health Insurance Co., Unicare, and Wellcare Health Plans
» Five Medicare Advantage organizations offering drug coverage with additional benefits and lower total out-of-pocket costs: Aloha Care, Kaiser Foundation, Hawaii Medical Service Association (65 Plus) and two United Healthcare plans
» Medicare's Web site, www.medicare.gov, and its 24-hour toll-free number, 800-MEDICARE (800-633-4227), will have specific information to help beneficiaries find an appropriate plan beginning in mid-October.
» Early next month, the "Medicare & You 2006" handbook will be mailed to every beneficiary with detailed information. Islanders also can get local help by calling SagePLUS at 888-875-9229.