Medicaid D 2007 Plan Not All That Rosy

The fact that there are more plans available, and a shorter period of time to choose from them, just might add to the difficulty and confusion in getting a good plan. It’s still a pretty difficult choice to make.

Even seniors who signed up last year have to decide whether to stay with the plans they have -- which have the option of changing the costs and formulary of the plan. Yet worse - they’re going to have to keep doing this every year.

When the six-week enrollment period for 2007 begins Nov. 15, seniors will have about 50 plans to choose from in every state, from 17 different insurers nationwide that have been contracted to administer the federally financed benefit.

Seniors concerned about the gap in coverage between $2,250 and $5,100 known as the 'doughnut hole' will also have more plans to choose from. Is this good or bad? More plans? How but fewer and less confusing.

For example, there will be 15 or 16 plans in each state that offer full coverage for generic drugs even during the coverage gap, unlike other plans, which require beneficiaries to pay for all of their drug costs during the gap out-of-pocket.

The plans that offer doughnut-hole coverage may also be out of reach for the lower-income individuals who need them the most.

Instead of leaving seniors open to all these problems, wouldn't a better alternative be to offer a Medicare-administered plan that does not have a coverage gap? The low average premium of $24.00 touted by the administration shows that seniors are choosing low-cost plans that may not be meeting their needs. It’s hard to know if a lower-priced option is lower-priced because it’s giving you less of what you want.

Maybe the question we should be asking is, ‘Is this the best program we could have for the massive resources being devoted to it?’

XLPharmacy Canada