Developments in Drug CoverageMedicare beneficiaries have 48 free-standing Part D Prescription Drug Plans to choose from for 2010, in addition to receiving drug coverage through an employer group health plan, a Medicare Advantage Plan, the VA or Tri-Care, or Wisconsin Senior Care. The average premium of the PDPs has increased $2.92, with only one plan available for less than $30 a month. Ten plans have also increased their deductibles more than $100, including 7 that had no deductible in 2009. Case managers, benefit specialists, and others who work especially with individuals who qualify for the Low Income Subsidy (extra Help) for Part D should note that we have dropped from 16 to only 10 plans that are fully covered by the low income premium subsidy. Four low income plans from 2009 have 2010 premiums just slightly above the full subsidy amount, which could lead to complications if members are not aware of their need to pay these small additional costs to their plans. To view the changes in low income plans for Part D in Wisconsin, click here. Do you work with Medicare beneficiaries going into Family Care? An excellent resource to understand the Medicare considerations and implications of enrolling in Family care is now available on the web as Resource Memo (RS 09-01): Family Care and Medicare - What You Should Know (along with all of the attachments). SeniorCare Extended until end of 2012! SeniorCare is Wisconsin's unique solution to negotiating for prescription drug coverage for Wisconsin residents 65 and over. There is a $30 per person enrollment fee for twelve months of coverage; your income determines costs such as deductibles that must be paid before receiving SeniorCare discounted copays of $5 for generics and $15 for brand names. There is no asset limit to qualify. For details and applications, go to Wisconsin’s SeniorCare webpage. 1) SeniorCare is counted as "creditable coverage" so that members are protected from incurring a potential penalty for not enrolling in Medicare Part D. This creditable coverage counts even if your income is so high that you would have a large spend-down before qualifying for SeniorCare discounts on drugs. 2) Because there is no monthly premium for SeniorCare compared to an average monthly premium of about $30 for stand alone Part D Plans, individuals might spend less over all on their medications with SeniorCare—depending on their income and the bundle of drugs they need. 3) For individuals who qualify for the Full Subsidy Extra Help with Part D, the cost of copayments may actually be less in a Part D benchmark plan that it would be in SeniorCare. 4) If clients are enrolled in a Part D Plan and concerned about "hitting the donut hole," SeniorCare coordinates as secondary coverage to Part D Plans to "fill the donut hole." 5) Note: Because SeniorCare is a Medicaid waiver program, SeniorCare will terminate members who become eligible for another source of Medicaid and Part D as of their date of MA coverage. Individuals who have resisted enrolling in Part D and even those who have might do well to compare the Medicare option to the SeniorCare option. Medicare D, SeniorCare, and the Coverage Gap Flyer
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