Low Income Health Advocate Alert:

California’s Prescription Drug Plan Information is Now Available

Prescription drug plan information is now available on the web and in the “Medicare & You 2006” Handbooks.  Handbooks, which include individual plan information for each beneficiary’s region, have been provided to some HICAP offices in California and will soon be mailed to every Medicare beneficiary, including dual eligibles.  A copy of the booklet (without regional plan information) is posted on the Internet (www.medicare.gov/publications/pubs/pdf/10050.pdf).  The Handbook includes each plan’s premium, co-payment and deductible information, as well as information about the Low Income Subsidy (LIS).  (The information, however, appears to include errors; see below). 

On the web, state-by-state drug plan information is now available at: www.cms.hhs.gov/map/map.asp#.  Plan information is presented on the web in a slightly different format than in the Handbook; the website contains information about additional coverage offered during the “doughnut hole” coverage gap; mail order availability; and the number of included “Top 100 Drugs” included in the plan’s formulary.

 In California (Prescription Drug Plan Region 32), there are 18 companies with 47 stand alone plans that will be available statewide.  In addition, 22 companies will be offering  113 Medicare Advantage and Cost Prescription Drug Plans.  Of these Medicare Advantage (MA) plans, one company - Blue Cross - will offer 2 different Regional PPO plans that will be available statewide; the availability of the remaining MA plans will vary county-by-county throughout California (for example, according to CMS, Los Angeles county might have approximately 30 different MA-PD options).  

According to the Handbook, every one of the 47 stand-alone Prescription Drug Plans (PDPs) listed is available premium-free to LIS recipients, even though premium costs range from $17.65 to $66.08.  We are concerned, however, that this may an error.  We were previously informed that there would be 8 plans at or below the benchmark.  12 stand-alone plans appear to be under California’s $23.25 LIS benchmark.  We will seek clarification of this as soon as possible.

Jeanne Finberg, Katharine Hsiao, Marguerita Fa-Kaji

National Senior Citizens Law Center (www.nsclc.org)

David Lipschutz

California Health Advocates (www.calmedicare.org)