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FOR IMMEDIATE RELEASE: September 19, 2006

Schumer Reveals Major Medicare Part D Drug Plans Could Suddenly Drop Out Of Program Next Month; Seniors Left With Less Than Three Months To Find New Coverage

Unbeknownst to the More Than 486,000 Upstate New York Seniors Enrolled In Medicare Part D, CMS Will Announce Oct 2 that Some Drug Plans May Not Be Around in 2007; Thousands of Seniors Forced Go Through Sign-Up Ordeal All Over Again

Senator Calls on CMS to Provide Individual Notifications to Seniors Who Could Suddenly Lose Coverage; Give Specific Guidance About Similar Plans and Advice t

Today, U.S. Senator Charles E. Schumer revealed untold numbers seniors could find out next month that they will either have to change prescription drug plans or lose coverage altogether because plans participating in the Medicare Part D program could suddenly drop out of the program. On October 2, the Centers for Medicaid and Medicare Services, the agency that administers the Part D program, is expected to announce which insurance companies have decided not to offer coverage in Medicare Part D next year. Unfortunately for the more than 486,000 upstate New York seniors enrolled in Part D who thought they had finished the onerous sign-up process, CMS has only given them less than three months to go through it all over again and find a new plan.

“There are so many twists and turns with Medicare Part D, it’s as if upstate New York seniors are doing the slalom,” Schumer said. “Seniors just went through the time intensive and complicated process of signing up for one of these programs last year and now they find out they may have to do it all over again. CMS needs to give upstate New York seniors straight and easy to understand information about their program choices so we don’t have a repeat of last year’s near chaos.”

On October 2, CMS will release the new list of plans that will offer Medicare Part D drug coverage for calendar year 2007. Unfortunately for many seniors, some plans have already notified CMS that they will not offer coverage next year, forcing seniors to choose another plan. In addition, insurance providers that opt to continue to participate in Part D have the option to change, scale back, or raise premiums for their coverage. This could confuse many seniors that already had enough trouble picking a plan that meets their needs in the first place.

According to the rules set by CMS, plans that are staying in Medicare Part D will be able to start sending out advertising materials for their new 2007 plans on October 1 of this year. However, seniors will only have from November 15 to January 1, 2007 to decide which new plan they want, or risk losing all coverage for the entire year. The true timeframe is even tighter, given that seniors who sign up in the last half of December will probably encounter problems at the pharmacy because CMS will not have been able to fully process their requests by January 1st. Schumer said CMS has only given seniors less than two and a half months to go through a process that took far longer last year.

More than 486,000 upstate New York seniors have enrolled in Medicare Part D.

In light of what could be a very sudden change for tens of thousands of seniors, Schumer today called on CMS Administrator Mark McClellan to provide individual notifications for seniors whose plans are being discontinued. In these notifications, Schumer urged McClellan to include personalized information and specific recommendations of plans that seniors can easily sign up for with similar costs and benefits, as well as informing seniors of options for enhanced coverage that would avoid following into the donut hole.

In addition, Schumer pointed out that the new “open season” from November 15 to January 1 would also provide an opportunity for all of the more than 77,000 upstate New York seniors who will fall in to the donut hole this year to pick a new plan with coverage in the gap. In July, Schumer revealed that under the current system, drug plans will pay 75 percent of senior’s drug costs between $250 and $2,250, but zero percent of the total costs between $2,250 and $5,100 (with beneficiaries paying 100% of costs in the “donut hole”). Coverage does not resume until the beneficiary reaches $5,100, leaving New York seniors to pay $2,850 in direct costs while in the donut hole.

Once seniors fall in the donut hole, beneficiaries who had been paying $20 or $30 per month in co-pays for their prescription medications will be forced to pay hundreds of dollars more. In addition, Schumer said that seniors in the donut hole get hit twice because they are forced to continue to pay their monthly premiums despite the lack of coverage. In July, Schumer announced he was pushing legislation to fill the gap in coverage, eliminate premiums for seniors while they are in the donut hole, and calling on insurers to provide plans without the donut hole in the future.

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