aTypical Joe: a gay New Yorker living in the rural South

Wednesday, April 26, 2006

Medicare prescription drug plan fix

Progress. But nowhere near perfection.

A big bad glaring hole in the Medicare prescription drug program was a bizarre provision that allowed plans to drop medications during the course of the year as long as they gave 60 days notice. That’s changed:

The Bush administration issued a new policy on Wednesday that protects Medicare beneficiaries against the sudden loss of coverage for drugs they are taking under the prescription drug program.

Under the policy, insurers can still change their lists of covered drugs, known as formularies. But if they drop any drugs or impose new restrictions, they must exempt beneficiaries who are now taking those drugs.

Dr. Mark B. McClellan, administrator of the Centers for Medicare and Medicaid Services, summarized the policy this way: “In general, a plan cannot change your coverage for the drugs you are using during the year. The stability of drug formularies is extremely important for many of our beneficiaries.”

Stability? This only means that now when the insurance company drops the drug you’re covered for the remainder of the year before you have to go through the arduous process of changing plans.