Medicare is about to cut back on its number of drug plans, and a new report from Avalere Health suggests the change could force more than 3 million seniors to make a potentially disruptive plan change starting in October.

Others, among them AARP, suggest the changes are more likely to ease seniors' confusion than cause it. They say the range of current Part D choices is just way too confusing, presenting seniors with way too many lookalike plans to assess.

The changes are coming in Medicare's prescription drug coverage. Each year from October through December, seniors in the Medicare program pick from various plans offering prescription drug coverage. Currently, depending on the state, there are from 41 to 55 plans for seniors to chose from, with prices running from zero (for low-income seniors) to $40 a month, depending on the exact benefits offered. The plans offering brand name drug coverage generally cost more.Avalere's research report this week suggested the narrowing could force 2.75 million seniors in basic plans and 350,000 in enhanced plans to make changes. In addition, about 645,000 people who have some extra coverage for gaps in Medicare would need to change plans.

Bonnie Washington, Avalere Health's senior vice president, said the changes will "narrow the field of choices [and] remove plans that do not offer a significantly different set of benefits."

In some cases, companies that offer the drug coverage will have to combine some of their existing choices. In others, they will have to more clearly separate their choices both in benefits and price, she said.

Washington estimated that the number of choices will probably fall by 20%. Likely to go are drug plans with the fewest sign-ups, she said. Despite the narrowing, there will still be a number of choices.

"Early signs show that the market will have plenty of low-cost options for seniors to choose from," she said.
Meanwhile, AARP and some other groups have suggested the number of current choices are confusing to seniors.

A 2006 poll by the Kaiser Family Foundation found that 71% of seniors either agree or strongly agree that the prescription drug option choices are too complicated, and 60% agree or strongly agree that the number of plans presented should be reduced.

"There could be a real bargain in simplifying the choices," said Tricia Neuman, the director of the foundation's Medical Policy Project. "There are dozens of plans available to seniors across the plans, and some of the insurers are offering multiple plans that look similar, creating some confusion."

"The idea behind this policy is to minimize the number of times when there are minimal differences ... to see real differences and make better choices."

She said there could be disruptions, "but there are benefits to simplifying the marketing."

Tony Salters, a spokesman for Medicare at the government's Centers for Medicare and Medicaid Services, said the report of the number of people who will have to change is premature because the government hasn't yet detailed the plans to be offered.

He also noted that changes in the plans offered happen every year and said the suggestion to reduce duplicative plans came from consumer and advocacy groups.

"People wanted fewer choices, rather than hundreds of choices like Silver and Silver Plus and Silver Plus Plus that people could not comprehend."

He also said that under no condition would seniors lose coverage. Seniors have from October to mid-December to pick a new plan but will be assigned a plan if they don't choose and continue to receive some drug benefits.

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