Medi-CareFirst BlueCross BlueShield To Offer Improved Prescription Program for Seniors
Coverage of Generics During “Doughnut Hole” Period Now Offered
OWINGS MILLS, MD (October 16, 2006) – Medi-CareFirst BlueCross BlueShield (Medi-CareFirst), a CareFirst BlueCross BlueShield affiliate, will now offer an option to cover the so-called “doughnut hole” in the Medicare Part D plan for beneficiaries. The Centers for Medicare and Medicaid Services (CMS) has approved Medi-CareFirst’s contract for 2007, enabling the insurer to offer Medicare Part D prescription drug products to beneficiaries in Maryland, Delaware, and the District of Columbia.
Legislation enacted by Congress establishing a new voluntary Medicare prescription drug benefit provides for coverage up to the first $2,400 in total drug purchases in 2007, after which the beneficiary is totally responsible for any drug purchases up to $3,850 in out-of-pocket spending — a period known as the “doughnut hole.” Above that amount, 95 percent of drug expenses are covered for the rest of the year.
Medicare beneficiaries will be able to enroll in a Medi-CareFirst plan between November 15 and December 31 this year. Two products are available this year - Blue Rx Standard and Blue Rx Enhanced. The first, Blue Rx Standard, is a standard product carrying a $34.20 monthly premium. The new product offering for 2007, Blue Rx Enhanced, provides seniors and disabled individuals covered by Medicare with doughnut hole coverage for a $42.20 monthly premium that covers all generic drugs throughout the coverage gap.
“We realize how important it is for seniors to feel secure in their health care benefits, and providing them coverage in the doughnut hole is a high priority,” said Gregory A. Devou, CareFirst Executive Vice President and Chief Marketing Officer. “As always, Medi-CareFirst BlueCross BlueShield is available to help seniors navigate what can be a confusing process.”
In another program change, the little-used prescription drug mail order option has been eliminated. Enrolled seniors will now have the option of getting a three-month supply of their medications at their local pharmacy. As an added benefit, three-month supplies will be available for the cost of two monthly copays – providing additional savings over the course of the year.
Medi-CareFirst is offering informational seminars at various locations throughout the Maryland, the District of Columbia and Delaware during October, November and December. In addition, outreach and sales staff will be available at numerous state and county-sponsored events throughout the region.
Newly eligible Medicare beneficiaries may still enroll after the December 31 deadline for the Annual Election period. However, current Medicare beneficiaries who do not enroll by December 31 will have to wait for the next Annual Election enrollment period, November 15 through December 31 of 2007. Those beneficiaries who wait to enroll past their initial eligibility period will have to pay a 1 percent penalty for life for every month they did not have coverage that was equally as good as Medicare prescription drug coverage. Newly eligible Medicare beneficiaries who first became entitled to Medicare October 1, 2006 and later can still enroll after December 31 without a penalty as long as they enroll within their 7-month initial eligibility window (three months prior to eligibility, the month of eligibility and three months after eligibility).
“We recommend that people enroll online at www.medi-carefirst.com or over the phone at 1-888-784-0790,” said Devou.
Medi-CareFirst is the only Blue Cross Blue Shield-licensed Medicare Part D plan offered in Maryland, Washington, D.C. and Delaware. More than 32,000 individuals are enrolled in a Medi-CareFirst plan, and they will automatically be re-enrolled in the Blue Rx Standard plan, with the option of enrolling in the new Blue Rx Enhanced plan.
Medi-CareFirst BlueCross BlueShield is the trade name of First Care, Inc., which like its affiliate CareFirst BlueCross BlueShield (CareFirst), is an independent licensee of the Blue Cross and Blue Shield Association. CareFirst is a not-for-profit health care company which, through its affiliates and subsidiaries, offers a comprehensive portfolio of health insurance products and administrative services to nearly 3 million individuals and groups in Northern Virginia, the District of Columbia and Maryland. Through its CareFirst Commitment initiative and other public mission activities, CareFirst supports efforts to increase the accessibility, affordability, safety and quality of health care throughout its market areas.