CMS Expands Enrollment Rights for Medicare Part D Low-Income Beneficiaries


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California Medicare Part D Language Access Coalition

CMS Expands Enrollment Rights for Medicare Part D Low-Income Beneficiaries

Oakland, CA - Dealing with the Medicare Prescription Drug Program (Part D) just got a little easier for people with low incomes. Low-income Medicare Part D beneficiaries now enjoy a new, important right to change plans at any time during the year. Previously, many of these Medicare beneficiaries could only change plans once a year, during the fall enrollment period.

The expansion of enrollment rights was announced by the Centers for Medicaid and Medicare Services in July 2007 and takes effect immediately. Under the expansion, all Medicare Part D beneficiaries eligible for the Low Income Subsidy, also called “extra help,” (1.1 million Californians, 9.2 million beneficiaries nationwide) may switch plans as often as once a month. The new right is most helpful to those who are in a plan that is too expensive or does not cover all of their drugs. An individual who changes plans in July can be in a new plan as of August 1.

This continuous special enrollment period has many benefits. If a beneficiary finds that his or her plan does not cover a necessary drug, it may be easier to switch plans than to seek an exception to the plan’s formulary. Because of the plans’ intensive, at times misleading marketing efforts, many individuals have joined plans that they do not understand or that they later realize do not meet their needs. The continuous enrollment period makes it easy for them to switch to a better plan.

Advocates nationwide support the enrollment right expansion as an improvement to the Medicare prescription drug program. “This change is a step in the right direction. It will help many low income individuals who have been trapped in a plan that does not cover their drugs,” says Katharine Hsiao, Staff Attorney at the National Senior Citizens Law Center, a member organization of the California Medicare Part D Language Access Coalition. “It is very important to spread the word about this new development, especially to low-income communities, including limited- English proficient communities. This change is likely to assist thousands of individuals across the country.”

“This change will help many in our community get access to the drugs they need,” says Caroline Lee, Health Access Advocacy Director of the Korean Resource Center in Los Angeles. “Last week, a couple came in because they could not afford to buy a newly prescribed heart medication that was not covered by their Part D plan. Because of the enrollment right expansion, they were able to change to a plan that will save them over $300 a month. Getting accurate information about Part D has been even more difficult for limited-English proficient clients than for English speakers. We need to spread the word about changes like this one that can help low-income individuals.”

The California Medicare Part D Language Access Coalition is a coalition of advocacy and service providers working to improve access to Medicare Part D for limited-English proficient beneficiaries. Members include the Asian Pacific Islander American Health Forum, the California Pan-Ethnic Health Network, the Center for Health Care Rights, the Korean Resource Center and the National Senior Citizens Law Center. For further information on Medicare Part D or for a copy of the Coalition’s recent report, “Medicare Prescription Drug Plans Fail Limited English Proficient Beneficiaries,” see