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WASHINGTON, DC – One of the problems that Nebraskans continue to bring to me in my travels through the state is that the new Medicare Part D prescription drug plan is causing them a lot of confusion. The plan is going to be a great benefit to help seniors pay for expensive prescriptions once it is in place, but getting there has proven to be difficult.
One of the sources of the confusion is the apparent ability of some of the plans to change the list of drugs they cover. This presents a problem for seniors who are currently taking specific medication. There is no guarantee that the specific drug they are taking will continue to be covered by the plan they choose. Drug plans can decide to switch drugs at any time as long as the new drug offered is equivalent.
In an effort to give peace of mind to seniors who have already enrolled in a prescription drug plan through Medicare, I am co-sponsoring legislation that would require that the drugs covered by a plan on the date of enrollment cannot be removed for that calendar year.
Under this bi-partisan bill, approved Medicare prescription drug plans are prohibited from removing a drug from their list of “covered” drugs or changing the cost structure of such a drug until the beginning of each plan year or from the point a Medicare beneficiary enrolls in their plan until the end of the year in which they enroll with certain exceptions.
In other words: If you sign up for a plan, they can’t change or eliminate coverage of your medication for the calendar year – ensuring some consistency for seniors.
If at the end of the year during the open enrollment period, a prescription drug plan wants to change its formulary, it can do that. The plan must notify its enrollees of the formulary changes and seniors can then decide whether to stick with that plan or switch to a different plan.
This makes good sense because the way it is now, prescription drug plans can change their drug formulary as many times as they want but seniors are prohibited from changing drug plans except during the annual open enrollment period with very few exceptions.
That is akin to bait and switch. After wading through the maze of prescription plans offered in their region and enrolling in a plan, there is presently no guarantee that the drug they need will be covered all year.
My bill assures seniors that the drug plan they enrolled in will cover the drugs it said it would when the senior enrolled in that plan. This is round two in my efforts to protect seniors as they enroll in the RX drug plan. Legislation I announced earlier to extend signup deadlines is still in the works.
Both of these plans address some of the confusion and give seniors peace of mind. They are part of my complete health care agenda which is aimed at lowering costs, increasing access, and improving care for all Nebraskans.
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