More Than 25 Million Medicare Beneficiaries Now Have Prescription Drug Coverage

Wednesday, Feb. 22, 2006, The number of Medicare beneficiaries receiving prescription drug coverage continues to grow with more than 25 million Medicare beneficiaries now covered, well on track toward the goal of 28 to 30 million enrollees in the first year. This number reflects more than 5.3 million beneficiaries who have signed up individually for prescription drug coverage in the last three months, including 1.5 million who signed up in the last 30 days. Most of the new enrollees in stand-alone drug plans chose plans offering other than the “standard” drug benefit. Many beneficiaries chose coverage with low or no deductible, fixed copays for most prescriptions instead of coinsurance, or coverage in the coverage gap or “donut hole.”

More than 500,000 new beneficiaries have enrolled in the Medicare Advantage health plans since drug coverage enrollment began on Nov. 15, 2005 (415,823 since mid-January). Though many Medicare Advantage plans had some drug coverage before 2006, the coverage is now generally much more extensive and does not include caps on coverage that were common before the drug benefit. As with other benefits, drug coverage is often more generous than the basic Medicare drug benefit, and drug premiums are significantly lower. Some Medicare Advantage plans are even offering prescription coverage for no additional premium.

“The promise of the new Medicare law is being realized for more than 25 million Medicare beneficiaries who are getting help paying for the medicines they need,” HHS Secretary Mike Leavitt said. “We are encouraged by the millions of people who are enrolling each month, even as we continue to reach out to those who have not yet signed up but can benefit from the new program.”

Secretary Leavitt noted that those with coverage include not only those new stand-alone prescription drug plans, but also those in Medicare Advantage plans made stronger by the new Medicare law, as well as retirees who are in employer- or union-sponsored plans that are for the first time getting support from Medicare to keep their coverage more secure.

“We’ve seen enrollment continue at a steady pace, faster than what we saw before the late December surge,” said Centers for Medicare & Medicaid Services Administrator (CMS) Mark B. McClellan, M.D., Ph.D. “Any beneficiary who has questions about what the drug coverage means for them can call1-800-MEDICARE anytime with little or no waiting, or go to medicare.gov, or get face-to-face help from one of our many partner organizations and events around the country.”

CMS continues to urge Medicare beneficiaries to sign up for drug coverage early in the month before they want coverage, or at least 2 to 3 weeks before they plan to use their coverage. “Signing up before the 15th makes it more likely that you will get your prescriptions filled quickly the first time you use your coverage,” Dr. McClellan said. “We want everyone to get the most out of their coverage starting the first time they go to the drug store.” The enrollment period continues through May 15, 2006.

The overall drug benefit enrollment figures as of Feb. 13 are:

* Stand-alone Prescription Drug Plans: about 4.9 million (1.3 million since Jan. 13)
* Medicare/Medicaid: 6.2 million (including 560,000 in Medicare Advantage plans).
* Medicare Advantage: 4.7 million plus 560,000 in Medicare/Medicaid.
* Retiree coverage: About 6.4 million retirees are enrolled in the Medicare retiree subsidy. As previously stated, another 1 million retirees are in employer coverage that incorporates or supplements Medicare’s coverage. Another estimated 500,000 retirees are continuing in coverage that is as good as Medicare’s.
* TRICARE/ FEHB retirees: 3.1 million.

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CMS Office of Public Affairs

U.S. Department of Health & Human Services

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