Open Enrollment

1
Open Enrollment

• November 2008

2
Fall 2008 Timeline

• Letters, mailings, information blitz, marketing
  started
• 2009 Part D plans and Illinois Cares Rx
  coordinating plans announced
• Plan Finder with 2009 info on www.medicare.gov
• Annual Notice of Change letter by October 31
• Medicare You 2009 sent

3
Annual Enrollment Period

• November 15 may begin enrolling in new plans
• December 31 open enrollment ends
• Sign up by first week in December to be sure
  everything is ready by January 1

4
Time to evaluate all options

• Apply (or re-apply) for all help programs might
  qualify for never too late
• If qualify for LIS, no penalty for joining Part D
  late
• May consider original Medicare with Medigap or
  join a Medicare Advantage (MA) plan
• Special enrollment period for people under 65 to
  join any plan without regard to health condition
  ends Nov 30th
• Be sure your Part D plan works for you

5
To enroll in a Part D Plan

• Contact the plan directly by phone, on-line or
  through a salesperson or
• Call 1-800-Medicare OR
• Contact a local agency for help
• NOTE do not disenroll from your current plan
  when you join the new one, you will be
  automatically switched

6
Prescription drug coverage in Illinois People
with Medicare

• 1,752,800 people with Medicare
• 1,477,000 with known creditable coverage (84)
• 58 in PDPs (853,000)
• 8 in MA-PDs (111,000)
• 23 in employer coverage with retiree subsidy
  (338,000)
• 12 other drug coverage (175,000)
• Includes 337,900 with LIS coverage
• 243,000 full dual eligibles
• 34,000 MSP and SSI
• Only 61,000 (18) applied and approved (not
  deemed)

7
PDP Changes in Illinois
8
Plan enrollment in 2008

• Top 3 companies in PDPs
• United HealthCare 313,100
• AARP 229,600
• UnitedHealthRx 83,500
• Blue Cross Blue Shield of Illinois 173,700
• Humana 92,000
• Dropping LIS plans
• AARP MedicareRx Preferred (207,300 total
  enrolled)
• Blue Medicare Rx Value (115,400 total enrolled)
• Humana PDP Standard (57,300 total enrolled)

9
Gap Coverage

• New categories for generics covered in the gap

10
Continuing eligibility for LIS

• People who automatically qualify for LIS
• CMS re-establishes eligibility each fall for the
  next calendar year
• Got letter from Medicare
• In September on gray paper if no longer qualify
  need to re-apply
• In October on orange paper if continue to
  qualify, but your co-payment has changed

11
Grey letters losing deemed status

• Critical population
• Will no longer be automatically in LIS for 2009
• Have to apply most will still qualify
• 14,700 in Illinois
• 6,000 in Cook and 1800 in Collar Counties

12
Blue letters- Re-assignment

• CMS (Medicare) will re-assign people with LIS to
  different plans.
• 2 groups
• Plan Premium Increase
• Have the full subsidy (100) and are still in the
  plan Medicare originally assigned them to.
• 2009 plan premium above the benchmark.
• If chose a different plan on your own or switched
  plans, will NOT be re-assigned.
• Plans leaving the Medicare Program
• Everyone with LIS enrolled in a plan that wont
  be offered in 2009.
• No matter if assigned, chose or switched plans.

13
Re-assignment

• If the company offers another LIS plan, you will
  be re-assigned to that plan (e.g., AARP Preferred
  switched to AARP Saver)
• If not, randomly assigned to a different LIS plan
• Notice from CMS includes list of 0 premium LIS
  plans
• Recommendation compare options and select a plan

14
Tan Letters to Choosers

• People who qualify for full (100 premium
  subsidy) LIS
• Plan premium going above benchmark in 2009
• Joined a plan on their own originally or switched
  later
• once a chooser, always a chooser
• Will NOT be re-assigned must act on their own
• Notice includes list of 0 premium LIS plans and
  explains options
• Stay in plan and pay the extra premium or join
  another plan

15
Whats your experience?

• How has the marketing been going since the new
  rules took effect October 1?
• How are you finding people who are losing
  coverage? Plans changing?
• How are you helping people compare options, make
  good decisions, apply for programs or new plans?
• Collecting stories?