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News Release

FOR IMMEDIATE RELEASE
Wednesday, June 14, 2006

Contact: HHS Press Office
(202) 690-6343

Over 38 Million People With Medicare Now Receiving Prescription Drug Coverage

HHS Secretary Mike Leavitt today announced that 38.2 million people with Medicare are now receiving comprehensive prescription drug coverage, in many cases even better coverage than they ever had before. A surge in enrollment took place in the closing weeks of the enrollment period, with more than 2 million beneficiaries signing up between May 1 and the May 15th deadline.

“Introduction of the Medicare prescription drug benefit created an unprecedented opportunity and a breathtaking challenge,” Secretary Leavitt said. “The challenge has been met, and today, for over 38 million Americans -- 90 percent of people with Medicare -- the promise is being fulfilled, day in and day out, prescription by prescription. In fact, more than 3.5 million Part D prescriptions are being filled each day and the cost of monthly plan premiums is nearly 40 percent lower than original estimates.”

The average premium in 2006 for beneficiaries, not counting retiree coverage, is less than $24. In addition, 87 percent of beneficiaries chose plans other than the standard benefit, according to the Centers for Medicare & Medicaid Services (CMS).

“With help from thousands of partners across the country, and personalized assistance from 1-800-MEDICARE and www.medicare.gov, people with Medicare and their family members were able to get the drug coverage they prefer at a far lower cost than expected,” said CMS Administrator Mark B. McClellan, M.D., Ph.D. “Thanks to Medicare beneficiaries making informed choices to meet their needs, the costs of Medicare drug coverage are way down -- and we will continue to support effective competition to provide high-quality, low-cost coverage.”

Total enrollment in Medicare Advantage plans increased by over 26 percent (1,249,041 self enrollees) during the six month enrollment period, bringing the total number of beneficiaries enrolled in Medicare Advantage plans to 7.4 million. Included in that total are about 4.8 million who chose to enroll in these plans before January, 2006.

About 87 percent of all beneficiaries who enrolled in a prescription drug plan chose a plan that offers coverage other than the standard benefit, such as no deductibles or coverage in the “donut hole.” Most beneficiaries enrolled in Medicare Advantage plans are also getting more comprehensive drug coverage than in the standard plan. In addition, almost 10 million low-income beneficiaries are getting comprehensive drug coverage for little or no cost.

Among the 38.2 million beneficiaries who are now receiving prescription drug coverage, approximately 32.8 million have coverage from Medicare and 5.4 million have coverage from other sources, including the Department of Veterans Affairs (VA), primary coverage from an employer (from beneficiaries who are working after age 65), and state prescription drug programs that are not yet combined with Medicare Part D. Based on the latest information on the choices of veterans with VA benefits and Medicare coverage, almost 40 percent are enrolled in Medicare Part D, a much larger number of VA beneficiaries than previously expected.

Enrollment for the new Medicare prescription drug coverage began on November 15, 2005 and ended on May 15, 2006.

Overall prescription drug coverage enrollment figures as of June 11 are:

  • Stand-Alone Prescription Drug Plans (PDPs): 10.4 million people with Medicare have enrolled in stand-alone prescription drug plans, including 2.2 million enrollees receiving the low income subsidy (LIS).
  • Medicare Advantage with Prescription Drugs (MA-PDs): 6 million beneficiaries receive coverage through Medicare Advantage plans with drug coverage (MA-PDs), including 1.2 million new enrollees. Medicare Advantage includes 925,000 enrollees receiving the LIS. About 478,000 of these are full Medicare/Medicaid beneficiaries. About 1.1 million beneficiaries are currently enrolled in MA-only plans; many of these beneficiaries in private fee-for-service plans are receiving Part D through a separate PDP and therefore included in the enrollment totals for PDPs.
  • Medicare/Medicaid: 6.1 million Medicare/Medicaid beneficiaries were automatically enrolled in prescription drug plans. An additional 478,000 Medicare/Medicaid beneficiaries enrolled in Medicare Advantage plans with prescription drug coverage and are counted in the MA-PD total above.
  • Retiree Coverage: 6.9 million retirees are enrolled in the Medicare retiree subsidy. In addition, about 1.5 million retirees are in employer and union-sponsored coverage that incorporates Medicare group drug coverage and about 400,000 retirees are in employer and union-sponsored coverage that wraps around Medicare drug coverage -- these beneficiaries are counted in the PDP and MA-PD totals above.
  • Federal retiree coverage: 3.5 million
    • TRICARE: Estimated 1.9 million beneficiaries with TRICARE retiree coverage, based on data that was provided by the Department of Defense (DoD). This number excludes nearly 7 percent who were found to be enrolled in Part D plans based on a person-level data match.
    • FEHB: Estimated 1.6 million beneficiaries with FEHB retiree coverage, includes both retirees and spouses, and excludes 2 percent who might be enrolled in Part D plans (based on information from OPM).
  • Additional Sources of Prescription Drug Coverage for Medicare Beneficiaries: HHS estimates that approximately 5.4 million Medicare beneficiaries have alternative sources of “creditable” prescription drug coverage:
    • VA: There are an estimated 2 million beneficiaries with creditable drug coverage through the VA who have not signed up for Part D. About 1 million VA beneficiaries enrolled in a Part D plan, and about 400,000 are receiving drug coverage from an employer receiving the Part D subsidy. These numbers are based on a sample person-level match provided by the VA.
    • Indian Health Service (IHS): There remains 0.1 million beneficiaries with creditable drug coverage through the IHS being served by I/T/U pharmacies in 28 states.
    • Active Workers with Medicare Secondary Payer: Nearly 2.6 million beneficiaries receive creditable drug coverage through an employer group health plan based on a person level match of our coordination of benefits files and Part D enrollment files.
    • Other Retiree Coverage: An estimated 0.1 million retirees are continuing in retiree coverage who are not already included in the other retiree coverage categories. Some of these retiree plans may apply for the Medicare retiree subsidy in their next full plan year, while others may have only a limited number of eligible retirees so that the financial impact of the RDS is small.
    • State Pharmaceutical Assistance Programs (SPAP): An estimated 0.59 million beneficiaries are continuing to receive creditable coverage through SPAPs. The estimate is based on information from four SPAP programs that have creditable coverage and are currently not requiring enrollment in Part D plans in order to retain SPAP coverage (NJ, NY, PA, and WI), and a person level match of SPAP files with Part D enrollment files.

Of the approximately 4.4 million Medicare beneficiaries who do not have secure, quality drug coverage, approximately 3.2 million are estimated to be eligible for the extra help. As President Bush announced, enrollment for these beneficiaries with limited incomes will continue throughout the year, with no late enrollment penalty.

HHS and CMS are continuing to work closely with the thousands of local organizations, whose efforts helped to inform and enroll the millions of Medicare beneficiaries across the country who enrolled in a prescription drug plan before the deadline, to reach these remaining beneficiaries. New outreach efforts include:

  • Collaboration with several intergovernmental partners including SSA; HUD; USDA; AoA; HRSA; and ACF to raise awareness and coordinate outreach events.
  • Enhanced outreach with many external partner organizations. For example, CMS is collaborating with minority groups including the NAACP to target federal outreach grants to the areas with greatest number of LIS eligibles.
  • New targeted outreach activities, including collaborations with NCOA to inform partners of best practices regarding data driven outreach methods.

“People with Medicare are already seeing significant savings through the new drug coverage, and beneficiaries with limited incomes have even more to save,” said Dr. McClellan. “It’s imperative that we reach as many of them to make sure that they are able to get the drugs they need.”

Total Medicare Beneficiaries with Drug Coverage
As of 6-11-06

Description

June
(millions)

Drug Coverage from Medicare or Former Employer

 

     Stand-Alone Prescription Drug Plan (PDP)

10.37

     Medicare Advantage with Prescription Drugs (MA-PD)

6.04

     Medicare- Medicaid (Automatically Enrolled)

6.07

     Medicare Retiree Drug Subsidy (RDS)

6.90

     FEHB Retiree Coverage

1.60

     TRICARE REtiree Coverage

1.86

TOTAL

32.84

Additional Sources of Credible Drug Coverage

 

     Veteran's Administration (VA) Coverage

2.01

     Indian Health Service Coverage

0.11

     Active Workers with Medicare Secondary Payer

2.57

     Other Retiree Coverage, Not Enrolled in RDS

0.10

     State Pharmaceutical Assistance Programs

0.59

TOTAL

5.38



LIS - Eligible Medicare Beneficiaries with Drug Coverage
As of 6-11-06

Description

Total LIS-Eligible Beneficiaries
(millions)

Total Beneficiareies Elibible for Low-Income Subsidy (1)

&13.20

Less: Drug Coverage from Medicare or Former Employer (2)

9.26

     SSA LIS Approved

1.80

     Other Deemed Full/Partial Duals and SSI Recipients

7.50

Less: Additional Sources of Creditable Drug Coverage (3)

0.59

     Veterans Affairs (VA) Coverage

0.35

     Indian Health Service Coverage

0.11

     SPAP Wraparound Coverage

0.13

Less: Anticipated Facilitated Enrollments (4)

0.10

TOTAL Remaining LIS-Eligible Beneficiaries

3.25

1/ CMS estimate based on analysis of updated SIPP and CPS survey data.
2/ CMS Management Information Intergrated Repository (MIIR), June 11, 2006
3/ CMS estimate of benficiaries recieving coverage from other sources, June 2006.
4/ LIS-approved beneficiaries expected to be included in the next round facilitated enrollments. CMS Management Information Intergrated Repository (MIIR), June 11, 2006.



State Enrollment in Medicare Prescription Drug Plans Nov. 15, 2005 - June 11, 2006
As of 6/11/2006

State

Stand-Alone Prescription Drug Plan*

Medicare Advantage with Prescription Drugs**

Medicare-Medicaid (Automatically Enrolled)

Medicare Retiree Drug Subsidy

Estimated Federal Retirees (Tricare, FEHBP)

Total

Alabama

229,367

83,005

96,550

117,448

93,930

620,300

Alaska

8,841

107

11,739

11,647

8,548

40,882

Arizona

137,246

254,527

61,809

106,791

85,643

646,016

Arkansas

180,410

16,332

70,790

52,712

45,916

366,160

California

570,138

1,292,709

924,354

433,835

332,533

3,553,569

Colorado

104,383

139,929

46,312

77,264

68,078

436,966

Connecticut

157,624

34,406

69,728

113,279

21,537

396,574

Delaware

46.656

728

10,912

32,732

11,799

102,827

District Of Columbia

10,673

5,096

15,896

3,831

22,658

58,154

Florida

636,995

646,904

364,944

472,155

296,837

2,417,835

Georgia

373,932

50,377

155,670

130,904

119,295

830,178

Hawaii

11,270

52,961

24,554

32,563

34,271

155,619

Idaho

63,889

18,325

20,301

20,817

19,904

143,236

Illinois

544,836

81,699

261,519

345,332

71,564

1,340,950

Indiana

311,871

21,236

104,820

200,363

44,243

682,533

Iowa

223,916

21,281

59,349

44,910

25,731

375,187

Kansas

160,578

19,296

42,620

33,612

36,370

292,476

Kentucky

228,317

35,556

93,560

127,581

44,543

529,557

Louisiana

153,881

74,732

106,087

92,887

44,752

472,339

Maine

77,330

1,140

47,558

34,536

21,947

182,511

Maryland

183,796

32,256

62,047

143,120

129,057

550,276

Massachusetts

174,492

140,546

192,429

195,022

55,256

757,745

Michigan

376,773

60,372

203,052

463,907

48,070

1,152,174

Minnesota

239,868

125,059

68,436

78,563

35,450

547,376

Mississippi

139,818

9,041

132,331

30,668

44,043

335,901

Missouri

251,885

123,467

150,456

120,157

70,774

716,709

Montana

56,818

6,992

16,376

14,923

15,151

110,260

Nebraska

114,887

13,679

33,243

25,146

21,085

208,040

Nevada

54,000

86,444

19,892

41,853

35,251

237,440

New Hampshire

54,018

1,528

20,847

35,596

17,774

129,763

New Jersey

363,033

80,008

142,000

280,451

63,908

929,400

New Mexico

58,106

51,084

36,211

39,115

35,933

220,449

New York

354,129

443,969

531,820

548,876

97,869

1,976,663

North Carolina

376,774

109,565

230,050

220,583

111,581

1,048,553

North Dakota

56,884

2,528

11,708

5,145

7,473

83,538

Ohio

363,918

242,273

189,805

521,368

86,704

1,403,438

Oklahoma

175,786

45,888

78,846

53,606

68,722

422,848

Oregon

144,307

126,858

43,811

46,966

45,988

407,940

Pennsylvania

350,842

515,124

162,816

325,920

121,181

1,475,883

Rhode Island

29,007

54,202

27,152

12,844

13,592

136,797

South Carolina

176,090

29,723

120,440

112,774

77,337

516,364

South Dakota

64,675

2,218

13,128

6,575

11,933

98,529

Tennessee

225,027

104,489

222,731

122,031

72,746

747,024

Texas

750,184

263,047

341,490

436,031

275,752

2,066,504

Utah

70,353

25,219

22,399

32,815

36,265

187,051

Vermont

33,659

124

16,615

17,446

6,394

74,238

Virginia

306,631

46,676

115,196

120,962

191,947

781,412

Washington

218,751

84,747

103,607

110,775

104,841

622,721

West Virginia

111,062

13,706

46,932

88.014

20,699

280,413

Wisconsin

182,128

67,282

112,648

143,489

35,092

540,639

Wyoming

29,560

1,515

6,217

8,035

7,438

52,765

Puerto Rico

42,238

277,518

1,928

11,788

11,650

345,122

Virgin Islands

3,493

68

24

3,092

238

6,915

Other^

3,997

2,082

1,183

0

32,271

39,533

Total

10,368,912

6,039,643

6,066,938

6,902,855

3,549,944

32,838,292

*Stand-Alone PDP includes 2.2 million enrollees recieving the limited income susidy.
**Medicare Advantage includes 925,000 enrollees recieving the limited income susidy. About 478,000 of these are full.
^Other includes other territories and beneficiaries whose address information is being updated.

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Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.

Last revised: January 12, 2009