We are approaching the end of the initial Medicare Part D open enrollment period on May 15. In anticipation of that event, CMS released today Creditable Coverage Guidance and Model Notices entities can use when disclosing creditable coverage status to beneficiaries after May 15, 2006.

On April 20, 2006, HHS announced that 30 million Medicare beneficiaries now have prescription drug coverage. 8.1 million voluntarily have enrolled in Medicare Part D prescription drug plan; 5.8 million voluntarily enrolled in a Medicare Part C (Advantage) plan offering a drug benefit, and 5.8 million with dual Medicare/Medicaid eligibility were enrolled automatically in Part D plans. 6.8 million are enrolled in employer sponsored plans receiving the Medicare Part D subsidy, 1.9 million are enrolled in TRICARE for Life, and 1.6 million are enrolled in the FEHB Program.

At the OPM Carrier conference held on April 6, Abby Block, the director of CMS’s Center for Beneficiary Choices, informed the attendees about the following breakdown of Medicare beneficiaries who voluntarily enrolled in Medicare Part D plans:

16% of standalone Rx plan and 5% of Medicare Advantage with Rx plan beneficiaries are enrolled for defined standard coverage (e.g, the $250 deductible, 25% coinsurance, the so-called donut hole, etc.)

46% of standalone Rx plan and 18% of Medicare Advantage with Rx plan beneficiaries are enrolled for basic alternative coverage (actuarially equivalent to standard coverage but offers reduced deductible or first dollar coverage.)

26% of standalone Rx plan and 76% of Medicare Advantage with Rx plan beneficiaries are enrolled for enhanced alternative coverage (higher premium but improved coverage, e.g. reduced donut hole).

12% of standalone Rx plan and 4% of Medicare Advantage with Rx plan beneficiaries are enrolled for actuarially equivalent coverage (tiered coinsurance levels based on the formulary).