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Health Care Reform:

Health Insurance & Affordable Care Act

Enrollment Opens for Medicare Rx Plans

Premiums for Many Plans Expected to Rise

Medicare's 'Doughnut Hole' continued...

Judith Stein, executive director of the Center for Medicare Advocacy, says fewer plans in 2007 will offer generics and branded drugs through the doughnut hole. That could affect seniors who take drugs for Alzheimer's disease, cancer, and some heart conditions because many available drugs are relatively new and sold only in brand form.

She warned that seniors should eye potential plan changes carefully before choosing to stay with a plan.

"What we're finding is that indeed some of the plans are quite different," she says. "You need to look at a lot of things beyond the premium and make sure that if you've benefited from brand- name drugs being covered in 2006 that you don't just assume that will be covered in 2007."

Some insurance companies came under criticism this week for marketing materials and plan names that advocacy groups called misleading. One complaint centered on plans using the word "complete" in their name while offering partial coverage for prescription costs.

"Just because a plan calls itself complete, doesn't mean it's actually complete, Stein says. "Don't be taken by the words. Look. Is there coverage for your drug? Is there coverage during the doughnut hole?" she says.

Seniors don't need to take any action if they wish to stay with their current plan, Norwalk says. Enrolling in a new plan for 2007 automatically terminates a 2006 plan.

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