More than half a million dual eligible beneficiaries soon will have to sign up on their own to be included in the Medicare prescription drug benefit next year.

Approximately 632,000 Medicare beneficiaries who were automatically enrolled by the government in the benefit for 2006 will not be automatically re-enrolled for 2007. One reason is because some of those beneficiaries no longer are enrolled in state Medicaid drug plans, according to the Centers for Medicare & Medicaid Services. Dual eligibles are those people eligible for both Medicare and Medicaid coverage. Many reside in nursing facilities.

Affected beneficiaries will have to sign up during the open enrollment period, which begins Nov. 15. CMS sent them a letter telling them they also should apply for a low-income subsidy that allows access to low-premium plans. Some advocates expressed concern that these seniors will not realize their enrollment has lapsed or read letters explaining the new process.