January 1, 2006 marked the turning of a new page in Medicare history with the implementation of broad enrollment to Medicare Part D. While some have called it the most significant change to the program since its inception, we all know by now that it did not come about without noticeable concern for many seniors and eligible beneficiaries. Representing a nationwide medical billing company, I've heard many of our clients - health care providers and practice owners across the US - remark how their patients are turning to them for assistance. Most of these providers maintain an inherent sense of care for their patients (perhaps why they entered medicine in the first place), but are unable to help due to limited resources, plan knowledge or time. Most have enough on their plate just keeping up on the latest medical news, not to mention managing their practice. So, to assist doctors in helping their patients, I thought it might be helpful to research a few of the most frequently asked questions and gather some reputable reference points to convey to patients... Who is eligible for the Medicare Part D prescription drug plan? - Coverage is voluntary and available to ALL people with Medicare. There is a multitude of choices in plan types, levels of coverage and premiums and co-pays for both generic and brand name prescriptions. Additional assistance is also available for limited income Medicare participants.
When can they enroll? - Enrollment for the prescription drug plan began November 15, 2005 and continues until May 15, 2006. If choosing a plan prior to December 31, 2005, coverage is effective on January 1, 2006. For those choosing a plan after December 30, 2005, coverage becomes effective on the first of the month following the enrollment choice. After May 15, 2006 enrollment is still available, but enrollees can expect that premiums will increase.
How can eligible beneficiaries enroll? - Enrollment information is available online at http://www.Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
What are the costs associated with Medicare Part D? - When Medicare beneficiaries join the plan, they will have a monthly premium (averaging around $32, depending on the coverage they choose) and co-pays related to the prescriptions types (i.e. brand name vs. generic). It's important for enrollees to consider the current cost of their prescriptions and weigh out the costs and benefits of the best options.
What factors should enrollees consider when making their decision? - When choosing a plan within the prescription drug coverage, enrollees will benefit by considering the current cost of the prescriptions and the cost under the different plan options, then consider premiums and co-pays and decide which plan might afford the most benefit.
Where can I find other resources for my patients? - Probably the most detailed "official" reference point for providers has been issued by the Centers for Medicare and Medicaid Services (CMS) through the Provider Tool Kit. It includes reproducible patient brochures, quick facts flyers in English and Spanish that can be posted in your waiting room, as well as a letter from CMS Administrator Mark McClellan.
- AARP provides detailed review of the prescription drug plan on its website as well at http://www.aarp.org/health/medicare/drug_coverage/medicarerx_coverage.html that includes a "Watchdog report," Blog and more.
- The Kaiser Family Foundation has created the Resource on the Medicare Prescription Drug Benefit pages, offering articles, general information, plan summaries and research reports.
As noted above, these are just a few of the most frequently asked questions. There are many other resources out available, but these appear to be among the most comprehensive and user friendly from our research. |
