Caregiver
alert: Medicare Drug Plan may mean unexpected changes
Medicare/Medicaid
beneficiaries must switch to new drug plans
On January 1st, seniors and some younger
people with severe disabilities who receive their benefits from both
Medicaid and Medicare, also known as “dual-eligibles,” will be required to
drop their Medicaid drug coverage and switch to the new Medicare Part D Drug
Plan. This change is mandatory and could lead to disruption in
treatment if people aren't aware that the changes are coming. Families,
caregivers, health professionals and beneficiaries affected by the change
are being urged to be on the alert for mailings from Medicaid and Medicare
advising of the changes and take the time to thoroughly review each of the
plans, ask questions and call Medicare/Medicaid hotlines if more information
is needed.
Kate Hale of the South Florida Mental Health
Association is working hard to help get the word out through organizations
such as NANAY. “We're concerned that many
people who have been getting their medications through Medicaid won’t
realize this change applies to them and may ignore or toss out the
information,” says Hale. “Continuity of care is critical for this
population. Many have severe and chronic medical conditions like bipolar
disorder or schizophrenia that require specific medications or combinations
of medications. That's why families and caregivers need to get involved.”
All drug plans are
not equal
Because many of the people covered by the new Medicare
benefit have chronic illnesses or complex medical conditions that require
strict drug regimens, selecting the right plan is critical. So it's
particularly important that beneficiaries and caregivers carefully review
and compare plans. From November 15th through December 31st,
beneficiaries will be able to choose a plan tailored to their specific
needs. If they don’t choose a plan,
Medicare will automatically enroll dual eligibles into a drug plan. The
plans will be randomly chosen and may not include all the necessary
medications. That could lead to treatment delays or compromise care.
Be prepared for
additional costs
Another important change: Those who have been
receiving their medications from Medicaid at no cost may be required to pay
minimal co-pays when they make the change to Medicare. For those who
are taking multiple medications, that can be a hardship. That's why it's so
important that beneficiaries and caregivers read the information carefully
and take steps to get questions answered before the January 1 deadline. In
some cases, additional subsidies may be available if co-pay levels can't be
met.
Plan ahead to ensure continuity of care
Adjusting to a new way of doing things is never easy.
Taking the time to plan now will help avoid problems or delays in getting
necessary medications when the new drug program begins on January 1.
But don't worry about making a mistake in selecting a plan. Medicare
recognizes the complex medical needs of the dual eligible population and
will allow them to change plans anytime.
“A huge change like this
is bound to cause confusion,” says Hale. “However, as long as senior and
disabled beneficiaries, as well as their doctors and caregivers, are aware
of the upcoming changes and have enough information to navigate through
them, preparations can be made to weather the transition.”
For more information about the new Medicare
prescription drug benefit, individuals may visit
www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227) or contact
Florida Medicaid toll free at: 1-866-465-2640.
Quick Tips
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Watch for mailings from Medicare and Medicaid
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Review and compare plans carefully
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Make sure your medications are covered before choosing a plan
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Don't rely on automatic enrollment. It's random and doesn't
consider individual needs
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Call the Medicare hotline if you have questions
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Make your selection before Jan. 1 to ensure your medication
regimen won't be interrupted
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Don't worry, if needs change, dual eligibles can switch plans
at any time
Open enrollment
is Nov 15-Dec. 31
