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MedPage Today Runs 5-Part Medicare Part D Drug Plan Series

The groundbreaking and controversial Medicare Part D prescription drug plan that will provide prescription drug coverage for seniors will be available January 1, 2006. The Centers for Medicare & Medicaid Services (CMS) has released the individual plans that will be available in each state. With the November 15th enrollment date fast approaching, MedPage Today has published a 5-part series to educate physicians so they may guide patients in the selection of a plan that will suit their individual needs.

•    Medicare Prescription Drug Organizations Release Marketing Blitz
•    Medicare Stumbles in Efforts to Explain Drug-Coverage Plan
•    Medicare Part D: Who Should Join?
•    Medicare Part D: What Drugs Are Covered?
•    Medicare Part D Drug Coverage: A Little Something for Everyone

Beneficiaries who wait until after May 15, 2006, to enroll will pay more for a drug program.

Medicare Part D: Still “a Lot of ’Splaining to Do”

Fred and Ethel Mertz, of “I Love Lucy” fame, have been resurrected as TV spokespersons to market Medicare’s groundbreaking prescription drug plan for seniors. However, a special report on Medpage Today regarding the Medicare Part D plan chides that these characters are “a good choice because, as Ricky would say, Medicare has ‘a lot of ’splaining to do.’” In a recently distributed handbook, the Centers for Medicare & Medicaid Services (CMS) misstated the enrollment eligibility for the Medicare-approved regional prescription drug plans (PDPs) for low-income seniors—the very group the plan was designed to serve. According to CMS, the correct information is posted on the Medicare website; however, the website is reported to contain other inaccuracies. Medpage Today states, “This single case may be an exception, but critics of the Medicare prescription drug plan say they suspect otherwise.”

Medicare Part D Prescription Drug Plans Announced

Medicare has formally approved the individual prescription drug coverage plans that will be available through the new Medicare Part D Prescription Drug Plan, which is set to begin January 1, 2006. The approvals will allow for prescription drug plans in every state, with between 11 and 20 organizations offering drug coverage in each region. Ten organizations will offer nationwide coverage. There will be at least one prescription drug plan with a monthly premium of less than $20 in all states but Alaska. Five or more prescription plans in each state will provide coverage with no premium for qualified beneficiaries. “Thanks to the range of options available, everyone in Medicare will be able to choose a prescription drug plan that addresses their individual concerns about cost, coverage, and convenience,” said Health and Human Services Secretary Mike Leavitt. The Centers for Medicare & Medicaid Services has published a map listing the prescription drug plans available in each state. Coverage providers may begin marketing their plans on October 1st, in anticipation of the November 15th start of patient enrollment.

Medicare Prescription Drug Coverage: Helping Patients Choose

The enrollment process of Medicare recipients in the new Medicare Part D prescription drug plan, which becomes available January 1, 2006, is expected to place increased demands on healthcare professionals. PENN CME is offering a free online 1-credit continuing medical education (CME) course entitled Medicare Prescription Drug Coverage: Helping Patients Choose. This CME activity is designed for physicians, nurses, pharmacists, and other healthcare workers who will interact with Medicare beneficiaries in order to explain choices and benefits of the prescription plan. Topics will include reviewing the extra help that is available for those with limited income and resources, assisting patients in determining which plans are available in their area, and counseling patients on how to join a Medicare prescription drug program.

New Medicare Drug Coverage Plan to Cost Less

The new Medicare Part D prescription drug program is likely to cost less than originally estimated. Based on favorable results from the competitive bidding process used to select providers, participants’ cost for the plan will be 14% lower, or $5 less than estimated. Medicare members can begin to sign up for the plan in October, and the benefit is to be implemented January 1, 2006. The monthly average cost is expected to be $32.20.  In addition, many Medicare beneficiaries may qualify for help, or have their full premium paid, if they choose plans that cost at or below preset levels based on region. However, some critics claim the new plan is too complicated and will deter seniors from participating. What feedback have you been getting from seniors regarding their choice to participate in the Medicare Part D drug prescription plan?

Toolkit for Healthcare Professionals: Medicare Prescription Drug Coverage

Medicare will begin offering prescription drug benefits to all members starting January 1, 2006. To inform healthcare professionals and their patients about the options and mechanics of the new plan, the Centers for Medicaid & Medicare Services (CMS) has issued The Toolkit for Healthcare Professionals: Medicare Prescription Drug Coverage.

The toolkit provides healthcare professionals a free downloadable resource consisting of:

•    A Call-to-Action letter from CMS administrator Mark   
      McClellan
•    Quick facts and a newsletter article
•    Information about coverage choices
•    Important dates for office staff and patients
•    Reproducible artwork, and brochures for patient education
•    A list of additional educational resources for physicians and
      patients

Practices may add their business logo to distributed materials.