Medicare Part D News from HRSA
Medicare's new prescription drug coverage starts January 1, 2006. The Centers for Medicare and Medicaid Services (CMS) has launched a campaign to notify the public about eligibility and enrollment in this new benefit. HRSA/HAB is a partner in the outreach effort and will develop resources and materials focused on the CARE Act community and people living with HIV/AIDS.
Called Part D, the new Medicare drug benefit will change the way many clients access HIV medications and will affect the services and operation of CARE Act programs in different ways. While enrollment in the new benefit is voluntary for most Medicare beneficiaries, the 50,000 to 60,000 PLWH who are covered under both Medicaid and Medicare (known as dual eligibles) will be automatically enrolled in Medicare Part D to ensure continuity of drug coverage. Medication coverage for these individuals will be switched from Medicaid to Medicare on January 1, 2006. Additionally, many PLWH on Medicare will qualify for low-income subsidies to help pay for the Medicare benefit, and these individuals will look to CARE Act programs for guidance on how to do this. Others will look to trusted providers for advice on whether to elect this new benefit and to case managers for help in choosing a plan or managing the costs of Medicare Part D.
Medicare Part D will be implemented in stages during 2005, so knowing the following implementation timeframe will help grantees in helping their Medicare-eligible clients.
May-June 2005 - CMS mails notices to dual eligibles that, starting January 1, 2006, Medicare will pay for their drugs instead of Medicaid. Applications for low-income subsidies will be accepted by Medicaid State Agencies and the Social Security Administration (SSA).
Summer 2005 - SSA mails applications to Medicare beneficiaries who may be eligible for low-income subsidies but who don't automatically qualify.
October 2005 - The "Medicare and You" handbook and the CMS web site "Medicare Compare" will tell Medicare beneficiaries about the drug plans available in their area and how to get help in choosing a drug plan. CMS notifies dual eligibles of the drug plan Medicare will enroll them in if they do not choose a different plan by December 31, 2005.
November 15, 2005 - Medicare beneficiaries may begin enrolling in Medicare Part D and choose a drug plan.
January 1, 2006 - All dual eligibles are switched to Medicare drug coverage.
May 2006 - CMS notifies others qualifying for a low-income subsidy that they will be assisted in enrolling in a plan by May 15, 2006
May 15, 2006 - Enrollment period for Medicare Part D complete
Please contact your case manager and/or local AAA agency (SCHIP) for additional information and the Centers for Medicare and Medicaid Services at www.cms.hhs.gov.