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Medicare Outlines Steps To Help Dual Eligibles Move To Comprehensive Medicare Drug Coverage

Armen Hareyan's picture

Medicare's Prescription Drug Coverage

Medicare's prescription drug coverage is available to everyone in Medicare, regardless of their income or how they get their Medicare. For those with limited incomes, there is extra help that will provide comprehensive coverage for no premium and no deductible.

Medicare beneficiaries who also get Medicaid, the state-federal assistance program for those with low incomes, automatically qualify for this extra help. These "full-benefit dual eligibles" are being automatically and randomly enrolled in a prescription drug plan to make sure that they do not lose a day of prescription coverage.

This week, the Centers for Medicare & Medicaid Services began mailing letters to these 5.5 million Medicare beneficiaries. The letters let the beneficiary know which Medicare prescription drug plan they will be enrolled in if they take no action prior to January 1.

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These letters are being mailed first class, so all "undeliverables" will be returned to CMS. CMS will follow up on each undeliverable notice in order to send to the correct address.

The letters are just one in a series of actions CMS is taking to make sure people who get Medicare and Medicaid are aware of the coming changes in their prescription drug coverage. Direct mail is one component:

  • In May, full-benefit dual eligibles received a letter from CMS informing them that they automatically qualify for the low-income subsidy and do not need to apply.

  • In October, all Medicare beneficiaries received the "Medicare & You" 2006 handbook.

  • Also, Medicare prescription drug plans will mail enrollment materials to the full-benefit dual eligible beneficiaries assigned to their plan. Those materials include a list of covered drugs and the pharmacy network.

Also, if a full-benefit dual eligible beneficiary goes to a pharmacy after January 1 unaware that prescription drug coverage is now through Medicare, the pharmacist can determine the beneficiary's enrollment information by submitting an on-line query through its billing system.