Mental Health Part D News Alert

October 2, 2006

Favorable Decisions in 2006

Patients (and physicians or their Representative) should review all letters of approval (Prior Authorizations, favorable Coverage Determinations, favorable Redeterminations, favorable ALJ rulings) received from the Plans in 2006 to determine the date coverage will end. Patients (and physicians or their Representative) should contact the Plan directly to determine whether they must file anew in order to continue receiving their currently approved drugs during the new plan year beginning January 1, 2007.

We recommend that you also review the Plan’s 2007 formulary for changes in covered medications as well as for any changes in Utilization Management (UM) requirements (Prior Authorization, Step Therapy, Quantity Limits). Patients have the option of choosing a new Plan during the 2006 annual election period (11/15-12/31), although CMS recommends enrollment be completed by 8 December to limit problems at the pharmacy in January.

For a general comparison of Plans, go to the Plan Comparison feature on the Medicare Prescription Drug Plan Finder (www.medicare.gov) and follow the steps. The tool provides general information on monthly premiums, monthly cost for medications and general UM measures. Before making a final decision always call the Plans to confirm information on this site.