Part D & Your Patients

What is Medicare Part D and which of my patients does it affect?

Enrollment & Eligibility

How and when can people with Medicare enroll? What are the special enrollment concerns for people with both Medicare and Medicaid?

Low-Income Subsidies

What kind of subsidies will be available nationally and locally to help low-income individuals pay for the new Medicare prescription drug benefit?  How can patients apply?

Patient Costs

What are patients’ responsibilities for premiums, deductibles, and co-payments?

Prescription Drug Plan Formularies

Which medications will be covered?

Utilization Management

What are the protocols prescription drug plans will employ to manage access to specific drugs?

Coverage Determinations, Exceptions, & Appeals

What can you do if a prescription drug isn’t on the formulary, is subject to prior authorization, or is subject to higher co-payments?

Transition & Continuity of Care

What should be done now to help the transition go smoothly? How will people with both Medicare and Medicaid switch from their current prescription drug coverage to the new benefit? 

Long-Term Care Facilities

How does the new benefit affect residents of long-term care facilities which include nursing homes?

State Medicaid Drug Coverage Policy

How will each state Medicaid agency handle the transition of patients from Medicaid to Medicare?

Current as of 11-17-2005