Medicare Health And Prescription Drug Plan Enrollees Expected To Experience Smooth Transition To 2008 - Medicare & Medicaid Services
"A top priority throughout the fall open enrollment season has been to help beneficiaries prepare and compare their plan choices so that they could make informed decisions about switching plans. In addition, we've been working hard to ensure a smooth enrollment process," said CMS Acting Administrator Kerry Weems.
The CMS has taken multiple steps to ensure that pharmacies can obtain accurate enrollment information in 2008, particularly for low-income beneficiaries. CMS has improved procedures for getting accurate plan information into the E1 eligibility system, which is the computer system that pharmacists use to identify current plan enrollment, often for beneficiaries who were reassigned to new plans, or who may not have received their new drug card. The CMS has also implemented better processing requirements for all enrollees, and CMS continues support a point-of-sale facilitated enrollment process that provides immediate coverage for people with Medicare who have Medicaid or have qualified for extra help, but aren't enrolled in a Medicare drug plan.
The CMS also has worked aggressively to ensure a smooth transition for low-income subsidy (LIS) eligible beneficiaries who would be responsible for paying a portion of their plan premium in 2008. Earlier this fall, these beneficiaries received letters explaining steps they could take to remain in their plan by paying a small premium and a list of all the zero premium plans available in their community. Blue reassignment letters were mailed to people who qualify for the full extra help and who will be reassigned to a new plan in 2008. Tan letters were sent to beneficiaries receiving the LIS who selected a plan, but who will be responsible for paying a portion of their plan premium beginning in January 2008 unless they join a new plan. Beneficiaries who received one of these letters can receive personalized assistance at their local State Health Insurance Assistance Program (SHIP) office or their local Social Security office.
While CMS does not expect beneficiaries to encounter difficulties at the pharmacy counter due to the collaborative work among beneficiaries, partners and advocates, pharmacies, and plans, nevertheless, those beneficiaries who have newly enrolled or changed plans should keep these four tips in mind when visiting the pharmacy:
-- Bring your red, white, and blue Medicare card, a photo ID, and your new drug plan membership card - these items will help the pharmacist in verifying your coverage;
-- Bring an enrollment acknowledgement, confirmation letter, or the name of your new drug plan if you have not received a plan membership card - your enrollment search might take longer, but these items will assist the pharmacist in verifying your coverage;
-- Keep copies of your receipts - in the rare instance where the pharmacist cannot confirm enrollment, you can work with your new plan prospectively to obtain reimbursement; and
-- Don't leave the pharmacy counter without your medicine - if you cannot pay out of pocket, call 1-800 MEDICARE for assistance or ask the pharmacist to dial the special hotline for these cases.
In addition, CMS and others have taken the following measures to smooth beneficiaries' transition into 2008:
Online Enrollment and Toll-Free Assistance: Since November 15, 2007, Medicare's online enrollment center has processed more than 347,000 enrollments. In the same period, its Web site has recorded over 36 million page views on http://www.medicare.gov and over 19 million page views of the Medicare Prescription Drug Plan Finder.
Since November 15, 2007, 1-800-MEDICARE has received more than three million calls and more than 3,000 customer service representatives are ready to answer questions about enrollment status. The Medicare ombudsman's office has senior casework analysts available to resolve problems for beneficiaries who need individualized assistance because of a critical health need or financial circumstance.
At the Pharmacy: National and local chains and independent pharmacies have worked closely with beneficiaries to provide information and assistance during the open enrollment period. Thousands of pharmacies have helped beneficiaries through in-store informational days, medication reviews, and community presentations. For example, Rotz Pharmacy, an independent pharmacy in Winchester , Va. , provides a navigation guide to the http://www.medicare.gov Medicare Drug Plan Finder, other comparison tools as well as personalized consultation to beneficiaries who need help in finding a plan that best suits their needs. In-person counseling and other enrollment assistance has been provided nationwide and regionally by many chains, including: CVS; Kroger; Longs Pharmacy; Medicine Shoppe International; Rite-Aid; Target; Stop & Shop, Giant Foods and Giant Food Stores; Walgreens; and Wal-Mart.
In-person: At more than 10,000 events held nationwide, Medicare has worked closely with its partner organizations, including the National Aging Services network of state, local and community service providers, to provide enrollment counseling and sign-up opportunities where people with Medicare live, work, play and pray.
The 2007 CMS Mobile Office Tour visited 128 communities across the nation sharing information about Part D with beneficiaries. That tour highlights the personalized assistance provided by the many thousands of partners across the country who are helping beneficiaries compare their drug plan options and change enrollment if necessary.
Through the Secret Shopper initiative, CMS officials have attended over 220 events to ensure that health plans are adhering to marketing and enrollment guidelines.
Recent surveys show that a large majority of seniors enrolled in the Medicare drug benefit are satisfied with their plan and few intend to change their plan in 2008. A Wall St. Journal /Harris Interactive survey of U.S. adults age 65 or older shows that 87 percent of Medicare drug benefit enrollees are satisfied with their plan. "Our educational efforts are paying off and we will continue to provide information and assistance throughout 2008," said Weems.
The annual open enrollment period for prescription drug coverage began on November 15 and runs through December 31, 2007. For Medicare Advantage plans only, beneficiaries can make one change in enrollment -- enrolling in a new plan, changing plans or canceling a plan -- between January 1 and March 31, 2008. However, beneficiaries cannot join or drop Medicare drug coverage during this time.
Beneficiaries eligible for the LIS have the ability to change plans at any time. They can continue to visit http://www.medicare.gov and view all the health and prescription plans available in their area. Users can compare plans based on costs, coverage, customer service and quality of each plan. They can also receive the same online information by calling 1-800-MEDICARE.
For more information on where to find a SHIP counselor available to provide free one-on-one help with your Medicare questions or problems, visit http://www.medicare.gov/contacts/static/allStateContacts.asp
Medicare Sãnãtate ºi de medicamente Planul Enrollees aºteaptã sã Experienþa tranziþie uºoarã pânã în 2008 - Medicare & Medicaid Services - Medicare Health And Prescription Drug Plan Enrollees Expected To Experience Smooth Transition To 2008 - Medicare & Medicaid Services - articole medicale engleza - startsanatate