NACHC Responds to Medicaid Editorial

On June 18, 2005, NACHC Communications responded to an editorial in the Sunday Washington Post, entitled “Medicaid Explosion” in a letter to the editor. The letter contains some talking points and new information that may be useful in creating editorial materials around the Medicaid debate. Click on link to read the editorial: Click Here.

Medicaid Explosion Letter

CMS (Center for Medicaid/Medicare Services) Provides Script for People with Medicare to Avoid Phone Scams. Help Keep Your Patients Safe.

Q. I understand that SSA may call me if they need more information to process the Application for Extra Help with Medicare Prescription Drug Costs. How will I know if a call is from SSA and not part of a scam?

A: SSA may call you if some questions on the application weren’t answered or if they can’t read the answer. They may also call you to check any differences between your answers on the application and information they receive from other Federal agencies about your income or resources. When SSA calls you for more information, they should never ask you for bank account numbers, credit card numbers, or life insurance policy numbers. The only time SSA will ask for your Social Security Number is if the number on the application isn’t valid, and they need the correct number. If you get a suspicious call from someone claiming to be from SSA, hang up and call SSA at 1-800-772-1213 to find out if the call was real.

Medicare Prescription Drug Coverage Outreach Toolkit

The partnership web site portal on cms.hhs.gov has been updated to include the Medicare Prescription Drug Coverage Outreach Toolkit. The toolkit is designed to equip community-level organizations with the materials needed to provide clear, accurate information and assistance to their clients on the Medicare prescription drug coverage. The toolkit is developed with basic, straightforward information that can be easily conveyed to beneficiaries. You can access it at: http://www.cms.hhs.gov/partnerships/tools/materials/medicaretraining/MPDCoutreachkit.asp

Medicare Prescription Drug Benefit (Medicare Part D) Fact Sheet

for Dual-Eligibles (As of June 13, 2005). This information was compiled and provided by the New Jersey Department of Human Services Division of Medical Assistance and Health Services.

Who qualifies for Medicare Prescription Drug Benefit (Part D)?

All people eligible for Medicare are eligible for the Part D Drug Benefit, including people who are enrolled in the Medicare Part A and Part B programs.

Medicare is a federal health insurance program for people over the age of 65 and people who are disabled. Medicaid is a state health insurance program for people of all ages who are poor or disabled.

In New Jersey, there are approximately 140,000 people who are eligible for both Medicaid and Medicare. These individuals are referred to as “dual-eligibles.”

These 140,000 dual-eligibles include people with disabilities and people receiving health care services in nursing homes, home- and community-based care waiver programs and in developmental centers and psychiatric hospitals.

When will the Medicare Prescription Drug Benefit start?

The Medicare Prescription Drug Benefit starts on January 1, 2006.

Why do I have to change programs?

The federal law does not allow Medicaid to provide prescription drugs that Medicare will start to offer in January 2006. In order for you to continue to receive prescription drugs, you must take advantage of the new Part D program.

What do I have to do to enroll in the Medicare Drug Benefit?

Nothing. The federal Medicare program will automatically enroll dual-eligibles into a Medicare prescription drug plan this coming fall.

Will all my drugs be covered by Medicare?

Unfortunately, this is not an easy answer. Medicare will automatically enroll dual-eligibles into a Medicare prescription drug plan, but you may switch plans based on what best meets your needs. No matter what plan you are assigned to or you select you should consult with your physician and pharmacist so you get the prescriptions that are medically necessary.

What else should I know about the Medicare Drug Benefit?

Starting January 2006, you will need to pay the pharmacist a co-pay for each prescription you pick up. Depending on your income, the co-pays will range between $1-2 for a generic drug and $3-5 for a brand name drug.

How can I learn more?

You should pay attention to what you receive in the mail. The New Jersey Department of Human Services and the federal Medicare program will be sending important information this summer and fall including a “Medicare & You” 2006 handbook. If you have internet access you can find more information about the program. Here are some useful websites:

www.medicare.gov www.familiesusa.org www.kff.org

Who do I call if I have a problem with the Medicare Drug Benefit?

You should call the Medicare hotline toll free at 1-800-MEDICARE (1-800-633-4227) or the State of New Jersey Medicaid toll free number at 1-800-356-1531.