Author: Minnesota Senior Federation. Metropolitan RegionPublisher:
ISBN:
Category : Home care services
Languages : en
Pages : 63
Book Description
2006 Medicare Prescription Drug Plan Preview
Author: Minnesota Senior Federation. Metropolitan RegionPublisher:
ISBN:
Category : Home care services
Languages : en
Pages : 63
Book Description
Medicare Part D Prescription Drug Benefit
Author: Jennifer O'SullivanPublisher: Novinka Books
ISBN: 9781604566222
Category : Medical
Languages : en
Pages : 0
Book Description
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 established a new voluntary prescription drug benefit under a new Medicare Part D, effective January 1, 2006. Prescription drug coverage is provided through private prescription drug plans (PDPs) or Medicare Advantage prescription drug (MA-PD) plans. Beneficiaries must enrol in one of these private plans in order to obtain their drug benefits. The program relies on these private plans to provide coverage and to bear some of the financial risk for drug costs; federal subsidies covering the bulk of the risk are provided to encourage participation. At a minimum, plans offer "standard coverage" or alternative coverage with actuarially equivalent benefits. They may also offer enhanced benefits. All plans are required to meet certain minimum requirements, including those related to beneficiary protections. However, there are significant differences among plans in terms of benefit design, drugs included on plan formularies (i.e., list of covered drugs), cost-sharing applicable for particular drugs, and monthly premiums. In general, beneficiaries can enrol in a plan, or change plan enrolment, when they first become eligible for Medicare or during the annual open enrolment period. The open enrolment period for 2008 is from November 15, 2007, to December 31, 2007. Plans can change from year to year. Beneficiary needs may also change. Therefore, beneficiaries should review their plan choice annually to make sure that their chosen plan continues to meet their needs.
Analysis of Medicare Prescription Drug Plans in 2011 and Key Trends Since 2006
Author: Publisher:
ISBN:
Category :
Languages : en
Pages : 20
Book Description
Since 2006, Medicare beneficiaries have had access to prescription drug coverage offered by private plans, either stand-alone prescription drug plans (PDPs) or Medicare Advantage prescription drug plans (MA-PD plans). These Medicare drug plans (also referred to as Part D plans) receive payments from the government to provide Medicare-subsidized drug coverage to beneficiaries enrolled in a Part D plan. Part D plans are required to offer a defined standard benefit or one that is equal in value. They may also offer an enhanced benefit. Medicare drug plans must meet defined requirements, but may vary in terms of premiums, benefit design, gap coverage, formularies, and utilization management rules. Currently, more than 29 million Medicare beneficiaries are enrolled in Medicare drug plans, including 18.6 million in PDPs and 10.7 million in MA-PD plans. More than 10 million enrollees are receiving extra help through the Part D Low-Income Subsidy (LIS) program to pay their drug plan premiums and cost sharing. Part D has evolved since its inception in 2006 due to changes in the private plan marketplace and the regulations that govern the program. The Patient Protection and Affordable Care Act of 2010 (ACA) is bringing significant improvements to the program over the next decade, primarily phasing out the coverage gap, or "doughnut hole," in the drug benefit. In 2012, the law provided a $250 rebate to 3.8 million Part D enrollees who reached the coverage gap. Starting in 2011, pharmaceutical manufacturers are giving a 50 percent discount on the price of brand-name drugs in the gap. The law also further reduces cost sharing for drugs in the gap, beginning in 2011 for generics and 2013 for brands, until it reaches the standard 25 percent level in 2020, thus eliminating the coverage gap. In addition, the Centers for Medicare & Medicaid Services (CMS) is implementing other statutory and regulatory changes that have resulted in some consolidation of Part D plan offerings in 2011. This report presents findings from an analysis of the Medicare Part D marketplace in 2011 and changes in drug coverage and costs since 2006. It presents key findings related to Medicare drug plan premiums, the subsidy for low-income beneficiaries, the coverage gap, benefit design and cost sharing, formularies, and utilization management, based on data from CMS for all plans participating in Part D.
Medicare
Author: Leslie G. Aronovitz (au)Publisher: DIANE Publishing
ISBN: 9781422306734
Category : Business & Economics
Languages : en
Pages : 88
Book Description
On Jan. 1, 2006, Medicare began providing coverage for outpatient prescription drugs through its new Part D benefit. Beneficiaries who enroll in Part D may choose a drug plan from those offered by private plan sponsors under contract to the Centers for Medicare & Medicaid Serv. (CMS), which administers the Part D benefit. Beneficiaries have until May 15, 2006, to enroll in the Part D benefit & select a plan without the risk of penalties. This report reviews the quality of CMS's commun. on the Part D benefit. This report: examined 70 CMS publications to select 6 documents to review & evaluate the clarity of these texts; made 500 calls to the 1-800-MEDICARE help line; & evaluated the usability of the Medicare Web site. Illus.
Medicare Part D Prescription Drug Benefit
Author: Elena MarshallPublisher:
ISBN: 9781634825252
Category : Electronic books
Languages : en
Pages : 130
Book Description
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 established a voluntary, outpatient prescription drug benefit under Medicare Part D, effective January 1, 2006. Medicare Part D provides coverage through private prescription drug plans (PDPs) that offer only drug coverage, or through Medicare Advantage (MA) prescription drug plans (MA-PDs) that offer coverage as part of broader, managed care plans. Private drug plans participating in Part D bear some financial risk, though federal subsidies cover most program costs in an effort to encourage participation and keep benefits affordable. This book discusses the prescription drug benefit of Medicare Part D. It also examines practices for promoting prescription drug program integrity, and the extent that CMS's oversight of Medicare Part D program integrity, including the program integrity contractors, reflects these practices.
Medicare Part D Prescription Drug Benefit
Author: Susanne M. KirchhoffPublisher: Createspace Independent Publishing Platform
ISBN: 9781540349224
Category :
Languages : en
Pages : 70
Book Description
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA, P.L. 108-173) established a voluntary, outpatient prescription drug benefit under Medicare Part D, effective January 1, 2006. Medicare Part D provides coverage through private prescription drugplans (PDPs) that offer only drug coverage, or through Medicare Advantage (MA) prescription drug plans (MA-PDs) that offer coverage as part of broader, managed care plans. Private drug plans participating in Part D bear some financial risk, though federal subsidies cover most program costs in an effort to encourage participation and keep benefits affordable. At a minimum, Medicare drug plans must offer a "standard coverage" package of benefits or alternative coverage that is actuarially equivalent to a standard plan. Plans also may offer enhanced benefits. Although all plans must meet certain minimum requirements, there can be significant differences among offerings in terms of benefit design, specific drugs included in formularies (i.e., list of covered drugs), cost sharing for particular drugs, or the level of monthlypremiums. In general, beneficiaries can enroll in a plan, or change plan enrollment, when they first become eligible for Medicare or during open enrollment periods each October 15 through December 7. For plan year 2016, there are between 19 and 29 PDPs in each of the nation's 34 PDP regions, as well as Medicare Advantage plans. Because sponsors are allowed to change planofferings from year to year, beneficiaries must review their annual choices carefully to select theplans that best meet their needs. A key element of the Part D program is enhanced coverage for low-income individuals. Personswith incomes up to 150% of the federal poverty level (FPL) and assets below set limits are eligible for extra assistance with Medicare Part D premiums and cost sharing. Individuals enrolled in both Medicare and Medicaid (so-called dual eligibles), and certain other low-incombeneficiaries, are automatically enrolled in no-premium plans, which are Part D plans that have premiums at or below specified levels. In 2015, about 39 million Medicare beneficiaries received prescription drug benefits through a PDP or an MA-PD, with almost one-third receiving a low-income subsidy. Another 2 million received drug assistance through a Part D-subsidized retiree health plan, and 8 million Medicare beneficiaries had separate, private drug coverage. Overall, about 88% of Medicare beneficiarieshad drug coverage through either PDP or MA-PD plans, retiree coverage, or private insurance ofcomparable scope. Total Part D expenditures were close to $90 billion in calendar year 2015. Medicare Part D has cost less than originally forecasted, due in part to lower-than-predicted enrollment and increased use of less expensive generic drugs. However, the Medicare Trustees project that spending on Part D benefits will accelerate over the next 10 years due to expectationof further increases in the number of enrollees, costs associated with the gradual elimination of the out-of-pocket cost coverage gap, changes in the distribution of enrollees among coverage categories, a slowing of the trend toward greater generic drug utilization, and an increase in the use and the prices of specialty drugs.
Implementation of the Medicare Prescription Drug Benefit
Author: United States. Congress. Senate. Committee on FinancePublisher:
ISBN:
Category : Medicare
Languages : en
Pages : 304
Book Description
Medicare Prescription Drug Coverage FOR DUMMIES (Volume 2 of 2) (EasyRead Large Bold Edition)
Author: Patricia BarryPublisher: ReadHowYouWant.com
ISBN: 1427087989
Category : Large type books
Languages : en
Pages : 450
Book Description
Medicare Part D Prescription Drug Benefit
Author: Congressional Research ServicePublisher: CreateSpace
ISBN: 9781502840547
Category : Health & Fitness
Languages : en
Pages : 64
Book Description
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA, P.L. 108-173) established a voluntary, outpatient prescription drug benefit under Medicare Part D, effective January 1, 2006. Medicare Part D provides coverage through private prescription drug plans (PDPs) that offer only drug coverage, or through Medicare Advantage (MA) prescription drug plans (MA-PDs) that offer coverage as part of broader, managed care plans. Private drug plans participating in Part D bear some financial risk, though federal subsidies cover most program costs in an effort to encourage participation and keep benefits affordable.
Implementation of the Medicare Drug Benefit
Author: United States. Congress. House. Committee on Ways and Means. Subcommittee on HealthPublisher:
ISBN:
Category : Business & Economics
Languages : en
Pages : 232
Book Description