Transition Period Ends April 1
Effective April 1, Part D health plans no longer have to pay for non-covered drugs for Medicare beneficiaries who enrolled in January or February -- many of whom are eligible for both Medicare and Medicaid (dual eligibles). Patients must either switch to switch to another medication on the formulary or pay for the non-covered drug out-of-pocket. In some cases, they can file for an exception [PDF ].
The Centers for Medicare & Medicaid (CMS) services reminded the plans that they must help beneficiaries successfully transition to a formulary drug or take the necessary action to maintain their current medication.
Newly enrolled patients still have a 30-day transition period.
See the CMS Part D Transition Toolkit.
Confused? TMA Can Help Answer Patients' Part D Questions
Are your patients confused about the new Medicare Part D prescription drug benefit? Are you? Can you answer your patients' questions? TMA can help.
Your Medicare patients are making a decision that could have a tremendous impact on their future health care. The new Part D benefit took effect in January, and Medicare beneficiaries across the nation have been asked to choose a plan that is best for them.
The Centers for Medicare & Medicaid Services has approved some four dozen separate plans offered by 20 different companies here in Texas. These plans vary greatly in what they cover and how much they cost. That means your patients may have a tough time determining which plan is right for them. They likely will turn to you as a trusted source of medical information for help in making this important decision. The Texas Medical Association wants to ensure that you and your staff have the information you need to be able to assist your Medicare patients in making the right decision for their health care.
Five Part D Resources You Can't Do Without
Educational Tools and Resources
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Last Updated On
September 11, 2015