Medicaid Users Assigned to New Drug Plans
According to The Detroit News:
With the starting date for the federal government’s new Medicare prescription drug plan approaching, the program has begun randomly enrolling beneficiaries who are also on Medicaid into approved drug plans.
Medicare last week began sending beneficiaries letters telling them which plans they have been assigned to effective Jan. 1. The action affects about 5.5 million people who are eligible for both Medicare and for Medicaid, the federal health care program for low-income individuals.
Each “dual eligible” beneficiary has been put in a plan with no premium, no deductible and low co-payments.
Medicare beneficiaries who are not eligible for Medicaid have to sign up for the program and choose a plan.
Enrollment begins Nov. 15.
About 5.5 million “dual eligibles” have randomly been assigned a plan with no premium, no deductible and low co-payments.
The federal government opted to automatically enroll dual eligibles — who tend to be among the poorest and sickest and often include nursing home residents — so they do not lose coverage during the transition.
“We needed to get the letters out now, so people know they will either need to take action come Nov. 15 or not take any action and be automatically enrolled in a plan,” said Peter Ashkenaz, spokesman for the Centers for Medicare and Medicaid Services in Washington, D.C.
Dual-eligible recipients can change plans every month, as many times as they like.
Medicare recipients who are not on Medicaid can change only once within the enrollment period.
Some health advocates are concerned dual eligibles will be assigned plans that don’t cover their drugs or don’t contract with their local pharmacies.
“You have coverage, but you might not have the right coverage,” said David Lipschutz, staff attorney for California Health Advocates, a nonprofit group in Los Angeles.
So long as the government performs due dilligence in selecting plans that are strong in the Medicaid user’s geographical area, this shouldn’t prove too problematic. We’ll see how it shakes out, though.