Get Educated, Get Enrolled

NMHA’s Medicare Rx Benefit Campaign

 

September 22, 2006

Welcome

The National Mental Health Association is a leading voice in ensuring that the scope and implementation of the Medicare Rx benefit meets the needs of beneficiaries with mental health disorders, particularly those who are dual eligibles. As the fall Annual Election Period nears, NMHA’s “Get Educated, Get Enrolled” Medicare Rx Benefit Campaign will send regular email bulletins with Medicare updates, resources and tools to help you assist consumers during open enrollment. Please forward the bulletin to others in your community and encourage them to subscribe by emailing shcrinfo@nmha.org.

 

Countdown

55 days until the Annual Election Period (November 15, 2006 – December 31, 2006)

 

Announcements

September 22—“Donut Hole Day”

The Kaiser Family Foundation predicted that nearly 7 million Part D enrollees would hit the donut hole—the gap in coverage between $2250 and $5700 in prescription expenditures—on September 22. Dubbed “Donut Hole Day,” this dubious holiday is an unfortunate milestone for the millions of seniors who will be forced to pay thousands in out-of-pocket expenses. To protest Part D’s coverage gap, numerous organizations have planned Donut Hole Day events across the country, and The Campaign for America’s Future has initiated a “No Donut Hole Campaign!” Visit their website to send a “No Donut Hole” letter to Congress and enter their video contest to showcase creative donut-hole-elimination ideas that can help build this campaign.

CMS Halts Efforts to Reclaim Erroneous Reimbursements

Some of the 230,000 Medicare beneficiaries who last month received erroneous reimbursements of their Medicare drug benefit premiums should not have to repay them, according to a lawsuit filed by the Center for Medicare Advocacy. According to CMA, federal law allows for waiver of recovery of funds when a beneficiary is not at fault in an overpayment. In response to the suit, CMS on Monday agreed to stop mailing letters that instruct beneficiaries to return the money and to remove content on the recovery of overpayments from its Web site.

Open Enrollment Begins November 15 and Ends December 31

During this fall’s Annual Election Period (AEP), all Medicare beneficiaries who wish to change prescription drug plans may enroll in a new plan between November 15 and December 31. Coverage will be effective January 1, 2007. CMS urges beneficiaries to sign up before December 8 to ensure they have their new prescription drug card in hand to fill prescriptions in early January. Click here for important AEP dates.

Late Enrollment Penalty Waived for Extra Help

Part D beneficiaries who qualify for Extra Help can still enroll in a prescription drug plan through December 31, 2006, and pay no late enrollment penalty. To determine eligibility, visit http://www.socialsecurity.gov/ or call Social Security at 1-800-772-1213 or 1-800-325-0078 (TTY).

Congressional Briefing by the National Health Council

On Tuesday, September 26, the National Health Council invites health policy legislative staff to a lunch briefing regarding the Council’s initiative “Putting Patients First.” Hear why CEOs from the nation's leading patient groups are joining forces to promote patient-focused care for people living with chronic diseases and/or disabilities. Access to Innovation: Recommendations for Improving the Medicare Prescription Drug Benefit is one of three reports to be unveiled by the Council's leadership. To RSVP, visit http://www.nationalhealthcouncil.org/hill.

 

Tools & Resources

My Health, My Medicare Fall Campaign Launched

Last week CMS launched it’s My Health, My Medicare Fall Campaign. Intended to support prevention and personalized coverage in Medicare, this initiative also introduces new tools to assist beneficiaries during the AEP, which begins November 15.

Changes in Qualifying for Extra Help in 2007

Up to 500,000 people who were automatically enrolled this year in Extra Help, Medicare’s low-income subsidy for prescription drug coverage, will not be automatically re-enrolled in 2007 because they no longer qualify for Medicaid or other programs for which the government automatically enrolls beneficiaries. Medicare and Social Security will mail notices to these individuals explaining why they no longer automatically qualify and encourage them to complete an enclosed application for extra help. A complete timeline of the various communications that will be sent to beneficiaries, copies of the notices and CMS’s guide “Changes in Qualifying for Extra Help in 2007: Materials for Partners and People with Medicare” are available on the CMS website.

New Screening Tool

BenefitsCheckUpRx(TM) is a new web-based tool from the Access to Benefits Coalition and the National Council on Aging that screens beneficiaries for state and federal prescription drug and health assistance programs. An organizational edition of BenefitsCheckUpRx(TM) provides agencies some extra tools that make it easier to screen, enroll and follow up with clients who are eligible to receive prescription drug coverage assistance.

Order Your Medicare RX Consumer Workbook Today!

As the Annual Election Period nears, NMHA’s Medicare RX Consumer Workbook is available to help Americans join, switch or disenroll from a prescription drug plan. To order workbooks for education and outreach efforts with Medicare beneficiaries, contact NMHA at shcrinfo@nmha.org or by calling 1-800-969-6642. Individuals may request a free copy of the workbook through the NMHA Resource Center, 1-800-969-NMHA (6642). PDF versions of the workbook in English and Spanish are also available at http://www.nmha.org/medicare.

 

In the News

Surveys Report Part D Coverage Problems

SHIP Counselors assisting people with Medicare have encountered myriad problems with the Part D benefit in areas that include enrollment, access to drugs and cost-sharing, according to a new report by the Kaiser Family Foundation. Two additional national surveys by the Foundation also found that the majority of doctors and pharmacists have had patients and customers who experienced trouble getting their prescriptions under the Part D prescription drug benefit.

Advocacy Groups Lobby Congress to End Late Enrollment Penalty

Advocacy organizations sent a letter to Senate Majority Leader Bill Frist (R-TN) and Senate Minority Leader Harry Reid (D-NV) last week urging them to act on legislation that would waive a financial penalty for Medicare beneficiaries who missed the May 15 enrollment deadline.

 

Get Educated, Get Enrolled e-bulletin is a project of the National Mental Health Association, the country's oldest and largest nonprofit organization addressing all aspects of mental health and mental illness. To subscribe, email us at shcrinfo@nmha.org. To access archived versions of the e-bulletin or for further information on the Medicare Rx benefit, go to http://www.nmha.org/medicare.