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National Alliance on Mental Illness
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Medicare Drug Benefit Update:  2008 Plan Year Enrollment Begins

November 14, 2007

November 15 marks the start of the open enrollment period for the Medicare Part D drug benefit for 2008.  During the “open season” period for 2008 drug plan enrollment, Medicare beneficiaries will be able to select prescription drug coverage that goes into effect on January 1, 2008. The open season ends December 31.

As the 2008 plan year approaches, NAMI is watching closely to ensure that beneficiaries with serious mental illness, especially low-income dual eligibles, are able to maintain continued access to drug coverage that meets their complex treatment needs.  Of particular concern are the 2.1 million dual eligibles and low-income subsidy (LIS) Medicare beneficiaries that are being required to switch to different prescription drug plans (PDPs) on January 1. 

For more information on the important issue of Medicare drug plan reassignment of dual eligibles and LIS beneficiaries for 2008, click here.

Wed-Based Search Tools for 2008 Drug Plan Options

There are a number of important web-based tools to search available plan options, research whether or not a specific medication is on a plan’s formulary for 2008 – or is subject to an access restriction (placed on a tier requiring higher cost sharing, prior authorization, step therapy, quantity limit, etc.).  Most can be searched by zip code to check on availability by geographic region.  Here are a few links to these websites:

Centers for Medicare and Medicaid Services

CMS 2008 Plan Finder

Online Enrollment for 2008 

CMS 2008 Formulary Finder

Medicare Rx Connect

Access to Benefits Coalition

MAP Rx Open Enrollment Answers to Key Questions

Compare Plans on CMS Website

In addition, for 2008 CMS has added a new ratings system for Medicare prescription drug plans that allows beneficiaries to compare plans based on three specific measures:

  • Access – including data on the number of exceptions and appeals sought by enrollees, as well as the rate at which decisions by drug plans to deny exceptions and appeals are overturned by Independent Review Entities (IREs),
  • Service – including customer wait times and dropped calls on drug plan 800 customer service numbers, and
  • Price Stability – including changes in beneficiary cost sharing.

These assessments and quality measures are available through the CMS "Plan Finder" tool though a quality icon next to each plan.

 

 

 

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