October 13, 2005

Q:  My mother is 83 and on Medicare but Medicaid pays for her prescriptions. Will Medicaid continue to cover these costs after the new Medicare drug benefit begins? -- Helen

A: Dear Helen,

Medicaid will stop covering prescription drugs for people who are on Medicare as of Dec. 31, 2005. When the new Medicare benefit goes into effect, individuals with both Medicare and Medicaid will continue to be eligible for other Medicaid benefits but, beginning Jan. 1, 2006, will get prescriptions covered under new Medicare prescription drug plans instead.

Even before January, people on Medicare who now get their prescriptions paid by Medicaid will be enrolled by the government into one of the new Medicare prescription drug plans. The government expects to assign these individuals to a Medicare plan before January to prevent a gap in their drug coverage. Before the end of this year, your mother should receive a letter from the government that tells her which Medicare drug plan will be covering her prescription drug costs in 2006. If she does not receive this letter, she should call 1-800-MEDICARE (or you can call for her) to be sure she is not without drug coverage next year.

Those who shift from Medicaid to Medicare plans for their drug coverage will not be required to pay premiums or a deductible. They will, however, be required to pay copayments of up to $5 per prescription. If your mom happens to be in a nursing home, she will not be required to pay any copayment for her prescriptions.

One more tip: if your mom receives a letter explaining that she is enrolled in a Medicare plan, check to be sure her new Medicare drug plan covers the medications she takes. If it does not, she might want to consider switching to another plan offered in her area that is better suited to her medication needs – with one important caveat.  Before switching plans, she should check to be sure that the plan that she prefers will not require her to pay an additional premium. This is clearly an important consideration.

For additional help, you may want to call 1-800-MEDICARE and ask for your state Medicaid office or State Health Insurance Assistance Program.

This column was prepared by the Kaiser Family Foundation, an independent, non-profit private foundation based in Menlo Park, Calif., that is not affiliated with the Kaiser Permanente health plan. Do you have questions about the new Medicare drug benefit? Send your questions to Medicare Q and A. The Kaiser Family Foundation. 1330 G St., NW. Washington, DC  20005 or MedicareQ@kff.org. 

(c) 2005, Knight Ridder/Tribune News Service.

Distributed by Knight Ridder/Tribune Information Services.