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  • Policy Workshop on Formularies and Medicare

    Event Date:
    Event

    The Kaiser Family Foundation hosted a March 14, 2005 policy workshop on the use of drug formularies in the private sector and their potential implications for beneficiaries under the new Medicare drug benefit, set to go into effect January 1, 2006. The workshop involved an expert panel, including perspectives from a health plan, a pharmacy benefits manager, a physician, the Centers for Medicare & Medicaid Services and policy experts. Agenda (.pdf) Presentation (.pdf) Speaker Biographies…

  • Navigating Medicare and Medicaid: Medicaid – online version

    Other Post

    Back to the Top What does it mean to be “medically needy”? Thirty-five states plus the District of Columbia operate medically needy programs. The medically needy option allows states to provide Medicaid to certain groups of individuals who are ineligible because of excess income, but who have high medical expenses. States often use the medically needy program to expand coverage primarily to persons who spend down by incurring medical expenses so that their income minus…

  • Keeping Medicare and Medicaid When You Work: Protecting Health Coverage for  People with Disabilities Who Work- online version

    Other Post

    Can a person with a disability on Medicare and/or Medicaid be employed? Do all work incentives apply to everyone on SSDI and SSI? Editors’ Note: The information presented in this Section regarding SSDI and SSI work incentives is adapted or reprinted from material from the Social Security Administration’s 2004 Red Book, available online at http://www.ssa.gov/work/ResourcesToolkit/redbook.html. Similarly, information presented on Medicare and/or Medicaid coverage options for employed individuals with disabilities is based on information that is…

  • The New Medicare Rx Benefit:  Challenges for Maintaining Access to Prescription Drugs

    Other Post

    The New Medicare Rx Benefit: Challenges for Maintaining Access to Prescription Drugs With the launch of the new Medicare Part D prescription drug benefit less than 18 months away, and growing interest in beneficiaries’ access to medications in the future, the Kaiser Family Foundation is pleased to release two new publications that examine issues concerning access to medications raised by the implementation of the new Part D Medicare prescription drug benefit. The New Medicare Drug…

  • Navigating Medicare and Medicaid: Interaction Between Medicare and Medicaid – online version

    Other Post

    Supplemental Medicaid Coverage for Low-Income Medicare Beneficiaries How does an individual become a dual eligible? How are dual eligibles different from other Medicare beneficiaries? What does it mean to be a primary and/or secondary payor? In 2003, Congress enacted a Medicare reform law that included a prescription drug benefit. How does this law affect dual eligibles? More than 7 million people receive both Medicare and Medicaid; these individuals are called “dual eligibles” or “dual enrollees.”…

  • The New Medicare Drug Benefit:  Potential Effects of Pharmacy Management Tools on Access to Medications

    Issue Brief

    The New Medicare Drug Benefit: Potential Effects of Pharmacy Management Tools on Access to Medications This report describes the pharmacy benefit management tools that will be available to private plans administering the new Medicare drug benefit, including formularies, the definition of categories and classes, and cost sharing requirements. The authors conclude that substantial flexibility given to plans to design management tools could have significant implications for beneficiaries’ access to needed medications and out-of-pocket spending. Issue…

  • Keeping Medicare and Medicaid When You Work: Work-related Incentives for Persons on Either SSDI or SSI- online version

    Other Post

    Training and Rehabilitation Incentives What are continued payments under a vocational rehabilitation program?  What is the Ticket to Work? Earnings-Related Incentives What is meant by the substantial gainful activity (SGA) limit? What are impairment-related work expenses (IRWEs)? What are “subsidies and special conditions”? What are unincurred business expenses? What are unsuccessful work attempts? What is a Plan for Achieving Self Support (a PASS plan)? Health Coverage Incentives How can people with disabilities obtain or retain…

  • Navigating Medicare and Medicaid: A Resource Guide for People with Disabilities, Their Families, and Their Advocates

    Report

    Navigating Medicare and Medicaid: Resource Guides for People with Disabilities, Their Families, and Their Advocates These guides explain the critical role Medicare and Medicaid have come to play in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and give people with disabilities new information to help them get the most from these programs. Navigating Medicare and Medicaid, 2005 Keeping Medicare and Medicaid When You Work, 2005

  • Keeping Medicare and Medicaid When You Work, 2005: A Resource Guide for People with Disabilities, Their Families, and Their Advocates

    Report

    This guide helps to explain the program rules for Medicare and Medicaid with regard to work. Medicare and Medicaid have come to play important roles in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and this guide gives people with disabilities new information to help them get the most from these programs. Full PDF Report Section 1: Protecting Health Coverage For People With Disabilities Who Work HTML…