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In a few short weeks, Medicare will undergo big changes that will have a major impact on more than 3 million Hispanic seniors and younger people with permanent disabilities who rely on Medicare for their health coverage. More than one in three Hispanics with Medicare lack coverage for their prescription drugs for at least part of the year. Many others will need to make decisions about their existing coverage and the new Medicare benefit. Starting…
These issue briefs, prepared by the Centers for Medicare Advocacy, Inc., provide information about how the Medicare drug benefit will affect beneficiaries. The briefs address issues related to dual eligibles, residents of nursing home and assisted living facilities, and the Part D exceptions and appeals processes. Medicare Part D: Issues for Dual Eligibles on the Eve of Implementation Medicare Prescription Drug Coverage for Residents of Nursing Homes and Assisted Living Facilities: Special Problems and Concerns…
This issue brief describes how Medicare beneficiaries navigate the Medicare Part D exceptions, appeals, and grievances processes to get access to medically necessary prescriptions not covered under their Medicare prescription drug plans. It identifies and describes policy issues that may make it difficult for beneficiaries to utilize the processes. Issue Brief (.pdf)
Medicare Part D: Issues for Dual Eligibles on the Eve of Implementation This issue brief describes how dual eligibles are treated under the Medicare drug benefit and the issues raised by their transition from Medicaid to Medicare drug coverage. The brief also explores key differences in the Medicare drug benefit compared to Medicaid drug coverage (formularies, copayments, and appeals policies) which could make the shift especially challenging for dual eligibles. Issue Brief (.pdf)
This issue brief describes Medicare drug benefit policy issues for residents of nursing homes and other long-term care settings, such as assisted living facilities and board and care facilities. The brief addresses differing rules for nursing home and non-nursing home settings, as well as for dual eligibles residing in long-term care facilities. Issue Brief (.pdf)
This Kaiser Family Foundation study estimates the potential impact in monthly Medicare drug premiums if enrollment does not reach 29 million in 2006 as the Congressional Budget Office (CBO) assumed, and if those who do enroll have relatively high total prescription drug costs. The study, prepared by Avalere Health LLC and based on a model developed by Actuarial Research Corporation, looks at various participation scenarios for the beneficiaries who are projected by the Congressional Budget…
State Medicaid Outpatient Prescription Drug Policies: Findings from a National Survey, 2005 Update This survey of state Medicaid pharmacy programs supplements surveys conducted in 2003 and 2000 and reports Medicaid prescription drug policies in effect in early 2005. It covers key elements of utilization management, drug purchasing and potential impacts of the implementation of the Medicare prescription drug benefit. Report (.pdf) Executive Summary (.pdf)
The summary and chartpack highlight key findings from the joint USA Today/Kaiser/Harvard School of Public Health survey exploring Americans’ views on health care costs. Survey Summary and Chartpack (.pdf)
This document includes the toplines from the joint USA Today/Kaiser/Harvard School of Public Health survey exploring Americans’ views on health care costs. Survey Toplines (.pdf)
This comprehensive survey from USA Today, the Kaiser Family Foundation, and the Harvard School of Public Health examines how Americans are being affected by health care costs. The survey includes information on the barriers health care costs pose to obtaining medical care and the alternative measures people take to lower their medical and prescription drug bills. The is based on a nationally representative sample of 1,531 adults ages 18 years and older, conducted between April…
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