People with Medicare who want to receive the drug benefit will need to enroll in a Medicare plan that offers the drug benefit. This can be either a Medicare Advantage Plan (such as a Medicare HMO), which will cover medical care as well as prescription drugs, or a stand-alone Medicare Prescription Drug Plan (PDP). Medicare PDPs offer only the prescription drug benefit—individuals who enroll in these plans can continue to receive coverage for hospital care, physician services, and other medical care through traditional fee-for-service Medicare.
Hundreds of private companies are providing drug coverage, but they are not all alike. In fact, there are major differences between plans. This has made picking a plan and counseling those in Medicare very difficult. Because the program gives plans a great deal of latitude in how they set up and manage the drug benefit, there are also concerns about how well the plans are serving beneficiaries.
Families USA will be monitoring Medicare drug plans on an ongoing basis. You can help. If you are having difficulty with a plan, if you have questions about a plan’s operations, or if you feel that a plan might be violating some of the program requirements, please contact us. Be sure to include the full name of the plan and the dates the problems occurred.
Plan Basics: Click here for frequently asked questions about how the plans work.
From Other Sources
The Medicare Rights Center has prepared a guide that can help you pick a plan.
The National Mental Health Association has prepared a consumer workbook that is available online.
Medicare Access for Patients-RX is a coalition of patient, family caregiver, and health professional organizations committed to safeguarding patients with chronic diseases and disabilities who enroll in the new Medicare drug benefit. The site has numerous links, both general and state-specific, that can put you in touch with organizations that might be able to help you sort through plan choices.
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