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Medicare/Medicaid Beneficiaries & Medicare Part D

Published byMarcia Barrett Modified over 6 years ago

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Presentation on theme: "Medicare/Medicaid Beneficiaries & Medicare Part D"— Presentation transcript:

1 Medicare/Medicaid Beneficiaries & Medicare Part D

2 Beneficiary Issues and Concerns
Will I get the drugs I need when I need them? What happens to me if there are “glitches” in the system? I’m in a nursing home – what do I do?

3 Will I Get the Drugs I Need – When I Need them?
The overriding question Random auto-enrollment into 1 of ? plans Will my drug needs be matched with plan formularies? How? Who? How do I “switch” to a plan that covers my drugs? I get a formula denial, now what? And how do I get my drugs while appealing?

4 Will I get the drugs I need – When I need them?
Medicaid v. Medicare New co pays with different rules Amounts Rules Medicare doesn’t cover drugs I used to get under Medicaid Medicaid picks them up so now I have 2 cards

5 “Glitches” In the system— What happens to me?
Formulary Denials Co pays Waiting for Appeals Who’s helping me with my drugs and medical care?

6 I’m in a Nursing Home – What Do I Do?
Random Enrollment Formula Transitioning I take a lot of drugs – what happens to me when my drugs change? What will my nursing home do?

7 Conclusion Work together to smooth transition not only for systems but for beneficiaries Know that “problems” will arise that will threaten health and well-being of beneficiaries Monitor and address the problems

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