Effective January 1, 2006, Medicare will
offer prescription drug benefits to all people entitled
to
Medicare Part A or enrolled in Part B. The new program is known as
Medicare Part D. This means that Medicare recipients
enrolled in Maryland Medicaid, will receive
their drugs through a Medicare-approved private Prescription Drug
Plan.
The federal program, Centers for Medicare and
Medicaid Services (CMS) will auto-assign dual eligible Medicaid
recipients into prescription drug plans. Recipients will receive a
letter from CMS informing them into which plans they have been
enrolled. If recipients wish to enroll with a
different plan they can switch once a month. The plan
will send a card to each enrollee which must be shown to the
pharmacist after January 1, 2006, when filling prescriptions. The
Medicaid recipient will be responsible to pay a $1 or $3 copay. If a
plan does not cover the specific drug that a recipient is currently
taking, he/she must discuss with their pharmacist and/or physician
alternative medications that can be taken. If a recipient still must
take a non-formulary medication, each plan must have an appeal process
for seeking coverage of non-formulary medications. The Medicaid
Program does not cover non-formulary drugs. If a Medicare Prescription
Drug Plan does not cover these drugs, a recipient may use their
Medicaid card in filling prescriptions for the following:
Barbiturates
Benzodiazepines
Prescription Vitamins
Prescription Mineral products
Prescription drugs for symptomatic relief of
coughs & colds
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Medicare Part D & Maryland Pharmacy Assistance
Program
|
As of January 1, 2006, the Maryland
Medicaid Pharmacy
Assistance Program (MPAP) will no longer provide pharmacy coverage to
persons eligible for Part D benefits. All enrollees as of December 31,
2005 with Medicare Part A or B will be disenrolled from the MPAP. No
one receiving Medicare will be enrolled into the MPAP after December
31, 2005. The last day that the MPAP will pay for enrollees’
prescription drugs is December 31, 2005.
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Medicare Part D & Maryland Pharmacy Discount
Program
|
- Since the Maryland
Medicaid Pharmacy Discount Program (MPDP)
only enrolls individuals with Medicare, due to implementation of the
Medicare Part D Pharmacy Program, the MPDP will cease as of December
31, 2005. To get Medicare prescription coverage, these individuals
must choose and enroll in a Medicare Prescription Drug Plan (PDP).
These individuals can join a Medicare prescription drug plan (PDP)
starting November 15, 2005. The Medicare website @
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