According to Cochran, who penned an article on the subject in the March 11th issue of the Gazette, more than 8 million Americans fall into that category.  When, under its new prescription benefit, Medicare took over drug coverage from Medicaid, millions became eligible for both programs. 

Cochran notes that the government was concerned about these dual eligibles and, since most are among the sickest in the nation, they believed that the majority of these individuals would fail to choose a prescription plan on their own.  So, rather than take that risk, Medicare randomly assigned plans to these so-called dual eligibles.

  That’s where the problems began.

These various companies, Cochran pointed out, do not all cover the same medications, so the random assignments were not necessarily the best option for each person. “It was left up to individuals to check with the plan they got to make sure it would cover their drugs at the $1 and $3 rates,” says the author.  Many did not.  They merely accepted the plan and wound up paying more than they should have for prescriptions medications until they were able to decipher the new program and choose a new plan.

Others are receiving the $1 and $3 rates now, but when the grace period ends on March 31, 2006, prices may revert to their more expensive rates.  The grace period was designed so that dual eligibles could shop for the right plan for them, but Medicare fears that many didn’t do their homework.

The article also points out that dual eligibles can check their prescriptions against their plans by calling the plan directly or by contacting Medicare.

 

Sentences: 12 Words: 280

Author:
[Move Content to]   [Edit Page Content]

Reader Comments [+ Add Your Comment]

---

Related Links [+ Add Link]

---