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Medicare Part D

On January 1, 2006 a new voluntary Medicare prescription drug program, referred to as Medicare Part D, went into effect for all Medicare eligible consumers.

Consumers who were eligible for both Medicare and Medicaid (dual eligibles) lost their Medicaid prescription coverage on December 31, 2005. The only way (i.e. not voluntarily) dual eligibles could continue to receive prescription drugs was through Medicare part D .

Some Medicare Part D eligible consumers were also eligible for a federal Low Income Subsidy (LIS) which eliminates premiums and deductibles. Dual eligibles were automatically enrolled in both the LIS and Medicare Part D programs.

In 2005 the Coalition created a Provider Guide to the Medicare D Part Prescription Drug benefit which was intended to educate community mental health providers about the many issues Medicare consumers may face when they enroll in a Medicare Prescription Drug Plan. This Guide was updated for the 2006/07 plan years. The Coalition's Provider Guide to the Medicare Prescription Drug Benefit (PDF) »

The frequently updated resource list below contains links to additional information. For a complete list of resources, visit the Medicare Part D Resources page.

Selfhelp Community Services'  Evelyn Frank Legal Resources Program
Training materials written and updated by various staff at the Evelyn Frank Legal Resources program since 2005.

An outline, updated for the 2010 Part D enrollment period, which begins November 15, 2009 covers the basic design of the Medicare Part D prescription drug benefit, the Extra Help subsidy for low income beneficiaries, how Part D works with other types of drug coverage including EPIC and Medicaid , and how to get Extra Help by using the Medicare Savings Program. It describe the Part D program and how it works in New York -- how it works with New York Medicaid, EPIC, ADAP , and other programs.

This Appendix contains charts, forms, and plan lists referenced in the outline described above.

Extra Help 2010 - From the Social Security Administration

A factsheet containing information on the changes to the Low Income Subsidy, “Extra Help” program for 2010 as a result of the Medicare Improvement for Patients and Providers Act (MIPPA). 

A factsheet containing information on the Extra Help redetermination process for 2009 and what you can expect during this process.

Center for Medicare and Medicaid Services

2010 Plan and Premium Information for Medicare Plans Offering Part D Coverage 

2010 Plan and Premium Information for Medicare Plans Offering Part D Coverage - New York Only

2010 Medicare Part D Stand-Alone Prescription Drug Plans - New York Only

2010 Medicare Advantage Plans with drug coverage (MA-PDs) in New York State

Medicare Rights Center

Medicare Interactive, which explains when people may enroll in a Medicare private plan and/or the Medicare prescription drug benefit, as well as when they can change or drop coverage.:

Can I change my Medicare private drug plan (Part D) at any time?

New England Journal of Medicine - July 23, 2009
Medicare Part D Update — Lessons Learned and Unfinished Business - Health Policy Report, Patricia Neuman, Sc.D., and Juliette Cubanski, Ph.D.
View PDF »

Medicare & You Handbook 2009

View PDF»

National Council on Aging
     June 2009 - Making Medicare Work for Your Dually Eligible Clients, Part I

This month we begin a two-part webinar series (June and July) that will focus on helping you figure out how to assist your dually eligible clients through the maze of Medicare and Medicaid. In June 2009 we explored the process of getting your clients bought into Medicare, so that they can receive help with their Medicare premiums, copayments, coinsurance and deductibles. We also looked at how your dually entitled clients gain access through coordinating Medicare and Medicaid to basic medical services, such as doctor visits.
View Part I

     July 2009 - Making Medicare Work for your Dually Eligible Clients , Part II

We conclude our two-part webinar series (in June and July) by focusing on helping you figure out how to assist your dually eligible clients through the maze of Medicare and Medicaid. This month, in the second session of our 2-part series, learn how Medicaid works for people with Medicare and Medicaid (duals) who choose to join Medicare Advantage plans.

We’ll talk about the general rules on enrollment, disenrollmemt, accessing services covered by both Medicare and Medicaid, and when Medicaid pays Medicare and Medicare Advantage out-of-pocket costs. We'll also look more closely at current and soon-to-be implemented rules for Special Needs Plans for duals (D-SNPs).
View Part II

Eligibility, Enrollment and Disenrollment Guidance

The new guides also announce continuous Special Enrollment Periods for ALL Low Income Subsidy Beneficiaries.

2008 PDP Guidance (PDF) »
2008 Medicare Advantage Guidance (PDF) »

Draft 2010 PDP Guidance (PDF) »
Draft 2010 Medicaid Advantage Guidance (PDF) »

Medicare Prescription Plan finder

Go to Finder »

Register for a free copy of "Medicare Part D Appeals"

An Advocate's manual to navigating the Medicare private drug plan appeals process". This manual offers an comprehensive overview of the entire process in an easy-to-understand manner.

View Part D Appeals Manual »

An essential resource for the Mental Health Community

This site has separate sections targeted specifically at Psychiatrics and Other Physicians, Providers at Community Behavioral Health and Integrated Health Centers and Consumers and Their Families.

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Tools for Advocates

There are tools for Transition Supples, Enrollment, Low Income Subsidy, Exception and Appeals as well as other general information.

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Medicare Part D 2008 Update or "The Plans, They are A-Changing"

View (PDF) »