Getting Ready for 2006:
MMA Timeline for SHIPs
October 18-22, 2004:
Medicare Savings Program (MSP) beneficiaries received a Medicare-approved drug discount card from a randomly selected card sponsor in the mail. The discount card will be effective as of November 1, 2004. In order to get the $600 credit associated with the discount card for 2004, beneficiaries must call 1-800-Medicare or the card sponsor to determine if they qualify for the credit. Beneficiaries will be asked about their income and if they have any prescription drug coverage. For those who do qualify, any enrollment fee for the card will be paid by the federal government. Beneficiaries who do not call to get the credit or who do not qualify for the credit will be charged any annual enrollment fee if they use the card to purchase their prescription drugs in 2004.
SHIP Action Point:
- What are you doing to help Medicare Savings Program beneficiaries understand and respond to the letters they received?
November 15-December 31, 2004:
Election period for 2005 enrollment in a Medicare-approved drug discount card AND the low-income benefit or $600 credit for 2005 (in addition to the $600 credit for 2004).
SHIP Action Point:
- Are you planning to reach out to low-income Medicare beneficiaries in your community who might benefit from the full $1,200 credit?
- Does your state offer a State Pharmacy Assistance Program (SPAP) that coordinates with the $600 credit or offers more favorable benefits?
December 31, 2004:
Deadline for card sponsors to receive the application form for enrollment in a Medicare-approved drug discount card and the application for the low-income benefit for a total credit of $1,200 ($600 in 2004 and $600 in 2005).
SHIP Action Point:
- Are you planning to do any additional outreach to low-income Medicare beneficiaries in your community to remind them that the deadline for the full $1,200 credit is quickly approaching?
March 31, 2005:
Deadline for low-income beneficiaries who did not previously enroll in a Medicare-approved drug discount card to receive the full $600 credit for 2005. (After this date, the $600 credit will be pro-rated.)
SHIP Action Point:
- Will you be prepared to find low-income beneficiaries in your community who can benefit from your program’s educational and counseling services about the $600 credit and/or your state’s pharmacy assistance program?
April 2005:
The Social Security Administration (SSA) launches an outreach campaign about the Medicare Part D low-income subsidies.
SHIP Action Point:
- How are you partnering with the SSA in your community to do outreach to low-income beneficiaries and other important target audiences?
July 1, 2005:
Individuals who are fully dually-entitled for Medicare and Medicaid will be notified that they will receive subsidies to help pay for their Medicare Part D drug coverage IF they enroll in a Medicare Part D plan.
Other low-income beneficiaries can apply for low-income subsidies at the SSA or their state Medicaid agency office.
SHIP Action Point:
- Will you have launched your educational campaign to help reach the fully dually-entitled population of your community so that they understand the need to take action before January 1, 2006 in order to assure a smooth transition from Medicaid drug coverage to Medicare Part D?
- How will you plan to reach other low-income beneficiaries so that they don't miss out on the benefits associated with enrollment in the Part D low-income subsidy?
- Will you be prepared to follow up your educational outreach with individualized counseling to this population?
September 15-November 15, 2005:
Medigap plans send notices to policyholders about Medigap changes and options for coverage in 2006.
SHIP Action Point:
- Have you held educational sessions to prepare your community for the Medigap notices that will be arriving?
- Will you be ready to respond with counseling services and materials (such as charts) that help answer any questions Medigap policyholders in your community will bring to you about the notice they will receive?
October 15, 2005:
Medicare Part D plans start to market (advertise) to Medicare beneficiaries. You should expect to see a wide variety of Medicare Part D plans (not just Standard Plans), Preferred Provider Organizations (PPOs), and other Medicare Advantage plans in your area.
CMS publicizes information on Medicare Part D plans via mail, the Internet and 1-800-Medicare.
SHIP Action Point:
- How have you prepared your community for these two major developments?
- Have you developed educational tools to meet the need for community education about the Medicare Part D options for Medicare beneficiaries?
- Have you enhanced your counseling capacity, perhaps through volunteers, to meet the demand for assistance by Medicare beneficiaries who will need to make decisions about their prescription drug coverage before January 1, 2006?
November 15, 2005-May15, 2006:
Initial Enrollment Period for 2006 Medicare Part D plans.
SHIP Action Point:
- Are you ready to educate and counsel the Medicare beneficiaries in your community about the decisions each beneficiary must make and when these decisions must be made in order to avoid any potentially harmful consequences?
December 31, 2005:
Last day of Medicaid drug coverage for individuals on both Medicare and Medicaid.
No more new Medigap plans H, I, J with prescription drug coverage issued.
SHIP Action Point:
- Will you be prepared to follow your educational outreach with 1:1 counseling for the Medicare beneficiaries in your community about the crucial changes to Medicare that will go into effect tomorrow?
January 1, 2006:
Medicare Part D plans begin operation.
SHIP Action Point:
- Are you prepared to begin this New Year ready to handle the fully dually-entitled beneficiaries who do not understand how to obtain their prescription drugs under Medicare Part D?
- Are you prepared to help fully dually-entitled beneficiaries make decisions about their prescription drug coverage in order to avoid any gaps in drug coverage?
Getting Ready for 2006:
The time is now. This task is too large to not be ready for!
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