Medicare Modernization Brings Big Changes: Easing the
Transition (Part 1)
By Rebecca A. Clay
Medicare—the national health care program for
Americans age 65 and older and younger people who qualify
because of a physical or mental disability—is about
to undergo the most dramatic change in its 40-year history.
The Medicare Prescription Drug, Improvement, and Modernization
Act of 2003 makes many improvements to Medicare. Of note,
all 42 million Medicare beneficiaries will have prescription
drug coverage for the very first time. That new coverage
has important implications, especially for those people
eligible for both Medicare and Medicaid.
These 6.3 million dually eligible people—almost
40 percent of whom have serious mental illnesses or cognitive
impairments—will receive their prescription medication
through Medicare rather than Medicaid starting January
"The prescription drug coverage coming next year is
for everyone in Medicare, regardless of their income
or how they get their Medicare," said Mark B. McClellan,
M.D., Ph.D., Administrator of the Centers for Medicare
& Medicaid Services (CMS). "At CMS, we are paying
particular attention to making sure that those with Medicaid
and Medicare have effective, smooth transitions to what
will be very comprehensive coverage for all medically
Whether you're a state mental health program director,
substance abuse program director, treatment provider,
advocate, or consumer, you need to know about these changes.
And SAMHSA is determined to help.
"Although this is a CMS program, it's a very high
priority for us here at SAMHSA as well," said SAMHSA
Administrator Charles G. Curie, M.A., A.C.S.W. "We've
made a commitment to the Secretary of Health and Human
Services that we'll do whatever we can to ensure this
program is a success for the vulnerable populations we
Timeline: Medicare Prescription Drug Coverage
Note: People eligible for both Medicare
and Medicaid should have already received information
about Medicare prescription drug coverage. Call
1 (800) MEDICARE for more information. TTY users
should call 1 (877) 486-2048.
Detailed information available about Medicare prescription
drug plans in the Medicare & You 2006
handbook and on www.medicare.gov.
People with both Medicare and Medicaid will be
notified which plan they'll be assigned if they
don't choose a plan within the next 2 months.
First day to join a Medicare prescription drug
November 15 to December 31
If people with Medicare and Medicaid don't join
a plan by December 31, Medicare will enroll them
in a plan effective January 1, 2006.
January 1, 2006
Medicare prescription drug coverage begins.
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