Experts Recommend Simple Prescription Drug Benefit Enrollment Process for Low-Income Medicare Beneficiaries
Low-income beneficiaries will need a simple enrollment process for the new Medicare prescription drug benefit, several health care policy experts said on Wednesday at a forum sponsored by the Kaiser Family Foundation, CQ HealthBeat reports.
HHS expects 11 million Medicare beneficiaries to receive subsidies to cover at least a portion of the out-of-pocket costs associated with the prescription drug benefit. About 6.9 million of those beneficiaries will be enrolled automatically because they are dually eligible for Medicare and Medicaid while other Medicare beneficiaries will automatically qualify for the subsidies but must enroll in a specific Medicare drug plan to receive benefits.
A third group -- eligible, low-income beneficiaries -- must apply for the subsidies beginning July 1 and subsequently enroll in a drug plan. The federal government has tried to simplify the application process for financial aid under the new benefit by creating an application form based on cognitive and focus testing to ease assistance by third parties.
In addition, beneficiaries have the option of applying over the Internet, and the Social Security Administration Web site has an anonymous "Qualifier Tool" to help beneficiaries determine eligibility for the subsidies. SSA also has produced an audio CD to help coach beneficiaries through the application process.
Vicki Gottlich, a senior policy attorney for the Center for Medicare Advocacy, said the main problem is that low-income beneficiaries are required to first apply for financial assistance and then take the additional step of enrolling.
CMS Deputy Director Michael McMullen said that because each beneficiary has different medication needs, a standard educational message will be ineffective. He added, "We have to get the information to people where they are, in ways they can understand it."
James Firman -- president and CEO of the National Council on the Aging and chair of the Access to Benefits Coalition, which is leading a grassroots effort to enroll beneficiaries in the new benefit -- said that to "achieve the kind of penetration that we want," the federal government will have to expect to spend between $24 and $280 per person enrolled. "We shouldn't kid ourselves and say that $10 million to $20 million" will be enough, he said (CQ HealthBeat, 6/8).
Additional information on the Medicare drug benefit is available online.