Medicare

Latest California Healthline Stories

Medicare Beneficiaries Dealing With ‘Doughnut Hole’

A gap in coverage in Medicare prescription drug plans is emerging as an issue for beneficiaries with high prescription drug costs, particularly those who did not retain employer-sponsored drug coverage.

Drug Benefit Enrollment Strategies Expand

Health care advocates are working with community groups and “mining” enrollment information for programs whose membership might include Medicare beneficiaries eligible for subsidies to help offset the cost of prescription drug coverage.

Drug Benefit Enrollment Varies by County

CMS attributes variations in enrollment in the Medicare drug benefit among counties to differences in managed care penetration and populations of dual eligibles, but some health care advocates fault CMS for inadequate outreach efforts.

Medicare Beneficiaries Face Enrollment Deadline

Counselors in California expect an increase in calls for assistance before the May 15 deadline for Medicare beneficiaries to enroll in the prescription drug benefit, as the federal government launches efforts to enroll beneficiaries who have put off choosing a drug plan.

Medicare Drug Benefit Could Increase Use of Generic Drugs

The so-called “doughnut hole” in coverage under the Medicare drug benefit could encourage more consumers to switch to generic drugs, a move that some drugmakers are taking steps to avoid.

Medicare Drug Coverage Has Growing Pains in California

California is one of at least 26 states providing emergency coverage of prescription drug costs for dual eligibles who have been unable to obtain medications under the drug benefit, and some health advocates say that some dual eligibles in California also are facing problems with language barriers and drug plan formularies.

Will PBMs Drive Up or Curb Medicare Drug Costs?

Pharmacy benefit managers play a central role in the Medicare drug benefit, leading some health care players to question what effect PBMs’ involvement will have on costs under the new benefit.

Chronic Ailments Increase the Challenge of Picking a Part D Plan

Some Medicare beneficiaries with chronic illnesses often must weigh additional considerations when selecting a Medicare drug plan, although California will provide additional assistance to some groups through other state programs.

Employers, Retirees With Drug Coverage Question Implications of Medicare Drug Benefit

Health insurers have begun marketing Medicare prescription drug plans, but some retirees with prescription drug coverage and employers that provide such coverage are questioning what the drug benefit means for them.

Care Provider Preparedness Could Affect Part D Rollout

The federal government has recommended that Medicare beneficiaries consult care providers with questions about the Medicare drug benefit, but some senior advocates and professional associations say providers might not be prepared to answer such questions.