Medicine Dish: Medicare Part D and Program Updates


Uploaded by CMSHHSgov on 14.01.2011

Transcript:
[Kitty Marx]
Welcome to Medicine Dish. I'm Kitty Marx, Director of the CMS Tribal Affairs
Group and your host of today's Medicine Dish. This broadcast will feature CMS
and IHS experts providing an overview of Medicare Part D and recent changes in
the Medicare program. All this and more on today's installment of Medicine Dish.
[music playing]
Again, welcome to Medicine Dish. As I mentioned earlier, today's topic is
Medicare Part D. But first, let's take just a minute to review what the Medicine
Dish is and how you can use the information.
The Medicine Dish introduces you to various topics pertinent to health care
programs operated by the Indian Health Service, Tribes, Tribal Organizations,
and Urban Indian Health Programs. Medicine Dish is now broadcast on the third
Wednesday of every other month at 1:30 Eastern Time and can be seen over the Web
through a partnership with the National Institutes of Health at
videocast.nih.gov. The next show will air on December 15. All of the shows are
archived at videocast.nih.gov and are easy to access if you can't watch at the
regularly scheduled time or want to review the information. And now let's turn
to the topic for today's Medicine Dish broadcast -- The Medicare Prescription
Drug Plan or Part D.
It's been a couple of years since we've covered this topic, and we have many
changes to tell you about. We're being joined by experts from CMS and IHS to
share that information with you. The changes include the new look of the
medicare.gov website. We'll have a demonstration of the plan finder tool
following our panel discussion. I'm going to turn the show over to David Nolley,
our moderator for today's show, to introduce our experts. David.
[David Nolley]
Thanks, Kitty.
As Kitty mentioned, it's been a while since our last show on Part D. This is the
time of year that CMS encourages all Medicare beneficiaries to review their
Medicare prescription drug, and health plan coverage to make sure they're
getting the best coverage for their needs. If not, it's time to make changes for
the year ahead. We know that Medicare Beneficiaries turn to IHS Tribal and Urban
Indian Health Programs for assistance in enrolling in their Medicare
prescription drug and health plans, so we've brought together a panel of experts
to share their insight with you. I am pleased to welcome Captain Pam Schweitzer
from the Indian Health Service, Kay Pokrzywa and Rosalyn Thomas from the Centers
for Medicare at CMS, and Rosie Norris, the Native American contact from our CMS
San Francisco Regional Office. Thank you all for joining us today.
We have a lot of information to cover, so let's get started, and Pam, I'm going
to start with you first.
What are some of the major changes for Indian Health This Year?
[Captain Pam Schweitzer]
Thanks Dave, and thanks for asking that question.
The first -- there's three areas that I wanted to cover. One of them is a
Creditable Coverage Letter, the other one is -- some of the changes in the
coverage gap, besides the plan information that everybody's used to hearing
every year. And first I want to start with the Creditable Coverage Letter
because this is a big change for us.
There were some trainings back at the end of October that I'm sure many of you
attended. They were offered by Lieutenant Commander John Rael from pretty much
across the nation for all the Areas and for the Urbans and the Indian Health --
the tribes and IHS sites. And what basically has happened is every year this
year, we were used to right now sending out all the letters to all the Medicare
Beneficiaries, and this year it's different because we won't have to do that.
And what we're going to do instead is change, and we're going to post posters
throughout our facilities, we're going to put notices in the community centers,
we're going to educate all the elders because the most important part is that
the beneficiaries -- the Medicare Beneficiaries realize and understand that
Indian Health Service or Indian Health is considered a creditable coverage -- a
provider. And so what that means is that if they want to enroll in a new plan,
that plan will actually look to see if they were in a creditable -- had received
creditable coverage. And if they did, then they provide that letter. And if they
did, then they won't have a penalty. So if they don't have that letter or if
they don't have that notice or information, then they may get a penalty. And
some of you in the field have already experienced this where your beneficiaries
are actually billed or charged a penalty for this, and the reason is, is because
they need to show that they have that creditable coverage, and Indian Health is
considered that. So that's probably a big change.
So what is available, and it's on the website, which I'll talk to you a little
bit later about, but there's a letter that's available. And all the sites have
to really get together and come up with a really good method for a beneficiary,
a member, to come in and if they are eligible for that letter, when they
register they are provided that notice, that notification or the letter. And
there's actually a template that it would be personalized where their name is on
it, the address, and the name of the facility. It's all filled out for them. And
that template is available. So each facility, this is both for Indian Health
Service, for Tribes, and for Urban Facilities, should have this template
available and provide that letter when a beneficiary either requests it or when
they're first initially registering for Medicare Part D or Medicare. So that's
probably the biggest change.
And I guess I can't emphasize enough, it's really, really important that the
Patient Benefit Coordinators that are out in the field really just make a big
effort to go out and make sure that the elders really understand what creditable
coverage means because it is a really confusing thing if they haven't heard it
before. I know that when I first heard it, as I didn't have any idea what it
was. So we need to make sure that they understand what Indian Health is and if
they change plans they won't get that penalty. So that's the first change.
And the second one is -- this is something that's during the coverage gap. This
is actually kind of a big change for us. This is for those people that don't
have Extra Help, they're not Dual Eligible patients. These are patients that
purchased the plan, the Medicare Part D plan on their own or their employer paid
for it or they actually have the plan separately from Dual Eligible or Extra
Help patient. And what ends up happening is, up to now -- and this is -- I'll go
through the example of what happens -- up to now, what ends up happening is they
go get their medication at a pharmacy, and they can go to Indian Health or they
go to outside pharmacy, and they're able to get their medication. And then when
they reach the part where they come up to the coverage gap, what ends up
happening is that's the part that they'd have to pay during that time. They
don't the whole time period. Well what ends up happening now is Federal funds
before would not count towards that coverage gap amount. So now what happens --
this is the new changes -- is that it does. So really what we want to do is
those patients that do have Medicare Part D purchased on their own or employer
purchased in that they are going to have to actually pay on their own during
this coverage gap time period, that we encourage them to come to Indian Health
sites, and that would be Indian Health Service, Tribes, and Urban Facilities --
if they have pharmacies -- and get their medications filled there because that
amount will count towards that coverage gap. And so then they're going to meet
the catastrophic coverage sooner and then they can go to any choice, any place
they want to go.
Did you guys have anything to add on that?
[Female Speakers]
No.
[Captain Pam Schweitzer]
Okay. So that's really a really neat benefit for people. And I know that this
question came up quite a bit in the previous years because people were using CHS
funds, and those CHS funds too are going -- are counted-- they're like Federal
-- they're Federal funds, and so they're going to count towards that coverage
gap time period. So this is really a big benefit for those that do already have
coverage.
And then the third thing is really the plan changes, which I'll talk a little
bit about a little bit later. So that's sort of it in a nutshell. Do you guys
have any more to say or expand on? No? Did you understand that? Okay.
[Female Speaker]
Yeah. No, you did a good job.
[laughter]
[David Nolley]
Well, actually my question, my next question was going to be it, especially
since you said you're going to talk about it some more anyways, what are the
plan changes for 2011?
[Captain Pam Schweitzer]
I'm glad you asked. Yes, there are. For those of you that are used to getting
this every year, we have a spreadsheet. And what it does is it lists all the
plans that are -- and that is going to be available again too. And I should
probably just mention right now, the places that this is going to be available
is available now is if you go to the FTP site and then and it's also there's a
website that's available, and it's the Pharmacy Issues website. It's going to be
posted up there. And then we'll also, for those of you that haven't joined the
Point of Sale Listserv, it'll go out on that information -- it'll go out on the
list serv, and then there's a business office on the Indian Health Service
business office has a website and we'll go ahead and post it up there too. So
they'll be plenty of places where it'll be available to you. But what this will
list is it lists all the different plans.
And I'll just kind of summarize a few of the changes that have taken place. If
you go look on the very first page of this spreadsheet, what it'll do is it'll
relist all the top plans that are available again this year. And how it lists is
it lists first the plan name and then the state that it's located in and sort of
just if there's a change up or down. If it was a name change -- you'll notice a
few of them have had some name changes, and you'll also know that some of the
plans aren't there this year. And those are listed at the bottom of that page.
They're just not listed -- they're not available this year. So that if you go to
the area that you're in, so it goes by Alaska area or the Bhimjee area, Aberdeen
area, it lists all the different areas. If you look at the tab, they're at the
bottom of the sheet.
What you'll do, you'll open up that page, and what you'll do is you'll see, once
again, the plan name and the state that it's in. And then there's a column that
lists -- and you see them all marked. It's kind of color-coded and it has a key
at the bottom. And what that color coding is, is if it was a plan, it's a plan
that's really for a Dual Eligible. Those are the ones that we marked because
those don't have premiums. And most of our patients tend to be Dual Eligibles or
they have extra coverage where they're ending up they're not paying the premium.
So that doesn't mean that -- that doesn't mean that you shouldn't look at the
ones that with paying the premium, but most of our patients, our population,
tends to not have to pay the premiums. So those are all marked for you
color-coded. So if you go and look at that, you'll see them all marked on there.
And for those of you that are in Indian Health Service, we have agreements with
all of the different plans, so you should just assume that you can enroll or if
people are going to change plans, that you can put them in any of those -- any
of those plans because we have agreements with all of them. If you're a tribal
facility or an urban facility and you have a pharmacy, then what you can do is
you'll need to make sure you have agreements with each of those plans to be able
-- so you can enroll people in them. A lot of it hasn't changed over the past
few years. We haven't had -- in fact, looking at all of the list, you'll notice
that we really haven't had to add any new agreements. There aren't any new
processes or PBMs in there. So if you have agreements in place, those should
probably be good for this year.
But you'll notice on the color-coding, it has yellow. And the yellow means that
there really isn't a change from last year. If it's a green, it's a new plan. So
you'll notice several new plans in some of your areas. And so those are new
plans that people can -- you can -- if you're a Patient Benefit Coordinator, you
can enroll them in. And then you'll notice the red ones. The red ones are the
ones we got to pay attention to, where it's marked red. Because what that means
is that was a plan that was available last year for a Dual Eligible patient. And
what happens this year, if they don't move from that plan, if they don't change
to a new plan, they're going to end up paying a premium. So those are the ones
in each area you want to look through, and look at the plans that are available,
and if you see a red, make sure that you, you know, identify those patients so
that you can make sure that they want to still remain in that plan.
Then if you continue down the column, you'll notice there's another column and
it says "Contract ID." And that number is really important to know, and I'll
talk a little bit about it because what ends up happening is you're probably
going to try to figure out which plan are people in? And how you normally do
this is you run an eligibility transaction or the patient comes in and tells
you. But if you run an eligibility transaction in your pharmacy software system,
then what you'll do is you'll end up having that Contract ID available, and that
refers back to the plan name. So that column's in there too. So the most
important columns on those spreadsheets that you're looking at are going to be
the plan name, whether it's for a Dual Eligible patient, and it says no premium
on there, and that's marked specially, and then the Contract ID. So those are
the ones to watch out for.
So that's kind of it in nutshell. So each person has to -- each facility needs
to really look at their area and see what plans have changed, but they're all
marked on that spreadsheet so it's kind of like a cheat sheet for that. Oh, and
one other thing -- and that's going to be available too. So that's the lands --
that's called the "landscape version." There's also another spreadsheet that I
know that most everybody wants is -- and what that is, is that lists all the
plan names. And really it's gone through for 2011 and listed all the different
plans, and then also how to set it up in the patient, in your patient
registration system, and then also the processor and the BIN and the PCN and all
the information for the billing. That's all available too. And so if -- that's
kind of like a cheat sheet for all of that, and that's also available on the
same websites that I mentioned.
[David Nolley]
Wow, lots of good information there! Well, what should Indian Health Sites be
doing right now?
[Captain Pam Schweitzer]
Okay. Good question. Okay, there's a couple of things right now that everybody
should be doing. No. 1, the Fraud, Waste, and Abuse Training. I think there's
been some e-mail messages coming out, out there. And actually they've been
sending out on the Point of Sale Listserv, I know. And so if you're on that
listserv, you're probably getting them. You also may be getting notices from the
payors that you have agreements with. And what that is, is Fraud, Waste, and
Abuse Training -- we've been doing it every year, and a lot of the PBMs or
payors, they actually -- or plans -- they actually provide it free for service.
So as long as you make sure that all your staff, everybody involved in pharmacy
billing, so that's going to be the pharmacy staff, any contractors, patient
registration, business office, anybody involved in the billing needs to make
sure that they take that and you have documentation of it and you have a -- and
it might be in the form of a certificate. Now, we have our own available -- we
have it's sort of like a Power Point that you can go through for the Indian
Health, and it's up on all those resources that I told you about, all upon the
websites. And you can actually run through that, and at the very end there's a
certificate. But also the PBMs have their own plan or their own training. You
can take one of those and then you can go ahead and go through and make sure all
the staff have taken that. But the important thing is to make sure that they
take it. And then you have documentation to show that you have taken it.
Then you're going to see these requests coming out from the payors or PBMs or
the plans saying, you know -- filling out, completing an attestation form saying
that you have completed it. And it's really important that everyone that --
here's -- there's a couple of different ways to do this. If you're an Indian
Health Service Site, we're trying to capture these at the headquarters level. So
Captain Chris Watson is trying to capture those. But just to be on the safe
side, if you are receiving one of those forms, and it says, you know, complete
this for your attestation saying that you completed the training, go ahead and
complete that, if you have -- need to complete it first, the training, and then
fill out the attestation and go ahead and submit that. Tribes, make sure you're
doing that, and any urban organizations that are providing Medicare Part D or
pharmacy services, go ahead and do that too. They need to complete that
attestation. So they'll be sending out reminders, and you just want to make sure
that you're completing it. Unfortunately, you have to complete it out for each
one of the plans. So they're all, each of them, are sending out their own
attestation letters, and we need to complete them for all of them.
The other thing is, and this is really important too now because we're starting
to get -- and this is for everybody -- we're actually starting to get audits
now. We haven't had audits really too much up until now, but I've heard several
in this past year where they're actually coming onsite and doing audits. So this
is really important that everybody has their paperwork in order. So I can't
emphasize the importance to make sure you have that Fraud, Waste, and Abuse
information.
The other things you need to have in place are signature logs, you need to have
really good records on your prescribers, meaning, making sure the prescribers
have your -- have their NPI and that it's in the system and that you're
transmitting it. On that same topic, there's going to be information on just to
check. We've had this question a lot here in the last month of how to make sure
that we're sending the NPI for the National Provider Identifier for the
prescriber because it was a software -- maybe back in 2007, we were just sort of
transitioning, but now we're actually everybody should be using the NPI for the
prescriber. So what happens, I actually posted up there some information on how
to verify if you're using the RPMS system, that you're actually transmitting the
NPI. So all you have to do if you're not sure, just go through and make sure the
settings are correct, and then you're okay. And if you have any problems with
that, then you can contact the OIT Helpdesk if you use RPMS.
And the other thing that you'll need to do is -- oh, this is for audits. The
other thing, and this is another area that's really important, is for our
providers, the ones that are providing service and ones the prescribers, you'll
need to make sure that you look on the OIG Exclusion List and make sure that the
provider isn't on there. There needs to be a process in place, and this is --
usually involves the credentialing department at each -- at each facility. But
you want to make sure that that's in place too. And this is just to get -- for
the audits. And probably what's going to happen is because we have so many
people that are being audited, that we want to make sure that we have everybody
up to speed on this. You'll be some Web access. They'll come out on the Point of
Sale Listserv. And I would highly encourage you to attend those so you kind of
get a feel of what you need to have prepared. But there are several documents
that are coming out from the payors, sending out on the audits, please read
those careful.
And then the other thing that you can actually start doing right now, which is
really a fun thing for everybody to do, and I know that a lot of facilities are
really creative at how they do this is you can start running the eligibility
transaction probably here in the early part of November because any changes in
plans will actually be in place by then. So if you run in your software system
the eligibility transaction, and again, the instructions are up on the FTP site,
what you can do is you can see what new plan that they've been enrolled in. And
you just run that. You can actually put a date in advance up to 90 days. You can
actually go back, most people don't know this, back 90 days too. So you can go
90 days past plus 90 days ahead and then you can see what plan they are in
during that time. So I would recommend that you get together and all of your
Medicare Beneficiaries then you go through and you run that on them and see if
there's any plan changes so you can kind of get ready in December so you're
ready to roll in January.
Along with that -- and I'm going to defer over here -- along with that, there's
a new or -- they started it last year, and it's still going to be in effect this
year -- when you run those eligibility transactions, when you go through and you
look, go down, and you look at the Contract ID field on there, you'll see like
an "S" or an "H" and then a series of numbers. If you see an "X0001," what that
means is they're in the LI NET Plan, which is actually -- I should probably
defer. Do you want to talk a little bit about it, Kay --?
[Kay Pokrzywa]
Sure.
[Captain Pam Schweitzer]
-- the LI NET Plan.
[Kay Pokrzywa]
Thanks, Pam. LI NET is new coverage that CMS instituted in January 2010. It is
retroactive coverage for people who are full duals. But it is also available as
point of sale coverage for other people with Extra Help, also known as the
low-income subsidy. It provides coverage right at the pharmacy counter for
people who are not enrolled in a plan but who do have LIS, and it will provide
them coverage until CMS can enroll them in a permanent ongoing prescription drug
plan. So it's temporary, it can be retroactive if the person is a full dual, but
it does provide that instantaneous coverage at the pharmacy so folks do not have
to go home without their prescriptions.
[Captain Pam Schweitzer]
Okay, great. So what that means for us is if you run that eligibility and you
see that "X0001" on there, what you would do is you can actually enter that in
your patient registration of your software system, and then you need to remember
to check it probably, you know, every month -- every time the patient comes back
because what will happen is eventually they're going to be in a plan and then
you'll need to go ahead and change them over to that new plan. But that at least
you'll have coverage during those visits that they're coming until they're in a
plan. So that's sort of it in a nutshell, things that they can be doing. So they
can be running their eligibility transactions, they make sure they do their
Fraud, Waste, and Abuse Training, make sure they have their providers, the NPIs,
all in the system set up correctly, and that would be good.
[David Nolley]
[laughs] Okay. Well, to me that sounds somewhat exhaustive, but I don't want to
assume too much. Is there any other information you want to share with our
viewers?
[Captain Pam Schweitzer]
Yeah, this is just general information. And some of this is just questions that
have come up just over the past few months here, and so we thought we'd just
address them here. And one of them is -- one of them is just notices that you
might have been seeing about the E-Prescribing Incentive Program. And I just
wanted to mention that really quickly that that program, there's several
different incentives for providers to do electronic prescribing. And those of
you that use our -- use the RPMS Electronic Health Record realize that you, they
actually are e-prescribing. But there's actually certain standards that are in
place that make the software a qualified e-prescribing system. And ours is --
fall short in one area for this particular incentive. And actually all the
emphasis right now is being put on meaningful use and getting ready -- getting
our software ready for that, which there's a lot more of a incentive for us to
move towards that. But eventually, I know that the programming will make enough
changes to be able to comply with it. So currently at this time, if you see that
incentive and you go, oh, how do we get it because we're e-prescribing?
Actually, the software doesn't quite comply with it. It will in the future, but
it does not at this time. So I wanted to mention that.
And then the other thing you're going to say along with that, you're seeing a
lot of notices coming out right now that say please use prescription origin
code, complete that field. And what that actually means is that's actually being
done. You actually don't have to do anything if you're using the RPMS system or
EHR, you do not have to populate anything. It's all been populated for you
behind the scenes. So the notice is kind of confusing when you see all these
because it says -- makes it sound like you have to go populate something, and
you don't at this time. So I just wanted to mention that. And then also what
will happen is there's a lot of place references, a lot of information that's up
here. There's going to be upcoming trainings. All that information is going to
be in the FTP site. And that's all. I didn't end that very good, sorry.
[laughter]
[David Nolley]
I think you did fine. I think you did fine. But --
[Captain Pam Schweitzer]
Did you understand it?
[simultaneous speaking]
[David Nolley]
Okay, Kay, we'll have a few questions for you at this point then.
[Kay Pokrzywa]
Okay, Dave.
[David Nolley]
So what activities will occur this fall for individuals who are eligible for
Extra Help? You know the individuals with limited income and resources?
[Kay Pokrzywa]
Those are good -- that's a good question. There are two key activities that are
occurring this fall, and that would be redeeming and reassignment. Redeeming is
CMS's process for determining which individuals are going to qualify for the low
income subsidy next year who qualified for it this year. And we look at state
records and at Social Security records for SSI eligible individuals to determine
who will and will not qualify for the low income subsidy in the coming year.
Reassignment is CMS's process for protecting beneficiaries, from plan
disenrollment -- that means plans that are going out of Medicare system
altogether at the end of the year -- and from premium increases in the coming
year. If the individual's plan will have a premium next year that is above the
regional low-income premium subsidy amount, that's also known as the benchmark,
that individual would be responsible for paying a portion of the premium even if
he or she has 100% premium subsidy. To prevent the individual from having this
premium liability, CMS will move him or her to a plan where the premium is
covered in full by the subsidy. If the individual's plan is terminating at the
end of the year, CMS will reassign subsidy-eligible individuals in that plan to
ensure that they have prescription drug coverage in the coming year.
[David Nolley]
Can you describe -- I'm sorry, did you have something to add?
[Captain Pam Schweitzer]
Well, no, I had a question for you.
[David Nolley]
Okay.
[Kay Pokrzywa]
Okay.
[Captain Pam Schweitzer]
So for the -- for the beneficiaries that their plan doesn't exist, because on
that list there's like four or five I saw that were on a list that aren't there,
at least that apply to us, so they will automatically move them over even if
they chose to be in that plan?
[Kay Pokrzywa]
That's a good question. Choosers are not moved to new plans by CMS. And choosers
are individuals who chose their plan on their own, even if prior to that choice,
CMS had put them in a plan. But we definitely honor the beneficiary's choice of
a plan and will not move them. However, they will get a letter telling them
about this premium liability in the coming year and offering them information
about other zero-premium plans that are available in their -- in their area.
[Captain Pam Schweitzer]
Okay. So that's important information for our Patient Benefit Coordinators.
[Kay Pokrzywa]
Yes, it is.
[David Nolley]
Okay, so now back to the redeem process. Can you describe what individuals can
expect from this process?
[Kay Pokrzywa]
Yes. The redeeming process has already occurred with the mailing of notices on
gray paper in September to individuals who will not automatically qualify for
the Extra Help in 2011. Included in this mailing is a Social Security Extra-Help
application and return envelope, prepaid, for individuals to fill out and return
to Social Security in order to help them requalify for the low-income subsidy in
the coming year. And we encourage people to fill that application out and return
it.
Also, in October, CMS is mailing or actually we already have mailed notices on
orange paper to individuals who are going to continue to qualify for the
low-income subsidy next year, but whose co-payments will change in the coming
year. And this is just an informational notice that lets them know they will
have a different co-pay level in the coming year, but they will be in the same
plan and they will have the subsidy. They actually don't have to do a thing if
they agree with the information in the letter, but they should keep that letter
on file for future reference.
[Captain Pam Schweitzer]
Oh, this is just another comment. So this is good information for the Patient
Benefit Coordinators too so they look at the color letter and they have that
great cheat sheet that --
[Kay Pokrzywa]
It's called The Guide to Mailing List.
[Captain Pam Schweitzer]
Guide to Mailing List. And then we have that up on our FTP site too, so --
[Kay Pokrzywa]
Okay. Individuals who aren't going to experience any change will not get a
letter.
[Captain Pam Schweitzer]
Okay.
[David Nolley]
Okay, can you also describe what individuals can expect from the reassignment
process?
[Kay Pokrzywa]
Yes, Dave, thanks. Individuals who will be reassigned to CMS by CMS to new plans
will receive notices on blue paper. These are going out this month. They should
be with beneficiaries probably within the next week. Individuals whose plans
have an increasing premium can choose to remain in that plan if they wish, and
the notice will give them information about how to remain in their current plan
if they don't want to move. If they don't do anything, they will be in the plan
that CMS has chosen for them next year or they can choose another plan
altogether. Not their current plan, not the one that CMS chooses for them, but
something else altogether that may suit their needs -- better suit their needs.
Individuals whose plans are terminating are also free to choose a plan other
than the plan that CMS is enrolling them in, and there will be information about
that in their letter. In all cases, CMS encourages beneficiaries to make sure
that the plans in which they were enrolled meet their needs and offer convenient
access.
[Captain Pam Schweitzer]
I have another. This is a comment. There is also a part of the change from this
last year is that tribes, tribal organizations and urban organizations, can also
-- can now pay the premiums for plans, so that's --
[Kay Pokrzywa]
That's a very good point and thank you for that information.
[David Nolley]
Well, are there other changes that have taken place in the redeeming and
reassignment processes?
[Kay Pokrzywa]
There are brand, some brand new factors that are taking place this year. There
aren't really any changes in the redeeming process. But in the reassignment
process, starting actually last year in 2009, we are now making reassignments
for individuals with a subsidy who are in Medicare Advantage Plans. All the
reassignment processes I described a moment ago pertained to prescription drug
plans only. But we became aware that there were subsidy-eligible individuals in
Medicare Advantage Plans that were terminating who, without some intervention by
CMS, were going to end up in the New Year without any drug coverage. Even though
their Medicare Advantage Plan was closing, they would go back into Original
Medicare for coverage of their Part A and B benefits, but there isn't a
corresponding fallback plan for Part D. So we took the initiative to enroll
those individuals into a standalone prescription drug plan for the New Year to
ensure that they had drug coverage January 1 when they needed it. And certainly
we encouraged them to look at the plan that CMS is enrolling them in and make
sure that it meets their needs.
The other major change, and this is very exciting, is one that was instituted by
the Affordable Care Act, and it is a provision for CMS to create notices to all
the individuals being reassigned that gives them a list of the drugs they took
in 2010 and compares the coverage of those drugs in the plan we have enrolled
them in for 2011. So it will give the list of drugs, and it will say covered,
covered as generic, covered with special rules, or not covered. And that is very
important additional information that will help the beneficiary make choices
about whether that plan is a good plan for them, the plan that CMS has chosen,
or whether they really want to look for some other plan to better meet their
needs. These notices are going to be sent out in December.
[Captain Pam Schweitzer]
Great. That's good.
[David Nolley]
Okay. Well, let's switch our focus to enrollment in a plan. Now, Rosalyn, I
heard that the Medicare open enrollment period has already started. Can you tell
us more about when people with Medicare can make changes to their coverage?
[Rosalyn Thomas]
Sure. Every year there are new prescription and health care coverage choices
available to people with Medicare. Open enrollment is the time of year when
people who are currently or newly eligible for Medicare should take a chance to
look over their coverage and compare it to the plans that are out there. There
are a lot of changes that are made in a plan that they will have -- may have
lower rates for prescription drug coverage, and so what a person should do is
really just look at the plan that's in their area and compare it to the coverage
that they have currently.
[David Nolley]
So what should everyone do during this time period?
[Rosalyn Thomas]
What everyone should do now is -- actually this is a perfect time to review your
current coverage. An individual with Medicare should really just take their
Medicare and You Handbook, go on the Medicare.gov website and just review your
coverage that they have and compare it with other plans in their area. The open
enrollment period is from November 15 to December 31. So really, it's just the
perfect time to review your coverage. There may be lower costs for prescription
drugs, there's also preventative care that is available now with the new health
care law, and also it have like, um, wellness checkups as well. So you really
want to take this time and this opportunity to review your current coverage and
compare it with other coverage that's available out there.
[Captain Pam Schweitzer]
For Indian beneficiaries, if they choose to change their coverage or if they
want to look and see if they have a better plan, like next April, can they do
that?
[Rosalyn Thomas]
Actually, typically, that's done during the open enrollment period, which is
this year from November 15 to December 31. But there's also a new annual
disenrollment period that is from January 1 through February 14. It's a 45-day
period that they can also change their coverage. But one thing to be mindful of
with that time period is that if you disenroll from your plan, you'll either go
back to Original Medicare with a prescription drug plan, or just Original
Medicare. Those are your two options, so --
[Kay Pokrzywa]
Individuals who have the low-income subsidy, also known as Extra Help, can make
changes at any time. And the change would be effective at the beginning of the
next month.
[Captain Pam Schweitzer]
Okay.
[Rosalyn Thomas]
And there are also those special circumstances in which an individual can change
their coverage during the time. Say, for example, if they move out of the
service area of their plan that they have now, then they can enroll in another
plan. Or if they lose creditable coverage. Those are other examples as well.
[David Nolley]
Wow, do you feel like you're being peppered with questions at this point?
Because I have another.
[Rosalyn Thomas]
Okay.
[laughter]
[David Nolley]
So how would an individual with Medicare go about getting information for making
changes to their coverage?
[Rosalyn Thomas]
Oh, there are lots of ways that an individual can get coverage -- information
about coverage in their area. Like I mentioned before, there's Medicare.gov.
There's also 1-800-MEDICARE. Also, the Medicare and You Handbook that they
should have now, that's an excellent tool to use to review your coverage. Also
the State Health Insurance Assistance Program, the SHIP program, is another good
tool for one-on-one opportunities where a person can talk with a person
one-on-one and go over the coverage that they have and other coverage options
that they have in their area. So those are different ways that a person can get
information.
[Captain Pam Schweitzer]
And just as a comment, we've put the Medicare and You handout upon the FTP site
too. We've added it there and that -- just so the people have it handy.
[Female Speaker]
Rosalyn, what about people who move around a lot? Would they benefit by like a
national plan or?
[Rosalyn Thomas]
Actually, it just depends on the service area. Sometimes a plan may cover a
different area. Just because you move from one city to another, the other city
could actually be part of their coverage area. So when they contact the plan and
say hey, I'm moving or I've moved and this is where I am now, the plan may
actually look and say well, hey, we cover that area and send them a new card,
so.
[Female Speaker]
[assent] Okay.
[Captain Pam Schweitzer]
I know that Patient Benefit Coordinators at a lot of the facilities, they get
really good at going on the website and helping to search too. So they're also a
good resource.
[David Nolley]
Well, you're talking about the differences in areas about a person moving from
Point A to Point B, what type of plan options are out there?
[Rosalyn Thomas]
There are many different plan options out there, and that's why I strongly
encourage people to please go to Medicare.gov and look at the plan finder and
see exactly what plans are available in their area. They could have Medicare
Advantage Plans, Medicare Advantage Plans with a prescription drug coverage,
also there is, of course, Original Medicare that's everywhere, but also Original
Medicare with prescription drugs. So really, honestly, Medicare.gov or your SHIP
coordinator or your --
[Captain Pam Schweitzer]
Patient Benefit Coordinator.
[laughter]
[Rosalyn Thomas]
Is an excellent resource.
[Captain Pam Schweitzer]
Is Medicare.gov, is that where the one where you go on and then you -- it asks
you what state you're in and you put the state and then it lists everything out,
and then you have to go make all the choices?
[Rosalyn Thomas]
Yeah.
[David Nolley]
Okay, well, back to the basics for a moment. Say someone found a plan they'd
like to enroll in, how do they do that?
[Rosalyn Thomas]
Well, there are many different ways a person can enroll in a plan. Of course,
every plan has paper enrollment forms. They offer paper enrollment forms, and
they are to accept paper enrollment forms. But also many plans offer on their
websites where you can enroll online or you can call the plan directly or you
could go to Medicare.gov or 1-800-Medicare and enroll that way as well.
[David Nolley]
Okay, so what if someone joins a plan for 2011 and they don't like their plan,
what do they do then?
[Rosalyn Thomas]
Ah, good question.
[laughter]
What they should do is use your open enrollment period -- typically, that's what
most people do -- to change your plan. If you don't like your plan, the open
enrollment period is, once again, an excellent opportunity to review your
coverage and look at other plans that are out there and see what exactly what
best suits your needs. Also, we do have the new 45-day disenrollment period,
which starts from January 1 to February 14. That's another opportunity to
disenroll from a plan if you don't like it. However, do keep in mind that during
that period, you have the option of going to Original Medicare or Original
Medicare with the prescription drug benefits, so.
[Captain Pam Schweitzer]
Yeah, and they need their Creditable Coverage Letter.
[Female Speaker]
Right.
[laughter]
[Rosalyn Thomas]
Yes, that's important too.
[laughter]
[David Nolley]
Well, I understand there used to be a Medicare open enrollment period. What
happened to that period?
[Rosalyn Thomas]
Well, that period is no longer with us. Now we have the 45 --
[David Nolley]
It sounds deceased.
[laughter]
[Rosalyn Thomas]
-- now, we have a -- that has been -- with the Affordable Care Act that time
period has been replaced with the annual disenrollment period, which is the
45-day period from January 1 to February 14.
[David Nolley]
So are there other times people can make changes to their coverage?
[Rosalyn Thomas]
Yes, there are some other times depending on the individual circumstance. Say,
for example, like I mentioned earlier, if you move from your service area, then
you have an option of first checking with your plan to see if they cover that
area, but, if not, then you have an opportunity to enroll in another plan. Also,
if you lose your creditable coverage. That's another time when you can enroll in
another plan that's outside of those two periods. And also if you are eligible
for Extra Help.
[David Nolley]
Okay. Well, finally, if I may, and please feel free to jump in at any time, but
this is my final question. What are the most important points to remember about
enrolling in a Medicare plan?
[Rosalyn Thomas]
The most important points to remember is first of all, your open enrollment
period is an excellent time for your to review your coverage and compare it with
coverage, other coverage, within your area. Utilize the tools. Medicare.gov,
1-800-MEDICARE, your SHIP, your Patient --
[Captain Pam Schweitzer]
Benefit Coordinator.
[Rosalyn Thomas]
-- Benefit Coordinator.
[laughter]
Also your Medicare and You Handbook is an excellent tool as well. Also, keep in
mind there is that 45-day disenrollment period that is from January 1 to
February 14. But remember, during that time, you have the option of disenrolling
from your plan but you go to Original Medicare or Original Medicare with a
prescription drug, and that's it, so those are my important points.
[David Nolley]
Oh, great. Okay, Rosie, I guess we saved the best for last.
[laughter]
Rosie, there's been other changes to the Medicare program recently, and I'd like
to ask you about some of them. Why did some Medicare beneficiaries get a $250
rebate check?
[Rosie Norris]
That's a great question, David. Basically, this flowed out of the Patient
Protection and Affordable Care Act that was signed on March 23, 2010 by the
President. It came with many, many benefits and so this was one of them. The
$250 rebate was included as a benefit, you know, for individuals who entered the
coverage gap. And so they received a $250 rebate check in the mail. And
generally, that comes about maybe six weeks later after they qualify for the
$250 benefit. And so that was one of the major changes. And you also, you know,
shouldn't have the Extra Help to qualify for that. And so, you know, I just want
to make that point. Let me see what else regarding that. Also want to note that
it is a tax-free $250 rebate. And that's it.
[Captain Pam Schweitzer]
So if that was -- that was a small percentage, probably, because most of our
patients probably have Extra Help and are Dual Eligible, so that would have been
small percentage receiving a check.
[Rosie Norris]
Yes, that's correct. But, you know, the question that also came from the
Intertribal Council of Arizona and also for Navajo Nation, they were interested
in how that work with Indian Health.
[Female Speaker]
Right.
[Rosie Norris]
So yes, thank you for that question.
[Captain Pam Schweitzer]
[assent]
[David Nolley]
Yeah, well, personally, I love rebate checks, so.
[laughter]
[Kay Pokrzywa]
Right, tax-free.
[David Nolley]
So my question, of course, is --
[Rosie Norris]
Tax free rebate checks.
[David Nolley]
-- can -- tax free, exactly. So my question is can people still qualify for the
payment?
[Rosie Norris]
Yes, they can still qualify up until the end of December -- December 31, because
it's only in 2010. And if they qualify in the last quarter of the year, they
will get their rebate check in about mid February.
[David Nolley]
Okay, great, great. So I recently heard there have been some recent changes with
the Medicare Preventative Benefits. Can you tell us more about that?
[Rosie Norris]
Yes, that is correct. Prior to the Affordable Care Act, you know, we charge 20
percent co-insurance on many of the preventive services, in addition to a
deductible. As a result of the Affordable Care Act, we will no longer charge the
deductible and the 20 percent co-insurance on many of the preventive services.
[David Nolley]
At the end of 2009, there was a lot of concern about Medicare reimbursement
ending for Part B services. What's the status now?
[Rosie Norris]
Okay, that's another change in the law that occurred on March 23, 2010, and
there was concerns at the end of year that part of the Medicare Part B services
would basically go away for the Indian Health Providers. However, the new law
has restored those services permanently and retroactively to January 1, 2010.
[David Nolley]
Okay, now, Rosie, I know that you work closely with the staff and the IHS,
Tribal and Urban Indian Health Programs. Based on your observations, what other
Medicare information would be helpful for our viewers?
[Rosie Norris]
Well, I think just to, you know, let them know where to go for help. Sometimes
it's very basic information, but, you know, the turnover at the Indian health
facilities is sometimes great. And so when they call me, I always let them know
of our different websites online. That is always helpful. And generally we'll
have a lot of good information, current information, as well as, you know,
information specifically on the prescription drug plans right now. So that would
be helpful for them to take a look at it. And we also have our Medicare Learning
Network, articles that we have online. What these articles do is break down our
policies and our technical information, and we put it into easy-to-understand
guidance. So this is available to them online. And in addition to that, we have
our open door forums, and it's available free of charge to everyone who wants to
listen in. And sometimes, some of them are very, very specific to Indian Health,
which, you know, our Benefits Coordinators could benefit by.
[David Nolley]
Well, do you have any provider enrollment updates?
[Rosie Norris]
Yes, I do. In, I believe it was 2008, we implemented a Provider Enrollment
Change and Ownership System, which provides our provider community with online
access so they can either do a paper provider enrollment application, or they
can also do an online application. And this year, in 2010, of course, we
included or enhanced that portion of the Web-based provider enrollment
application process, and so, you know, to ensure that the Indian health
facilities also had access to that as well, you know, to have an option to
either do an online application or a paper application.
[David Nolley]
Okay. Well, finally, can you tell us about the change in Medicare claims filing
limits?
[Rosie Norris]
Yes. This was also a change last year that reduced our timeline for the Medicare
providers to file their Medicare claims. And now we've reduced it to 12 months.
And so, you know, this is important because sometimes we have concerns that, you
know, some providers don't file the claims within that time period, so this way
it'll ensure that, you know, you don't have to file a new provider application.
[Captain Pam Schweitzer]
So we need to work and make sure we get all our --
[Rosie Norris]
Yes.
[Captain Pam Schweitzer]
-- billing done for January -- from January 1, 2010?
[Rosie Norris]
That is correct. Yes.
[Captain Pam Schweitzer]
All right, hear that, everybody.
[laughter]
[David Nolley]
Great, great.
[Rosie Norris]
I would also like to add some information regarding our Medicare provider
revalidation. CMS requires the providers to revalidate their information every
five years. And so, the providers will need to take a look at their information
in our Medicare system to make sure that everything is up to date. And so CMS
also has a process for that and that is to take a look at your CMS-855A and just
to make sure that we have current information. This could be a change in your
ownership, it could be a change in your location. And so all that information is
important to CMS. And so this is the process that we use to update our provider
information to make sure it's accurate.
[David Nolley]
I want to thank all of our panelists for their contribution to this discussion
and for joining us today. So thank you all again.
We know that many of you assist beneficiaries in reviewing and enrolling in
Medicare prescription drug and/or health plans. We have a new website and we
want it to walk you through the enrollment process. Earlier, Stacy Platte came
to our studio to tape a demonstration of the new Medicare.gov website.
[Stacy Platte]
Hi. Thank you very much for the opportunity to be here. Today I'm going to show
you how you can use the new Medicare Plan Finder to learn about health and drug
insurance options, compare plans, and enroll in one that best meets your needs.
As I go through this demonstration, I'll point out some enhancements that have
been made based on user feedback as well as some features you may find helpful
as you work with Medicare Beneficiaries in your community. We'll wrap up by
taking a look at the Online Enrollment Center and highlighting a few important
dates to keep in mind for this fall.
We'll start by showing you where you can find the Medicare Plan Finder resources
located on our website at www.medicare.gov. Once you get to the Medicare.gov
home page, there are two ways you can get to the Medicare Plan Finder. You can
go to the Resource Locator tab, located at the top of the page, and click on the
Drug and Health Plans link or you can select the Health and Drug Plans tab from
the left side of the page, and click on Compare Drug and Health Plans. Either
way, you'll get to the Medicare Plan Finder.
While we're on this page, there's one more link that I want to point out to you,
and that is the Check Your Enrollment link. You can use this feature of the
Medicare Plan Finder to learn about any current coverage the beneficiary has,
any future plans that they're enrolled in, as well as any pending enrollments
that they have. Additionally, if you have a confirmation number for them that
you've received by enrolling them through the Medicare.gov website, you can
enter that confirmation number here to check the status of their pending
enrollment.
For today, we're going to take you through the Medicare Plan Finder, which you
can access through the Compare Drug and Health Plans link. The first screen
you'll come to is the Medicare Plan Finder home page. And from this page you
have two options -- you can either complete a general plan search or a
personalized plan search. We do recommend that whenever possible, you enter all
of the beneficiary's information and do a personalized search because it will
provide the most accurate cost information through the Medicare Plan Finder. To
do a personalized search, you would need the beneficiary's zip code, their
Medicare number, last name, their Medicare Part A or Part B effective date,
their date of birth, and also you will need to add whether or not they have the
Medicare supplement health insurance policy or Medigap policy.
For today, we're just going to do a general search, so all we need to enter is
the zip code, and then select Find Plans. Since we're completing a general
search for this demonstration, the Plan Finder needs to know a little bit more
information about the coverage that we have and also whether or not we have
extra help to pay for our prescription drugs. For this demonstration, I'm going
to select that we have Original Medicare and that we do not receive a subsidy to
help paying for prescription drugs. After selecting those options, you can click
on Continue to Plan Results.
The next page that we come to is the Enter Your Drugs page. From this page you
have two options -- you can either choose to Enter Drugs into the Medicare Plan
Finder and personalize your drug search or you can choose Not to Add Drugs at
This Time. We do recommend that whenever possible, you enter the individual
drugs that a beneficiary takes into the Medicare Plan Finder because it will
provide the most accurate cost estimates for a beneficiary.
To add a drug, all you need to do is type the name of that drug into the Name of
Drug box, and then either select the name that appears below where you are
typing or click on the Find My Drug link. Once you click on the Find My Drug
link, search results will appear at the bottom of the page, and you can select
the drug that you were searching for and click the Add Drug button. Okay. A box
will pop up, which will allow you to confirm or change the dosage, the
frequency, and the quantity of each drug that you're adding to the Medicare Plan
Finder. Once you've made your selection, you can click on the Add Drug and
Dosage button. You can add as many drugs as you like to the new Medicare Plan
Finder. There is no limit.
Another new feature of the Plan Finder is that it automatically saves the drug
list as you complete either a general search or a personalized search. After
you've entered the first drug, you'll notice that the Saved Drug List ID, the
password, date, and the zip code will appear on the right side of the page so
that you can record that information and use it if you need it at a later time.
Another important thing to note about the Medicare Plan Finder is that it does
not include Part D covered medical supplies, such as diabetic supplies. If you
need information about those supplies, you'll need to contact the plan for
pricing information.
Once our drug list is complete, we can click on the My Drug List is Complete
button to proceed with the plan search. The next page you'll see is the Select
Your Pharmacy page. And, once again, from this page we have two options -- you
can choose to select the pharmacy that a beneficiary uses or select the button
that says I Don't Want To Add Pharmacies Now. When possible, you may want to
select a pharmacy to make sure that the pharmacy a beneficiary uses works with
the plan that he or she selects. For this instance, we're going to select the
Rosebud IHS Hospital Pharmacy by clicking the Add Pharmacy button. From this
page, you also have the option to expand the radius of the pharmacy search if
you need to search a larger geographical area and you also have the option to
click on the Search New Location button and enter a new zip code or a new
address if you need to search outside of the zip code that you already entered.
Once you're happy with your pharmacy selection, click on Continue to Plan
Results.
The next page that you'll see is the Refine Your Plan Results page. And this
page of the Medicare Plan Finder gives you an overview of all of the plans
available in the area that you're searching for. The summary of your Search
Results Table provides a breakdown of all of the plans available in the area,
including Original Medicare, Medicare Health Plans Without Drug Coverage,
Medicare Health Plans With Drug Coverage, and Standalone Prescription Drug
Plans. On the left side of the page, there are many filters available that will
allow you to refine your plan search. For instance, you can use the first filter
to select certain plan types. You can also limit your monthly premium, the
annual drug deductible, or for instance, select only a certain special needs
plans for people who have both Medicare and Medicaid or people who have certain
chronic conditions, as well as plans that are designed specifically for people
in certain long-term care facilities. If you would like to use any of these
filters, click on the plus button to expand the filter, make your selections,
and then click on the Update Plan Results button.
For the purpose of this search, we're just going to include all plans. So I'm
going to click on the Continue to Plan Results button. Now we've reached the
Plan Results Page. And this is the page that will show us detailed information
about all of the plans available in the area that we're searching for. As you
scroll down the page, you'll notice a few things. The first thing is that the
Plan Finder lets you know that we are now viewing 2011 plan data. If you'd like
to look at 2010 plan data, you can click on the link that says View 2010 Plan
Data. As you scroll down the page, the first things that will be displayed are
the beneficiary's current plan followed by any future plans they're enrolled in
followed by information about any prescription drug plans available in that
area, any Medicare Health Plans With Drug Coverage available, and finally,
Medicare Health Plans Without Drug Coverage.
If you scroll up to the top of the page, you'll notice that there is a box at
the top of -- top right-hand corner of the screen called My Current Profile. You
can look to this box for information about any current coverage, future
coverage, current subsidy, future subsidy that a beneficiary may have, as well
as the Drug List ID, the password, date, and the zip code that you entered for
the plan search. For the purpose of this example, we're going to look at three
prescription drug plans available in this area. These prescription drug plans
are sorted in order of Lowest Estimated Annual Drug Cost, which is the left-most
column on the Plan Results page. That number includes monthly premiums for all
12 months, the annual deductible if there is one for the plan, as well as the
co-payments or co-insurance amounts for any prescriptions that you entered into
the Medicare Plan Finder. To compare these plans, you can select the checkboxes
on the left-hand side of the screen and click Compare Plans.
Now we've reached the Plan Comparison Page. This page will give us detailed
information about the three plans that we've selected. You'll notice that the
new Medicare Plan Finder includes four tabs at the top of the page. Since we're
looking at prescription drug plans, we automatically see the Drug Costs and
Coverage tab first. This tab includes information about the fixed costs for
prescription drug plans, including the monthly premium and the annual
deductible, estimated annual drug costs, estimated monthly drug costs, as well
as drug coverage information, including any restrictions and formulary status
for each drug that you entered into the Plan Finder. The Overview tab includes
information about health and drug coverage. For these plans that we're looking
at today, which are Standalone Prescription Drug Plans, this tab would include
information about the Standalone Prescription Drug Plans, as well as Original
Medicare, which would be the health benefit portion. The Health Plan Benefits
tab includes information about Original Medicare only, since, once again, we are
looking at Standalone Prescription Drug Plans.
And finally, the Plan Ratings tab includes detailed information about how a plan
rated and different quality measures, and you can use that tab to help a
beneficiary make a decision about which plan they might want to enroll in based
on its reported quality. If, at any time, you would like to view details for one
specific plan, all you need to do is click on the name of the plan, and you'll
be directed to the Plan Details page, where you can view the same four tabs and
information for one specific plan. Now, if you'd like to enroll a beneficiary in
a plan, there is an Enroll button that you can select for any plan from the Plan
Results page, the Plan Comparison page, or the Plans Detail page. Since right
now we're looking at 2011 data, this message displays where the Enrollment
button would appear. I'm going to switch over to 2010 Plan Information so that I
can show you how an enrollment would work on the Medicare Plan Finder.
So from this page, we can enroll in the plan through the Online Enrollment
Center by clicking on the Enroll button. Since we're looking at a plan for 2010,
the first page that we're going to come to is a page that lets us know that we
can only enroll in a plan at this time if we're eligible for a special
enrollment period. Please be aware that when you begin enrolling beneficiaries
and plans for 2011, this page will not appear. I'm going to select Continue to
Enrollment to move onto the next page. The next page asks us to select which
special enrollment period a beneficiary is eligible for. Once again, this page
would not appear if you were enrolling in a plan for 2011. For the purpose of
this demonstration, though, I'm going to select that our beneficiary is new to
Medicare and click Continue.
Now we've reached the step where we need to enter information about the
beneficiary we're enrolling. It asks for a beneficiary's personal information,
as well as their permanent residence, and any mailing address information if
it's different from their permanent residence, as well as an optional emergency
contact. For this demonstration, I'm going to enter information about a fake
beneficiary. I'm going to leave the Mailing Address and Emergency Contacts
sections blank and click Continue. The next page asks for more personal
information about a beneficiary, including their Medicare number, their Part A
and Part B effective dates, as well as how they would like to pay for the Part D
premium. Again, for this example, I'm going to enter a fake Medicare number and
Medicare effective dates. And finally, at the bottom of the page, I can select
whether I would like to have the monthly Part D Plan premium billed to me or the
beneficiary at their home directly or whether it should be just deducted from a
beneficiary's Social Security benefit. Once you've selected the correct option,
click on Continue.
The next screen asks for additional information about whether a beneficiary has
another source of prescription drug coverage and whether or not they're a
resident of a long-term care facility, such as a nursing home. If a beneficiary
does have additional prescription drug coverage or is a resident of such a
facility, you can fill out that information on this page. For this example, I'm
going to select No, for both of those options, and click Continue. This page
asks you to review the information that you've entered into the Online
Enrollment Center forms. Scroll down the page, review that information. If it's
correct, click on Agree, Submit Enrollment, and if you need to change anything,
click on the Back to Beginning button.
The next page asks you to review important information before completing the
enrollment in a Medicare prescription drug or health plan. Once you've reviewed
the information with the beneficiary, you can click I Understand and continue.
Now you'll reach a page that requires you to read some additional information
before completing the application. Let's you know that the Prescription Drug
Plan has a contract with the federal government and goes through some
information to make sure you understand and the beneficiary understands what you
are enrolling in. There's a Release of Information toward the bottom of the
page. And then finally, you're asked to select the statement that best describes
your relationship to the person with Medicare who is listed on this enrollment
form. The options are I am the person listed on this enrollment form, or I am
simply helping to complete this enrollment form. That's the option that most of
you would select.
The next option is I am the person authorized to act on behalf of the individual
listed on this enrollment form under the laws of the state where the individual
resides. So you would select the option that best describes you, and then click
on the Agree Submit Enrollment button. Since this is a demonstration, I'm not
going to actually submit the enrollment. But if I did, the next page I would
come to is the Confirmation page that would include information about the
prescription drug plan I enrolled the beneficiary in, as well as a confirmation
number for enrolling through the Online Enrollment Center. And please remember,
it's important to have that number because you can use it on Medicare.gov to
check the status of a beneficiary's pending enrollment. So we do encourage you
once you reach that page to print it off and give a copy to the beneficiary, as
well as keep a copy for your records if you need that information on file.
That concludes my demonstration of the Online Enrollment Center. The last thing
I wanted to share with you were a few important dates to keep in mind for 2011.
Again, the 2011 Plan Data was released on the Medicare Plan Finder on October 7,
so it is available for you to view and compare at this time. Enrollment for
those 2011 plans will begin on November 15. The Enroll buttons will be enabled,
and you'll be able to enroll beneficiaries in their selected plans. Enrollment
for 2010 plans will continue until November 30. And at that time, enrollment for
2010 plans will be disabled, although you will still be able to view 2010 plan
information on the website. 2011 enrollment will end on December 31, and
coverage for all 2011 plans will begin on January 1.
This concludes my presentation. I hope you found this demonstration helpful.
Thank you, very much, for your time.
[Kitty Marx]
We've covered a lot of information today. I'd like to thank Stacy Platte, Pam
Schweitzer, Kay Pokrzywa, Rosalyn Thomas, and Rosie Norris for sharing their
insights on the Medicare program and its impact on Indian country. For more
information about Medicare Part D, go to www.medicare.gov. We're at the end of
our Medicine Dish show, and I want to thank you for your participation in our
broadcast. Our next broadcast will be on the third Wednesday of December, that's
December 15, at 1:30 p.m. Eastern Time. You can access previous Medicine Dish
shows at a new location on the NIH website, videocast.NIH.gov. That's right,
we've moved. Go to Past Events, select Training and Meetings, and then select
CMS Centers for Medicare and Medicaid Services.
Thank you, and I hope you enjoyed and benefitted from today's Medicine Dish
show. I'm Kitty Marx, host of Medicine Dish, wishing you a very productive day.