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Consumer Protection Issues Raised by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003

This paper identifies and examines consumer protection issues that arise from the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Key issue areas include: beneficiary information, marketing, enrollment and disenrollment, the drug benefit package and cost-sharing, the appeals process, concerns for low-income beneficiaries, challenges for nursing home issues, and…

Medicare: A Primer

This primer explains key elements of the Medicare program, which now provides health coverage to 47 million people — including 39 million people age 65 and older and another 8 million younger adults with permanent disabilities. It looks at the characteristics of the Medicare population, what benefits are covered, how…

Implications of the New Medicare Prescription Drug Benefit for State Medicaid Budgets

For a number of years, Governors and other state policymakers have maintained that Medicare – rather than state Medicaid programs – should play the key role in providing prescription drug coverage to Medicare beneficiaries, including those who also qualify for Medicaid because they are impoverished and/or have extensive health care…

The Emerging Role of Group Medicare Private Fee-for-Service Plans

This issue brief examines the recent boom in Medicare Advantage enrollment attributable to employers contracting with Private Fee-for-Service (PFFS) plans to cover their Medicare-eligible retirees. Between 2006 and 2008, the number of Medicare beneficiaries enrolled in Medicare Advantage group plans nearly doubled from 900,000 to nearly 1.7 million as of…

Medicare Part D 2009 Data Spotlight: The Coverage Gap

Medicare Part D 2009 Data Spotlight: The Coverage GapThis data spotlight examines the coverage gap, or “doughnut hole,” in Medicare drug plans available in 2009. While in the gap in coverage, Part D enrollees (other than those receiving low-income subsidies) are required to pay 100 percent of total drug costs…

Tracking Poll Finds Seniors Split on Medicare Drug Benefit

Tracking Poll Finds Seniors Now Split on Medicare Drug BenefitThis August tracking survey shows modest progress in seniors’ knowledge about the Medicare drug benefit. Also, for the first time, the tracking poll shows seniors are as likely to say that they have a favorable impression of the drug benefit as…

Choosing a Medicare Part D Plan: Are Medicare Beneficiaries Choosing Low-Cost Plans?

Since 2006, Medicare beneficiaries have had the opportunity to choose from among dozens of plans to get the Part D prescription drug benefit, facing wide variation in benefits, premiums and cost-sharing. The array of choices, with more than 50 stand-alone drug plans in many states, could allow beneficiaries to select…

The Exceptions and Appeals Process: Issues and Concerns in Obtaining Coverage Under the Medicare Part D Prescription Drug Benefit

This issue brief describes how Medicare beneficiaries navigate the Medicare Part D exceptions, appeals, and grievances processes to get access to medically necessary prescriptions not covered under their Medicare prescription drug plans. It identifies and describes policy issues that may make it difficult for beneficiaries to utilize the processes.Issue Brief…