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Letter from the Editor #551: Medicare Coverage Extensions and Part D Plans

Dec 12, 2010

As we come to the end of the year, there is some good news out there for our patients. Last week Congress finally got their act together and realized that patient care for seniors would suffer if the proposed cut in physician reimbursement came about. After extending the current reimbursement rate four times in 2010 and with primary care physicians threatening to quit serving Medicare and Medicaid patients, both the House and the Senate voted to extend the current pay rate for the next 12 months.

This could not happen at a better time, as millions of Medicare recipients are in the process of choosing a new Part D Plan for 2011. Since not every physician participates in every Medicare plan, patients have to figure out which plan to go with and whether their doctors will be participating in that one. Hopefully this extension of reimbursement rates will allow patients to stay with the physicians they want.

Speaking of Part D Plans, a lot of things are changing in the New Year; new copays, deductibles, and limits as well as a somewhat convoluted and confusing “donut hole” that gives extra credit towards the cap without charging full price. While I was researching this information I came across an excellent illustrated handout developed by Universal American for the National Community Pharmacists Association. This handout does a great job of explaining all the above and also who qualifies for Low Income Subsidies. (See this week’s Tool for Your Practice below.)


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Dave Joffe, Editor-in-chief