“Determining Eligibility And Enrollment for Low-Income Beneficiaries”

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Presentation transcript:

“Determining Eligibility And Enrollment for Low-Income Beneficiaries” Medicare Part D Prescription Drug Plan Challenges for States “Determining Eligibility And Enrollment for Low-Income Beneficiaries” Karl B. Kurtz, Director Idaho Department of Health and Welfare November 1, 2005 10/5/200511/24/2018

Medicare Part D Prescription Drug Plan The Department Vision Provide leadership for development and implementation of a sustainable, integrated health and human services system.

Medicare Part D Prescription Drug Plan The Department Mission To promote and protect the health and safety of Idahoans.

Medicare Part D Prescription Drug Plan The Department Values Integrity, customer service and quality are the foundation for all Department activities. A focus on these values will make us successful.

Medicare Part D Prescription Drug Plan IMPACT ON IDAHO 194,000 Medicare Enrollees (14% of population) 23,000 “Dual Eligibles” who will receive direct assistance from the state 23,000 Low Income Subsidy (LIS) candidates who may ask for assistance from the state What about the remaining 148,000 general Medicare population?

Medicare Part D Prescription Drug Plan CHALLENGES TO SERVING THE MEDICARE POPULATION Communication Issues: How to reach the target population? Complex program Many messages Best way to help not easy to pin down

Medicare Part D Prescription Drug Plan WHAT IDAHO HAS DONE Established coalition of agencies and advocacy groups to coordinate outreach including: Senior Health Insurance Benefits Administration (SHIBA) Commission on Aging Representative of Congressional Offices Representative of State Legislature Various health care provider organizations like pharmacy association

Medicare Part D Prescription Drug Plan WHAT IDAHO HAS DONE Added full time staff and temps to handle additional workload Contracted with Medicaid fiscal agent as a call center on Medicare pharmacy questions Developed communication plan Developed outreach materials in addition to those available from Medicare. Materials to key players like pharmacies Media outreach underway 2-1-1 State Referral Hotline

CHALLENGES Reaching affected population Training staff Assisting people with PDP enrollment Budgeting for impact The Great Unknown