If you are eligible and intend to apply for the new Medicare Part D prescription drug benefit, May 15, 2006 is the deadline. After the deadline, enrollment will remain closed until November 15-December 31, 2006, with new programs taking effect on January 1, 2007.
The rule applies to all eligible beneficiaries who have not decided to enroll in a program by May 15, 2006. Should they decide to enroll in a program after the deadline, they will have to wait until November 15 to enroll, and they will not have coverage until next year. When they do join, their premium cost goes up at least 1% per month for every month that they have waited to join.
This rule also applies to covered Medicare beneficiaries who want to enroll in a new program. If, for example an individual enrolls in a Medicare-approved plan and something occurs that causes them to have to take higher-priced medications not covered under their existing plan, then they would have to pay the costs until November 15, when they reenroll in a plan that may cover the new prescriptions after the beginning of next year.
More detailed information is available at www.medicare.gov.
Many patients feel this rule is unfair, especially in the first year of a new program when so much public confusion exists. However, this is part of a trend designed to limit the overall costs of the program; a program that has promised the American people more than federal leadership can deliver.
Since this is the first year of the Medicare Part D benefit, it is not expected that Congress will take up any significant reforms in the program this year.
Patients, family members, friends and medical professionals who have negative experiences with the delivery of their Medicare services are encouraged to document their experiences on the website www.accesswatch.org. This site is being maintained by the Global Access Project (GAP), a public policy coalition that the IMF participates in and supports. GAP is led and largely funded by the National Patient Advocate Foundation and is now supervising six ongoing academic studies to assess the impact of Medicare reform on the provision of quality oncology care. Your input is needed to make this national surveillance and advocacy more effective.
GAP reports will be released to the public and policy makers periodically as trends and conclusions develop. Please contact the IMF if you have experiences with this program that you feel are important to share with others.