Medicare Part D Cmss Process And Policy For Enrolling New Dual Eligible Beneficiaries PDF Download

To help defray out-of-pocket prescription drug costs for limited or low-income Medicare beneficiaries, the Medicare Part D outpatient prescription drug program offers a low-income subsidy (LIS) for eligible beneficiaries. In 2010, about 9.4 million beneficiaries received the LIS -- about 40%of the approx. 23 million Medicare Part D beneficiaries in that year. Most of the LIS beneficiaries received the full LIS, thus paying no premiums or deductibles as long as they enrolled in so-called "benchmark" stand-alone prescription drug plans (PDP). Benchmark PDPs are those plans with premiums at or below a specified benchmark for a given geographic region, calculated by the Centers for Medicare & Medicaid Services (CMS), the agency within the Dept. of Health and Human Services (HHS) that administers the Medicare program. Full LIS beneficiaries may also enroll in other Part D plans but must pay any difference between the premium of the plan in which they choose to enroll and the benchmark for their region. This report examines the features of benchmark PDPs and explores how the random reassignment process may affect beneficiaries' drug utilization. Tables. This is a print on demand report.