California: Medicare Part D Deadline Nears for People With AIDS
December 9, 2005
In order to ensure proper drug coverage, AIDS advocates are urging California HIV/AIDS patients to enroll before Jan. 1, 2006, for both the new Medicare prescription drug benefit (Part D) and the state AIDS Drug Assistance Program (ADAP). While most seniors have been told they can wait until May 15, 2006, to choose insurers under Part D, advocates say Medicare or Medi-Cal participants with HIV/AIDS should sign up before year's end.
"Everybody needs to pick a plan by Jan. 1," said Dana Van Gorder, director of local and state affairs for San Francisco AIDS Foundation (SFAF). "The reason why everyone with HIV needs to sign up for ADAP by Jan. 1 is ADAP is going to help people pay their deductibles and co-payments. It is something we were able to get the governor to agree to before last year's budget," Van Gorder said. "In order for those to occur you need to pick a plan and get prescription drugs from ADAP. If you don't pick a plan, ADAP can't help."
Nearly 50 Part D plans are being offered, and patients should make certain an insurer covers all the medications they currently take as well as medications they took in the past, said Van Gorder. Patients should check that their pharmacy is in the plan and in the ADAP network, he said. "This should not be much of an issue in San Francisco but it could be in rural areas."
Dual-eligible patients receiving primary medical care from Medicare and prescription drugs through Medi-Cal need to sign up for a zero-cost plan.
"If the plan is very difficult with its in-house appeals process, that is bad for HIV people," who would then petition to have a drug covered, said Van Gorder.
SFAF and Project Inform will hold a community briefing on Part D to help HIV-positive Medicare clients understand the program and how to prepare for it. The Dec. 12, 6-8 p.m. meeting will be held at San Francisco's Everett Middle School Auditorium, 450 Church St. (between 16th and 17th streets). A plan finder is available at www.medicare.gov. Also visit www.sfaf.org/policy/medicare or www.projectinform.org/org/medicare/partd.html.
Bay Area Reporter (San Francisco)
12.08.2005; Matthew S. Bajko
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.